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#148819 - 07/13/09 10:47 AM Final report on my MRI - can someone clarify for m
aslee9 Offline
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Registered: 08/28/08
Posts: 2119
Loc: michigan
Final report - MRI of the lumbar spine]

Clinical history: Patient feels a clicking in low back when sitting. Pain down both legs with right leg electrical/tingling sensation, this sensation going into the right foot.
Multiplanar, multiecho imaging of the lumbar spine was performed without contrast.

Findings: STIR images demonstrate no evidence for acute edema or fracture. There is minimal grade I retrolisthesis of L2 over L3 and L3 over L4. Loss of disc hydration and height is noticed throughout the lumbar spine. The conus ends at the L1-L2 level and demonstrates normal signal intensity.

At the L5-S1 level, there is a circumferential disc bulge with a patent spinal canal. Facet hypertrophy and ligamentum laxity with bilateral foraminal stenosis, findings are minimally worse on the left side.

At the L4-L5 level, there is a circumferential disc bulge and facet hypertrophy with ligamentum laxity visualized. The disc bulge is worse in the foraminal location with mild to moderate foraminal stenosis. The spinal canal is widely patent. Mild lateral recess stenosis visualized.

At the L3-L4 level, there is a minimal disc bulge, which is circumferential. The spinal canal and neural foramina are widely patent. Facet hypertrophy is visualized. The disc encroaches upon the inferior aspect of the neural foramen at L3-L4 on the left.

At the L2-L3 level, there is a circumferential disc bulge with a patent spinal canal. Minimal encroachment of the inferior aspect of the neural foramina is visualized bilaterally. The foramina appear patent, however. Ligamentum laxity and facet hypertrophy is visualized.

At the L1-L2 level, there is no significant spinal canal stenosis. Minimal disc bulge is visualized.

The lower thoracic levels also demonstrate minimal disc bulges without significant narrowing of the canal.

IMPRESSION: Multilevel degenerative changes are seen throughout the lumbar spine without significant narrowing of the canal. The findings are worst at the L4L5 level with facet hypertrophy, ligamentum laxity, and disc bulge with bilateral foraminal stenosis at the L4-L5 and L5-S1 levels. Minimal similar changes are noticed throughout the rest of the lumbar spine as described.


Okay, I know many of you out there know a whole lot more medical terminalogy than I! When I talked with the doctor, all they told me was some degeneration and bulging discs with some bony spurs possibly pressing on a nerve. Even mentioned neurosurgeon or pain management doctor for some injections to try to reduce swelling. Also wants me to go ahead with the emg nerve testing appt. tomorrow.

What is facet hypertrophy, ligamentum laxity, and disc bulge with bilateral foraminal stenosis?

Can anyone understand these findings? Help, please!

Ann
_________________________
Ann
HLAB27+
62 years old flexeril, tramadol, tramadol er, percocet, lidoderm patch, flector patch, voltaren gel + other meds for other conditions + lots of vitamins


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#148850 - 07/13/09 11:45 AM Re: Final report on my MRI - can someone clarify for m [Re: aslee9]
JenInCincy Offline
Registered Visitor

Registered: 05/19/08
Posts: 13201
Loc: Cincinnati, OH
Hi Ann .... here's some stuff for you... FYI, I get a LOT of info from this site: http://www.spine-health.com/

Hypertrophy means enlargement ... I think facet hypertrophy is essentially arthritis. Both AS and OA can cause facet joint arthropathy.

Laxity is looseness.... loose ligaments could be simply related to hypermobility in joints, or possibly (less likely) some sort of connective tissue disease.

Disc bulge is one most people know ... can also be referred to with the terms herniated, ruptured, torn, protruding. If the contents of the disc are "leaking out" they can irritate nerves and cause pain (I have this.) The swelling from a bulging disc could also lead to stenosis.

Stenosis is narrowing... bilateral is both sides... the foramen is a space kind of between the vertebrae that the nerves go through.

A big problem with these sort of MRI findings is that they often do not correlate with the "clinical" presentation - that is, how you FEEL and the symptoms you describe. Some people have a lot of pain from a minor herniation, others are found to have large herniation with no pain!! So I don't know if these will be useful for you or not.... the EMG testing should help clear things up regarding specific nerve impingements, if any.

I would also put in a plug for pain management - I've been having epidural steroid injections for disc related pain and it has helped A TON!!!!

Good luck sorting it out... MRIs are a mixed blessing at times!
_________________________
Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates

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#148855 - 07/13/09 12:18 PM Re: Final report on my MRI - can someone clarify for m [Re: JenInCincy]
aslee9 Offline
Registered Visitor

Registered: 08/28/08
Posts: 2119
Loc: michigan
Thanks a lot for your help Jen! This was very concerning to me. It was the slipping, clicking that sent me in to doctor to check out. Really feels freaky, to just be sitting and to feel one spot just moving around.

Right now my back pain is minimal. Still have some tingling down the right leg, but its not painful.

My left leg has woken me out of a sound sleep with pain from my hip all the was down to bottom of my foot. I don't know if this is related to any of the disc findings. This hasn't happened in a couple of weeks, but when it does, its like a toothache all the way down my leg.

Doctor did mention epidural injections to try to get the swelling down.

All of these conversations on the results were over the phone, so you can understand my confusion. I don't have another appt. with rheumy until January!

Ann
_________________________
Ann
HLAB27+
62 years old flexeril, tramadol, tramadol er, percocet, lidoderm patch, flector patch, voltaren gel + other meds for other conditions + lots of vitamins


Top
#148858 - 07/13/09 12:40 PM Re: Final report on my MRI - can someone clarify for m [Re: aslee9]
JenInCincy Offline
Registered Visitor

Registered: 05/19/08
Posts: 13201
Loc: Cincinnati, OH
The type of pain you describe in your left leg is consistent with sciatica... lots of causes but herniated disc is certainly one! I can imagine how strange it must be to feel a spot moving around like that - ugh!

The thing about the epidural injections, they can be a treatment but also in a way, a diagnosis... if an epidural injection provides relief you can be pretty confident that the disc was the source of the pain. Unfortunately, however, if it DOESN'T help your pain, it doesn't mean anything!! Because it doesn't always work for this type of pain! Happily it worked for me... hopefully you'll get the pain doc referral and it can work for you, too!
_________________________
Jen, 42, happy partner of James and Moma to Evan, 14, & Lucy, 12.5 (Crohn's dx @ age 3; on Remicade since April 2010.) I take piroxicam, Flexeril, & Nucynta ER nightly. 3 anti-TNFs didn't pan out for me.

"Science is the father of knowledge, but opinion breeds ignorance." -- Hippocrates

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#148882 - 07/13/09 03:21 PM Re: Final report on my MRI - can someone clarify for m [Re: JenInCincy]
jewelz Offline
Registered Visitor

Registered: 09/27/07
Posts: 1545
Loc: Wisconsin
Seems like yours isn't much different than my MRI - you might want to read the thread, it's just a couple days old. I don't have the hypertrophy though.

I can appreciate your pain and sure wish you didn't have to deal with this.

Jewelz

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#148950 - 07/13/09 07:46 PM Re: Final report on my MRI - can someone clarify for m [Re: jewelz]
aslee9 Offline
Registered Visitor

Registered: 08/28/08
Posts: 2119
Loc: michigan
Jewelz,

I did go back and read your post about your MRI. I remember reading it earlier when you first posted it and I didn't have a clue as to what it was saying either. Don't you wish they would just spell it out for us in plain English?

Yours does sound suspiciously like mine, just used different wording/terms!
_________________________
Ann
HLAB27+
62 years old flexeril, tramadol, tramadol er, percocet, lidoderm patch, flector patch, voltaren gel + other meds for other conditions + lots of vitamins


Top
#148969 - 07/13/09 09:38 PM Re: Final report on my MRI - can someone clarify for m [Re: aslee9]
jewelz Offline
Registered Visitor

Registered: 09/27/07
Posts: 1545
Loc: Wisconsin
Yeah Aslee - I do wish you could get a "laymans" term copy of the results so you knew what it meant!

I just think I'm too young to be having this kind of stuff to the degree that I have it and there must be something more wrong than just regular degenerative arthritis. Or if it is regular degenerative arthritis, then why do I have this at such a young age? Something must be causeing it?!

No doc has formally Dx'd me yet. My GP thinks I've got Reactive Arthritis. Rheumy ponders Psoriatic without the Psoriasis but he ponders other stuff too... Foot doc thinks Reactive also. Everyone seems to be in the spondy category - and that's what I think too. But I need something definitive so I can be properly treated. Several years ago they thought I had RA so they put me on RA drugs. Humira and MTX and it didn't help me at all. Then the RA Dx was recinded and here I am today.

Please get yourself a copy of the results and the EMG done. Let us know how it goes. I'm send you some wishes and hopes for less pain.

take care,
Jewelz

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