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MRI and X-Ray Results

Hello, I am a 60 year old male weighing about 238 (I've lost 66 pounds so far) and I have had 2 back operations for Spinal Stenosis.  At the end of July my Neurosurgeon told me that my MRI showed that almost all my discs were bulged or herniated.  He only said that he could operate and gave me a 50% change he could "fix" anything.  I decided those weren't good enough odds.  Well in March I apparently herniated a disc and the pain is shooting down to my knee on the right leg with a burning sensation.  I decided to go to another neurosurgeon that someone I work with goes to.  She sent me for an MRI and X-Rays and then had her staff member leave me a message with the MRI results verbatim.  Not being a doctor I have no idea what this all means.  I was hoping someone could help me out.  Here are the MRI and X-Ray results.


EXAM:  MRI LUMBAR SPINE WITHOUT CONTRAST

HISTORY:  Intervertebral disc disorder is. Status post L2-L4 decompressive laminectomy in 2000.

TECHNIQUE:  Multiple pulse sequences were obtained without contrast administration. This study was performed on a high-field 1.5T MRI scanner.

COMPARISON:  MRI lumbar spine dated 7/13/2017.

FINDINGS: 

Status post bilateral laminectomies at L1-L2, L2-L3, and L3-L4 with postsurgical changes visualized. No acute fracture is visualized. There is slight anterolisthesis of L2 on L3 and L5 on S1. There is slight retrolisthesis of L3 on L4 and L4 and L5. Straightening of the normal lumbar lordosis. Reactive endplate changes are most prominent at L2-L3 and L3-L4.

Desiccation of the intervertebral discs with loss of disc space height throughout the lumbar spine. Schmorl's node at L3-L4 indents the superior endplate of L4. Schmorl's node at L2-L3 is also visualized.

The conus medullaris appears to terminate at the L1 level. Fatty atrophy of the paraspinal muscles. Epidural lipomatosis in the lower lumbar spine and sacrum. Tarlov cyst in the sacrum.

Individual levels:

L1-2:  Status post bilateral laminectomies. There is again a disc bulge with right subarticular disc extrusion and inferior migration of disc resulting in narrowing of the right lateral recess. Facet arthropathy with moderate bilateral neuroforaminal narrowing.

L2-3:  Status post bilateral laminectomies. Diffuse disc bulge with superimposed left subarticular disc extrusion results in narrowing of the bilateral lateral recesses. Facet arthropathy with moderate to severe bilateral neuroforaminal narrowing.

L3-4:  Status post bilateral laminectomies. Disc bulge and facet arthropathy contribute to moderate to severe bilateral neuroforaminal narrowing.

L4-5:  Disc bulge with superimposed right subarticular/foraminal disc protrusion contributes to moderate spinal canal narrowing. There is narrowing of the right lateral recess. Facet arthropathy with moderate to severe right and moderate left neuroforaminal narrowing.

L5-S1:  Epidural lipomatosis and disc bulge contribute to moderate spinal canal narrowing. Facet arthropathy with moderate bilateral neuroforaminal narrowing.

IMPRESSION: 

Status post bilateral laminectomies at L1-L2, L2-L3, and L3-L4 with postsurgical changes visualized.

Multilevel degenerative changes of the lumbar spine. At L1-L2 there is a right subarticular disc extrusion with inferior migration of the disc resulting in narrowing of the right lateral recess.

Moderate to severe bilateral neuroforaminal narrowing at L2-L3, L3-L4 and on the right at L4-L5.




EXAM:  X-RAY LUMBAR SPINE MINIMUM 4 VIEWS

HISTORY:  Intervertebral disc disorder.

TECHNIQUE:  4 views were obtained.

COMPARISON:  None.

FINDINGS:  No acute fracture is visualized. Slight anterolisthesis of L2 on L3 and L5 on S1 and slight retrolisthesis of L3 on L4 and L4 on L5. These findings do not significantly change on the flexion and extension views. Multilevel degenerative changes with marginal osteophytes and intervertebral disc space narrowing. Facet arthropathy.   

IMPRESSION: 

Advanced degenerative changes of the lumbar spine.   


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Comments

  • LizLiz Posts: 9,636
    edited 04/11/2018 - 2:34 PM

    Hello pops0128 

    Welcome to Spine Health


    No one on the Spine-Health patient forums is medically qualified or permitted to provide any advice or recommendations on any diagnostic test. However, the following key words can always be applied.
     
    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  

    All new members should take the System Tutorial 



    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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