MRI Results received - please help translate jargon!

[mrjackderges]

Hi there

 

I have just received my MRI scan results for my lower back & I have no idea what it means!

 

I injured my back deadlifting in the gym over a year ago, so the lower back problem has been present for some time.

 

Findings of MRI are as follows:

 

"The conus is sited at the T12-L1 disk level.

The visualised cord and cauda return normal signal.

Normal visualised vertebral marrow signal.

The canal is capacious throughout the lumbar and sacral levels.

 

Bulky moderate multilevel facet OA present and this is particularly pronounced at the L4-L5 and L5-S1 levels.

 

The upper 2 lumbar disks are slightly dehydrated but there is no compromise seen to nerve roots at these levels.

The L3-L4 disk is dehydrated with a broad-based disk bulge and focal central protrusion which is small but effaces thecal sac.

No definite compromise seen at this level however.

 

The L4-L5 disc is dehydrated witha broad-based disk bulge. This accompanies bulky facet OA particularly on the left side narrowing lateral recess and there is some mild effacement of the left L5 nerve root in this region.

However, there is a moderate left foraminal stenosis in which the foraminal L4 root on the left side does appear to be impinged to some degree. This is predominantly due to bulky facet osteophytosis.

 

The L5-S1 disk is reasonably well-preserved. There is sacralisation of the L5 vertebral body. Focal high signal in the pars on each side may reflect some low-grade stress.

 

Conclusion: evolving degenerative changes within the facets and lower lumbar disks as detailed above. Moderate to"

 

(The report literally finishes like that... not sure what the "moderate to" was about to refer to.)

 

Any doctors on the forum?? Can you advise??

 

Kind regards,

 

Jack

[leonmassey]

Layman = gradual worsening of your lower back. Ie not going to get better. Sorry

[liverbird37]

Hope the site don't mind me recommending another to you where you can be given very detailed advice, and a thorough breakdown of everything on the MRI report. You have some pretty major Osteoarthritis going on there. Major to severe is the highest grading according to severity. You also have nerve impingement due to the extra bony growths which would most likely need surgery if symptoms persist so as to prevent permanent damage.

 

I use this site as also have lower back issues, and they will happily interpret your results for you, and give you an idea of what possible treatments may be available to you.

 

 

** EDIT ** and visit the forum section and all the health conditions are listed alphabetically.

All the very best.

Edited August 8, 2012 by citizenB
removed website

[mrjackderges]

Looks like CAG have removed your link!

 

I'll keep looking. Thanks for trying to help - seems odd that the site has edited your post, despite you helping with a medical issue!!

 

Got Docs appointment tomorrow (GP), will have to follow the route through to see a specialist I'm sure.

[honeybee13]

Hello there.

 

You may find information on the BBC health website, which I find useful. They also have links to non-commercial organisations who provide help for specific conditions.

 

Hopefully though, your GP will be able to explain.

 

My best, HB

[Night Owl]

Hi there

 

I have just received my MRI scan results for my lower back & I have no idea what it means!

 

I injured my back deadlifting in the gym over a year ago, so the lower back problem has been present for some time.

 

Findings of MRI are as follows:

 

"The conus is sited at the T12-L1 disk level.

The visualised cord and cauda return normal signal.

Normal visualised vertebral marrow signal.

The canal is capacious throughout the lumbar and sacral levels.

 

Bulky moderate multilevel facet OA present and this is particularly pronounced at the L4-L5 and L5-S1 levels.

 

The upper 2 lumbar disks are slightly dehydrated but there is no compromise seen to nerve roots at these levels.

The L3-L4 disk is dehydrated with a broad-based disk bulge and focal central protrusion which is small but effaces thecal sac.

No definite compromise seen at this level however.

 

The L4-L5 disc is dehydrated witha broad-based disk bulge. This accompanies bulky facet OA particularly on the left side narrowing lateral recess and there is some mild effacement of the left L5 nerve root in this region.

However, there is a moderate left foraminal stenosis in which the foraminal L4 root on the left side does appear to be impinged to some degree. This is predominantly due to bulky facet osteophytosis.

 

The L5-S1 disk is reasonably well-preserved. There is sacralisation of the L5 vertebral body. Focal high signal in the pars on each side may reflect some low-grade stress.

 

Conclusion: evolving degenerative changes within the facets and lower lumbar disks as detailed above. Moderate to"

 

(The report literally finishes like that... not sure what the "moderate to" was about to refer to.)

 

Any doctors on the forum?? Can you advise??

 

Kind regards,

 

Jack

 

Jack, I can't believe that you have been sent this as your MRI result! That is appalling! How in heavens name are you supposed to understand this!

Make an appointment with your Consultant for a proper, and understandable result and further advice.

[feefofum]

Yes defo get your consultant to explain this to you as an MRI is just a number of many tests which are firstly used to diagnose what might be causing the pain in order for the correct treatment to be identified (which even in the case of severe degeneration may not be surgery.

 

In some instances conservative therapy can achieve the same outcomes as surgery, reduction in pain and disability).

 

The problem with MRI alone is that degeneration in the discs and facets is as normal as grey hair and wrinkles, but for some it causes pain and for others it doesn't cause any pain (ie dark discs and facet OA are seen on MRI scans of people without back pain).

 

"The conus is sited at the T12-L1 disk level. - NORMAL, THIS IS THE END OF YOUR SPINAL CORD, BELOW WHICH IT BECOMES MORE LIKE A HORSES TAIL AS THE NERVES SEPERATE OUT (and this part is called cauda equina - horse!)

 

The visualised cord and cauda return normal signal. - NORMAL Normal visualised vertebral marrow signal. - NORMAL The canal is capacious throughout the lumbar and sacral levels.- YOU HAVE A GOOD SPACE AROUND YOUR SPINAL CORD IN YOUR LOWER BACK

 

Bulky moderate multilevel facet OA present and this is particularly pronounced at the L4-L5 and L5-S1 levels. DEGENERATION OF JOINTS BETWEEN THE VERTEBRAE THAT ARE CALLED FACETS. THE FACETS SLIDE OVER EACH OTHER WHEN YOU MOVE YOUR BACK. DEGENERATION OF THE FACETS CAN SOMETIMES CAUSE BONY OUTGROWTHS WHICH CAN IMPINGE ON NERVES AND CAUSE PAIN, BUT NOT ALWAYS. DEGENERATION OF FACETS IS NORMAL - DEPENDING ON YOUR AGE, USED TO THINK IT WAS DUE TO WEAR AND TEAR, BUT GENETICS PLAY A BIG PART TOO.

 

The upper 2 lumbar disks are slightly dehydrated but there is no compromise seen to nerve roots at these levels. DEPENDING ON YOUR AGE COULD BE NORMAL, DEHYDRATED DISCS ALONE DO NOT CAUSE PAIN (RECENT RESEARCH WHICH I CAN QUOTE IF YOU WANT ME TO) THE PROBLEM IS WHEN THE DISC LOOSES ITS TURGIDITY(HARDNESS) THROUGH DEHYDRATION IT CAN 'COLLAPSE' WHICH THEN PRESSES ON NERVE ROOTS - BUT THAT HASN'T HAPPENED AT THESE LEVELS

 

The L3-L4 disk is dehydrated with a broad-based disk bulge and focal central protrusion which is small but effaces thecal sac. THE DEHYDRATED DISC HERE HAS COLLAPSED A BIT AND IS PRESSING ON THE SAC WHICH SORROUNDS THE SPINAL CORD AND CAUDA EQUINA. THE BULGE IN IN THE MIDDLE AND GOES IN TOWARDS YOUR SPINAL CANAL (THE BULGES CAN BULGE IN ANY DIRECTION) THIS MAY CAUSE PAIN IF IT IS ALSO IRRITATING A NERVE ROOT (AND YOU CAN'T ALWAYS SEE NERVE ROOTS ON MRI)

 

No definite compromise seen at this level however.(SEE ABOVE, THEY CANNOT SEE WHETHER A NERVE ROOT IS ALSO AFFECTED The L4-L5 disc is dehydrated witha broad-based disk bulge. AS ABOVE BUT A BIGGER BULGE This accompanies bulky facet OA particularly on the left side narrowing lateral recess THE OA ON THE LEFT SIDE HAS NARROWED THE EXIT CANCAL THROUGH WHERE THE NERVE PASSES and there is some mild effacement of the left L5 nerve root in this region. AND IT IS IRRITATING THAT NERVE TO A MILD DEGREE

 

However, there is a moderate left foraminal stenosis in which the foraminal L4 root on the left side does appear to be impinged to some degree. This is predominantly due to bulky facet osteophytosis.SAME ASA BOVE, A FORAMINA IS A HOLE BETWEEN TWO BONES THROUGH WHICH NERVES AND OTHER STRICTURES OASS (LIGAMENTS ETC) IN YOUR CASE THIS HOLE IS NARROWED AND IT IS IMPINGING ON THE NERVE (A STENOSIS IS A NARROWING)

 

The L5-S1 disk is reasonably well-preserved. There is sacralisation of the L5 vertebral body NORMAL ANATOMICAL VARIANT, YOUR L5 VERTEBRAL BODY HAS A DIFFERENT APPEARANCE TO 75% OF THE POPULATION, BUT IT IS NOT ABNORMAL, JUST A VARIANT.IT MEANS THE TRANSVERSE PROCESSES (STICKY OUT BITS ON THE SIDE) ARE WIDE

 

Focal high signal in the pars on each side may reflect some low-grade stress THIS VARIANT MAY BE CAUSING YOU EXTRA MECHANICAL STRESS (IE WHEN YOU MOVE AROUND) DUE TO ITS SIZE Conclusion: evolving degenerative changes within the facets and lower lumbar disks as detailed above. Moderate to"

Edited October 2, 2012 by slick132
layout sorted

[feefofum]

BTW apologies when I typed this I used the return key to create paragraphs etc - but it has uploaded as one big lump of difficult to read text.

[mrjackderges]

Thank you so much for this - it has really helped me.

 

I am seeing a specialist soon. Being 25, it seems the degenerative stuff going on is too soon for someone my age. Obviously don't want surgery, but these 'boney growths' sound like they need removing!

 

I do a lot of work in the gym with weights and hate the thought this is going to affect that.

 

Thanks again for the help!

[feefofum]

Just like grey hair, some people get this sooner than others - and its the same inside our bodies too. As I said, genetics play a big part.

 

The bony growths (osteophytes) cannot be simply removed, because they grow back! It is a case of making the hole through which the nerves and other structures pass (foramen) either larger or more stable (or sometimes both). Can be achieved by surgery (but a possible side effect is that scar tissue can form in the space created and press on the nerve so your symptoms return), and in some cases by good rehabilitation and conservative therapy (i.e structured and supervised excercise programs, not merely seeing a physio once a week for 10 mins then not continuiung with exercises and stretching/strengthening whilst at home).

 

Given your age I would try to avoid any large operations such as a fusion or disc replacement (especially the latter as the long term performance of these is not yet known), your surgeon may offer a discectomy which is a relatively minor op (although still needs aneasthetic with associated risks).

 

I would try GOOD conservative management for 6 months (discuss with your surgeon as to what GOOD conservative management is, its not a physio appt once a week) and then consider surgery.

 

That said, its YOUR decision taken in conjunction with YOUR healthcare practitioner. Advice on the internet is always superficial and shallow. Good luck

Edited October 2, 2012 by slick132
layout sorted

[feefofum]

GRRRR, anyone know why my replies do not inlcude paragrapsh when I have typed in paragraphs? thanks

[slick132]

Hi FFF,

 

Not sure why your excellent replies stayed compressed but I've entered paras for you.