INTERPRETATION: There are five lumbar-type vertebral bodies, with normal lumbar lordosis and mild generalized curvature to the right. There is normal vertebral body height and alignment. Patient is status post L3-L5 decompressive laminectomies, with anticipated signal changes and enhancement in the operative bed. No abnormal nerve enhancement. No edema or enhancement that would suggest active osteomyelitis. No bone marrow infiltration or destructive bony lesion. Tip of the conus medullaris is normally positioned at the T12-L1 level. No evidence of arachnoid adhesions.
The visualized sacroiliac joints are normal. Images through the sacrum and iliac bones are unremarkable. Aside from postoperative changes, pre- and paravertebral soft tissues are normal. The visualized abdominal aorta, IVC and kidneys are unremarkable.
L5-S1: Mild disc degeneration with preserved disc height and disc bulge touching the ventral thecal sac. No spinal canal stenosis or transiting nerve root impingement. Disc and degenerative facets mildly narrow the neural foramina with abutment of the L5 ganglia. Mild bilateral facet arthropathy with small facet joint effusions and mild perifacet edema.
L4-5: There is ankylosis of the intervertebral disc and facet joints at this level. No spinal canal or foraminal stenosis.
L3-4: Moderate disc degeneration with loss of disc height and hydration signal, type I and type II reactive endplate changes and broad-based 5 mm AP disc protrusion flattening the ventral thecal sac. Disc and degenerative facets cause moderate left and mild right subarticular recess narrowing with impingement of the transiting left L4 root (series 5 image 15). No spinal canal stenosis. Severe bilateral foraminal narrowing with disc and degenerative facets impinging the L3 ganglia (series 2 images 5 and 10). Moderate left facet arthropathy with moderate facet joints effusion and perifacet edema. There is a 3 mm synovial cyst projecting medially from the right facet joint contributing to right subarticular recess narrowing. Mild facet arthropathy on the left.
L2-3: Mild disc degeneration with disc desiccation and annular disc bulge flattening the ventral thecal sac. No spinal canal stenosis. Disc and degenerative facets mildly narrow the neural foramina. Mild bilateral facet arthropathy.
L1-2: Mild disc degeneration with disc desiccation and mild disc bulging. No spinal canal or foraminal stenosis. Facet joints are normal.
T12-L1: Moderate disc degeneration with loss of disc height and hydration signal, mild disc bulge and superimposed 3 mm AP left central disc protrusion flattening the ventral thecal sac. No spinal canal or foraminal stenosis. Facet joints are normal.
CONCLUSION: Degenerative and postoperative changes in the lumbar spine with specific impressions as follows:
1. Status post L3-L5 laminectomies. There is ankylosis of the intervertebral disc and facet joints at L4-5, with disc ankylosis likely sequela of prior osteomyelitis. No evidence of active infectious process.
2. At L3-4, broad-based disc protrusion combining with disc to moderately narrow the left subarticular recess with impingement of the transiting left L4 root. There is severe foraminal narrowing at this level with impingement of the L3 ganglia.
3. Disc bulging from T12-L1 through L2-3 and at L5-S1, with superimposed small disc protrusion at T12-L1. No transiting nerve root impingement at these levels.
4. There is no spinal canal stenosis.
5. Facet arthropathy moderate left at L3-4 with facet joint effusion and perifacet edema. There is mild facet arthropathy with effusions and perifacet edema at L5-S1.
6. There is no evidence of fracture, infection, tumor or arachnoiditis.
As compared to MRI from 2009, postoperative changes are new. Caliber of the spinal canal is increased at the levels of laminectomy. New disc protrusion at L3-4 and new disc bulging at L1-2 and L2-3.
New disc and facet joint ankylosis at L4-5. More prominent facet arthropathy at L3-4 with new right effusion. Progression of facet arthropathy at L5-S1.****************************************************************************************************** Welcome to Spine-Health
One of the most important things that members can do is to provide the rest of the community with as much information about themselves as possible. It is so very difficult for anyone to respond when we do not have enough information to go on. This is not meant to indicate that you are doing anything wrong or violated any rule, we are just trying to be pro-active and get the information upfront so that people can start responding and your thread is more effective.
So many times we read about members who have different tests and they all come back negative. The more clues and information you provide, the better chances in finding out what is wrong, The fact that your test results are negative does not mean that you are fine and without any concerns. Many times it takes several diagnostic tests and procedures to isolate a specific condition.
Here are some questions that you should answer:
- When did this first start?
. Year, Your age, etc
- Was it the result of an accident or trauma?
- Are there others in your family with similar medication conditions?
- What doctors have you seen? (Orthopedic, Neurosurgeon, Spine Specialist, etc)
. Which doctor did you start with? Ie Primary Care Physician
. Who are you currently seeing?
- What Conservative treatments have you had? Which ones?
. Physical Therapy
. Ultrasound / Tens unit
. Spinal Injections
. Massage Therapy
- What diagnostic tests have you had? And their results (MRI, CTScan, XRay, EMG, etc)
. Summarize the results, please do not post all details, we cannot analyze them
. How many different tests have you had over the years? Similar results?
- What medications are you currently using? (details, dosage, frequency, etc)
. Name of Medication
. How long have you been using this?
- Has surgery been discussed as an option? (If so, what kind)
- Is there any nerve pain/damage associated?
- What is your doctor’s action plan for treating you?
Providing answers to questions like this will give the member community here a better understanding
of your situation and make it easier to respond.
Please take a look at our forum rules: Forum Rules
I also strongly suggest that you take a look at our FAQ (Frequently Asked Questions) which can be found at the top of the forum menu tab or by going to FAQ
There you will find much information that will
- Help you better utilize the Spine-Health system
- Provide pointers on how to make your threads / posts
- Tips on how to create your avatar (your picture), posting images, etc
- General pieces of valuable information
Please remember that no one at Spine-Health is a formally trained medical professional.
Everything that is posted here is based on personal experiences and perhaps additional research.
As such, no member is permitted to provide
- Analysis or interpretation of any diagnostic test (ie MRI, CTscan, Xray, etc)
- Medical advice of any kind
- Recommendations in terms of Medications, Treatments, Exercises, etc
What could be good for someone could spell disaster for another.
You should also consult your doctor to better understand your condition and the do’s and don’t’s.
It is very important that new members (or even seasoned members) provide others with details about their condition(s). It is virtually impossible to help another member when all the details we have areI’ve had this for years, it hurts, I cant move my shoulder – what could this be, what treatment should I get?
Diagnosing spinal problems can be very difficult. In many ways it’s like a game of clue. Especially, when the diagnostic tests come back negative – no trouble found! Then it’s up to the patient and the doctor to start digging deeper. The doctor is like a detective. They need clues to help them move along. So, you as the patient need to provide the doctor with all sorts of clues. That is like it is here. Without having information about a condition, its impossible for anyone here to try to help.Specific comments :Personal Opinion, not medical advice : ____________________________________________________________________
No on one the Spine-Health patient forums is medically qualified to provide any advice or
or recommendations on any diagnostic test. However, the following key words can apply
MILD Treated with conservative measures such as Physical Therapy and mild medications. Many times these situations can be cleared up and the condition can be resolved.
MODERATE Some more treatments may be needed, ie Spinal Injections, Ultra sound and stronger medications. Always a possibility of more aggressive treatment if the conservative measures don't help
SEVERE Need for stronger medications. The requirement for surgery may be necessary
You need to get the answer to your question from your doctor(s)
--- Ron DiLauro, Spine-Health System Moderator : 12/09/15 16:47 est