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Help with MRI and CT reports

AnonymousUserAAnonymousUser Posts: 49,512
edited 06/11/2012 - 7:27 AM in Back Surgery and Neck Surgery
I am 4 months post-op from my 2nd Micro-d w/Laminectony( the 1st one was 5/08)at L5-S1 and I still have LBP, left-sided buttock pain and hip pain. My neuro sent me for follow up x-rays, a CT w/o contrast, and an MRI with and without Contrast. I am scheduled to see the doc on 2/2, but was hoping that someone could provide some clarification between some of the difference in the MRI and CT reports.

Here is how the MRI reads:
FINDINGS: L2-L3: No posterior disc abnormality, neural foraminal narrowing or central canal stenosis present. Mild right facet hypertrophy is present.

L3-L4: Decreased intervertebral signal here and at L4-L5. There is a minimal broad based disk bulge with small superimposed central protrusion. There is no central canal or neural foraminal narrowing.

L4-L5: There is a moderate broad based disc bulge with supperimposed central protrusion and mild facet and ligamentum flavum hypertrophy. There is mild bilateral neural foraminal and central canal narrowing.

L5-S1: The disc height is decreased, probably from a combination of degenrative disease and partial discectomy. There is a small paracentral/forminal left disc protrusion producing moderate left neural foraminal narrowing. The right neural foramin is narrowed due to facet arthropathy. There is increased disc signal on T2 weighted images, similar to comparison study. There is stable enhancing granulation tissue surrounding the left S1 nerve root in the lateral recess and extensive enhancing granulation tissue in the post laminectomy space. Severe facet and ligamentum flavum hypertrophy.

Impression: No appreciable change from prior study. Enhancing scar tissue encasing the transversing left S1 nerve root in left lateral recess, with residual left paacentral/formaninal disc protrusion resulting in moderate left neural foraminal narrowing.

Be advised that I did not have any scar tissue on the previous study.

The CT findings are as follows:
Mild levoscoliosis of the lumbar spine is noted, but alignment of the lumbar spine otherwise normal. The vetebral bodies are normal in height.
Post surgical changes noted from laminectomy on the left at L5 and S1.

At L2-3, a mild diffuse disc bulge and facet/ligamentous hypertrophy result in triangulation of the thecalsac without signicant central cnal stenosis and mild inferior foraminal narrowing bilaterally.

At L3-4, diffuse disc bulge with superimposed cntral disc-osteophyte complex and facet/ligamentous hypertrophy result in triangulation of the thecal sac with probable moderate central canal stenosis and mild inferior foraminal narrowing bilaterally.

At L4-5, diffuse disc bulge with possible superimposed left paracentral disc protrusion and severe facet/ligamentous hypertrophy result in moderate-severe central canal stenosis, and moderate inferior foraminal narrowing bilaterally.

At L5-S1, diffuse disc bulge with facet/ligamentous hypertrophy result in severe bilateral neural foraminal narrowing, worse on the left. Laminectomy noted, without central canal stenosis.

Impression: Status post laminectomy at L5 and S1. Mild levoscoliosis of the lumbar spine. Multilevel degenerative changes as described, resulting in moderate to severe central canal stenosis at L3-4 and L4-5, moderate foraminal narrowing at L4-5, and severe foraminal narrowing bilaterally at L5-S1.

I just want to know why such the discrepancy between the two reports.
Sorry about the length of the post.


  • bigstone,
    I've also had both tests done recently - for the L5-S1 disc. MRI's (from my experience) can pick up more soft tissue pictures, hence the reading about the scar tissue surrounding the nerve roots on the MRI. Cat Scans view mostly bone and harder structures in the body. Cat Scans would be useful more in detecting a disc rupture or vertebrae problem. I'm not sure if a Cat Scan would show scar tissue at all. Mine did not mention it, whereas the MRI did (like yours). Both of my tests also read differently.

    What I've done is go onto the net and look up MRI verses CT. Read a little about what kinds of things each test is used for. I know that MRI's can show lots and lots and lots of things that are normal for someone (your/my/whoever's) age. MRI's are so detailed that they can give you a positive reading for areas you're not even having problems with (pain-wise).

    Anyway, I'm no expert - these are just things I've read online and noticed on my tests.

    Good luck. I know how anxious you must be reading all this. Getting on line and looking up what certain words mean medically can really help. I found a site that said MRI's show so much, that they can scare patients to death, when there's really nothing to worry about.

    The scar tissue, however, I would think would be causing your pain, as I believe mine is. Especially since it's right on the nerves your pain seems to be coming from.

  • csp has a great point.
    I remember my first MRI report. Wow, I was bouncing off the walls.
    Keep in mind that you can give an imaging study to 10 radiologists and you can get 10 different interpretations.
    The imaging studies are also not 100% foolproof, as they may not show what is actually going on inside.

    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
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