[mrsalkire]

I got a copy of some of my records which included my MRI that was done 4/19.

First off:The study was compromised because by motion:Its hard to stay still for that long Flat on my back lol!

There is suggestion of transitional vertebral anatomy. Coronal imaging suggests the possibility of rudimentary ribs @ T12 amd [artocal sacralization of L5. Would correlate with plain film radiographs.

There is significant levoconvex rotoscoliosis of the lumbar spine. Conus terminates @ L1. There is diffuse dgenerative disc desiccation thourghout the Thoracolumbar spine. Axial imaging was obtained from L1-2 throuh L5-S1.

L1-2: There is mild circumferential dis buldge, mild facet hypertrophy. No significant central canal stenosis or foraminal stenosis is evident.

L2-3: There is minimal circmferential disc bldg, mild to moderate facet hypertrophy and ligamentum flavum hypertrophy is present. No significant central canal stenosis develops. Mild left side foraminal narrowing is present.

L3-4: There is circumferential disc buldge with small central dorsal annylar fissure. There is mild flattening of the anterior thecal sac. Mild to moderate facet hypertrophy and ligamentum flavum hypertrophy is present. No significant central canal stenosis develops. Disc buldge contributes to mild left greater than right, forminal narrowing.

L4=5: There is mild disc space narrowing. There is circumferential disc buldge with small central dorsal annular fissure. Moderate facet hypertrophy facet and ligamentum flavum hypertrophy is present. There is mild flattening of the anterior thecal sac with minmal central canal narrowing. Disc buldge contributes to mild left great than right foraminal narrowing.

L5-S1: No focal HNP is evident. Moderate facet hypertrophy is present no significant central canal stenosis or foraminal stenosis develops.

2 CM Tarlov Cyst @ s2.

Impression: Suspect transitional vertebral anatomy @ T12-L5. This could be correlated with plan film radiographs.
Significant levoconvex rotoscoliosis
Mulfi level degenerative disc disease and facet arthropathy throughout the thoracolumbar spine.
this results in recess narrowing and foraminal narrowing as described above.

[mg neck prob]

Hi mrsalkire;

Wow Im sorry Leesa expert on mri --im sure she will see this post. I remember you had acdf too right last year ? Im sorry you know have the back as well. How are you doing with your neck ?

[Leesa]

I'll try to help:

First I'm not sure what they mean by "transitional vertebra." They say you have "rudimentary ribs at T12 which means that they are imperfectly developed. Plus I BELIEVE they're saying that the sacralization of L5 means that it fused into the sacrum.

I also am not sure what the first sentence in the next paragraph means. The diffuse degenerative disc desiccation throughout the thoracic spine means that the discs have dried out -- this happens to everyone with aging.

L1-2 There's a mild disc bulge with mild facet hypertrophy. Hypertrophy means that there is an overgrowth of bone. The facets are the "wing-like" structures on each side of the spinal cord, and you can even see them if you hunch your back.

L2-3 There is minimal disc bulge, mild to moderate facet hypertrophy (see above) and ligamentum flavum hypertrophy. The ligamentum Flavum is a series of ligaments of yellow elastic tissue connecting the lamina (neural arch of vertebra) of adjacent bertebrae from axis to sacrum.

L3-4 There is a disc bulge with small central dorsal annular fissure. The annula is a fluid filled sac that the disc sits in, and it has a tear in it. There is also mild flattening of the anterior thecal sac. The thecal sac is a membrane of dura matter that surrounds the spinal cord and cauda equina. The thecal sac is filled with cerebral spinal fluid. There is also mild to moderate facet hypertrophy and ligamentum flavum hypertrophy. Disc bulge contributes to mild left greater than right foraminal narrowing. The foramen are the holes that the nerves pass through to get to the spinal cord. These holes are getting narrow.

L4-5 There is mild disc space narrowing. This is caused by the discs drying out. There is a disc bulge with small central dorsal annular fissure. (see above) Mild facet hypertrophy and ligamentum flavum hypertrophy are present. (see above) There is mild flattening of the anterior thecal sac with minimal central canal narrowiing. Disc bulge contributes to mild left greater than right foraminal narrowing. (see above)

L5-S1 Moderate facet hypertrophy.

In the impressions, the radiologists mentions "significant levoconvex rotoscoliosis" which obviously denotes some significant curvature. However, I'm not familiar with these terms, so I cannot comment too much.

He also says you have multilevel degenerative disc disease, which is just drying out of the discs, plus facet arthropathy which is disease of the facet joints.

I wish I could comment on the "transitional vertebral anatomy" but I haven't run across that YET. lol

Please let us know how you come out, ok? God bless and if you have any questions or if I confused you, let me know. LOL Hugs, Lee

[mrsalkire]

you explained a lot. But...... LOL! What the heck does it mean? Can it be fixed? Right now my neurosurgeon is focusing on my neck. But can they fix lumbar?

[mrsalkire]

2 CM Tarlov Cyst @ s2.??? What is it??

[Leesa]

Well, a cyst is just that - a cyst is a closed sac having a membrane and developing abnormally in a body cavity. They are almost ALWAYS benign. The one you have is at S2, below the lumbar area.

He said you have Degenerative disc disease, multilevel - which means many discs are drying out. When the discs dry out they tend to flatten and that causes them to bulge and/or herniate. When that happens, sometimes they push on nerves and that HURTS. The Facet arthrophy is diseased joints of the facets, which is probably (and i said PROBABLY) osteoarthritis. And that hurts too!

The levoconvex rotoscoliosis -- I haven't a clue. I've looked all over the place, and I can't find that particular wording. I wish I could help with that, but you're going to have to ask your doctor about that one. All I know is it denotes curvature -- you must have significant curvature of the spine.

Of course you have other issues as well, such as foraminal narrowiing, which I mentioned is where the holes that the nerves pass thru to get to the spinal cord are getting narrow.

I cannot tell you if surgery is an option for you. I'm no doctor -- but from my UN PROFESSIONAL VIEW -- I would say that right now, I don't think surgery would be an option. At least I would ask for physical therapy right now to see if it would help. You should ALWAYS try ALL CONSERVATIVE METHODS and exhaust them all before undergoing surgery. Surgery will NOT take care of your pain. Surgery is ONLY for mechanical problems. After surgery, you will be left with the same pain or worse most of the time. So don't expect surgery to relieve your pain. Doctors don't tell you this -- or else they tell the patient that they can relieve their pain, which is a lie. Almost ALL surgery patients still need pain medications after surgery. Then there is the "domino effect" which doctors don't mention. This is where the levels above and below the surgery site fail. That's because they have to take on more of the load. As an example -- if you have surgery on L4-5, then L3-4 OR L5-S1 will need surgery too! That's because they took on more of the load when L4-5 was operated on and afterwards. Plus later studies have shown that people who have had surgery get the same results as people who have had physical therapy!!! How about THAT!

So there is a lot to think about as far as having surgery. Do your research and be SURE to get at least 2 OTHER opinions other than your first surgeon. You need to know if others agree with your surgeon.

I wish you the best of luck. Sorry I didn't make things more clear to you. If you have more questions, let me know. Hugs, Lee

[mrsalkire]

leesa,,
Thank you so much! Funny you have told me more than any dr out thee that I have seen.

I know all too well about surgery. I go for my2nd cervical surgery on the 11th. I had a 3 level 7 months ago. Now he will remove plate in front and then go through the back. Ihave not worked etc since surgery. I just cant stand the pain and sayingthis has all turned my life upside down is a understatement. Thank you you are amazing!!!

Love Mrs Alkire

[Leesa]

Oh bless your heart~ I wish you didn't have to have MORE surgery!! Why is he removing the plate? Was that just temporary or has it moved and caused problems?? Once he removes it, will you have to have more surgery later? Lord, I hope not.

You've been thru alot. I'll certainly keep you in my prayers. PLEASE let me know how you are after the surgery, will you -- PLEASE?? I really want to know!! I'll be with you in the OR in spirit -- holding your hand.

Take care, and be SURE to ask the doc about POST-OP MEDICATIONS cause you're going to need them!!! Don't forget, ok? Don't accept Vicodin or some nonsense like that -- tell him you want something that's going to WORK!!! Perhaps MS Contin -- that would be good (if he gives you a high enough dosage). Anyway -- God bless & hope to hear from you! Love, Lee

[ginnie]

I will be with you in spirit too. I am sorry you are going through so much. I can add one thing that may shed some light. I reversed the curve of my spine, it was definate structure problems, and herniations etc. DDD, DJD. In my case he straightened my neck, as I did indeed have the domino effect. first fused C6-7, then six years later, C3-7. In my case, the pain was alot less after the second surgery. Some of the surgery does help. Mine did. I wish you all the best. I will be thinking of you. ginnie

[mrsalkire]

One more question..... Sorry I know lots of ???? Did they go through the back the second time? Or just through the front? I am anxious about it all. After #1 I literally couldnt eat ANYTHING besides liquids closest thing to food was pudding cream soup etc. Everyone from nurses to dr. To family, said oh it cant be that bad. Evertime I took pills they would get lodged in my throat,and Id choke and gag end up in tears, then usually I STILL wouldnt get them down. Everyone acted as if I was being a drama queen. But it was THAT bad! So needless to say I dont want to do that again. Thats why I ask. They will go through both ways with me. Front first posterier second.