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-   -   help understanding MRI (https://www.neurotalk.org/spinal-disorders-and-back-pain/166553-help-understanding-mri.html)

chevysucks 03-15-2012 12:27 AM

help understanding MRI
 
Had a head, neck, back injury back in 2010 i was 27 when it happened having a hard time understanding the MRI reports? Cervical mri shows all disks normal except c7-t1 shallow disk bulge, t1-t2 shallow broad-based disk protrusion. Mild effacement of the ventral thecal sac, the neural foramina are patent. Mild facet degenerative changes bilaterally

Thoracic MRI. Shows mild central disk protrusion at t3-t4. Effacement of the ventral thecal sac. Flattening of the cord focally at this level. CSF does surround the cord posteriorly. Shallow central disk protrusion at t4-t5. Shallow right paracentral disk protrusion at t5-t6 with a moderate right paracentral protrusion at t6-t7. Shallow central protrusion/bulge at t7-t8

Lumber MRI shows all disks normal except L4-L5mild disk bulge somewhat asymmetric to the left. Mild inferior neural foraminal narrowing is demonstrated with slight contact of the exiting left L4 nerve root The conus demonstrate normal morphology and signal characteristics, terminating posterior to T12-L1

Have been in constant pain since injury, all doctors keep doing is trying different anti inflammatory meds and muscle relaxers every few weeks

eeyore2 03-15-2012 07:11 AM

Here's an attempt
 
Cervical mri shows all disks normal except c7-t1 shallow disk bulge, t1-t2 shallow broad-based disk protrusion. Mild effacement of the ventral thecal sac, the neural foramina are patent. Mild facet degenerative changes bilaterally

at T1-2 the disc is touching the cord (may or may not cause problems)
Thoracic MRI. Shows mild central disk protrusion at t3-t4. Effacement of the ventral thecal sac. Flattening of the cord focally at this level. CSF does surround the cord posteriorly.

T3-4 the disc is touching the cord and pushing enough to deform it anteriorly, but there is still some room in the backMore likely to cause problems, but it depends on sx---with the room in the back, the cord is not truely "compressed"

Shallow central disk protrusion at t4-t5. Shallow right paracentral disk protrusion at t5-t6 with a moderate right paracentral protrusion at t6-t7. Shallow central protrusion/bulge at t7-t8

These discs are somewhat "slipped"--they do not state nueral foriminal of cord compression, so there likely is none

Lumber MRI shows all disks normal except L4-L5mild disk bulge somewhat asymmetric to the left. Mild inferior neural foraminal narrowing is demonstrated with slight contact of the exiting left L4 nerve root

L4-5 is pushing on the left L4 nerve--if your sx correspond, this could be the reason, but even this may not be causing a problem
The conus demonstrate normal morphology and signal characteristics, terminating posterior to T12-L1

ginnie 03-15-2012 04:26 PM

Hi chevy
 
The post you just received was perfect. I looked the information up. Welcome to Neruo Talk. The only thing I can add, is that when the words "mild" are used, you have a better chance with other therapies, other than surgery. When these issues start to say "severe" degenerative or " severe" disk intrusion, that is when a more surgical approach is used. In any case I would go for a second opinion to a neurologist. I failed to do this the first time around, and paid a price for it. I didn't get all the information I needed to make a good decision. I do wish you all the best, and hope that some relief can be found. ginnie

chevysucks 03-16-2012 02:17 AM

Thanks for the information on it! My primary doctor told me that the lumbar MRI shows arthritis and bone spurs pinching a nerve? So should i be getting a 2nd opinion?

Dr. Smith 03-16-2012 11:00 AM

Quote:

Originally Posted by chevysucks (Post 861461)
My primary doctor told me that the lumbar MRI shows arthritis and bone spurs pinching a nerve? So should i be getting a 2nd opinion?

First, this kind of arthritis (osteo) and bone spurs are a natural part of aging, though most folks get them a little later than yourself (you're ~29/30, right?) There's nothing you can do about that; it is what it is. Bone spurs are a way the body uses to protect itself. They are usually not of concern unless they impinge on nerves or cause pain in some other way (heel spurs, etc.)

It's not really your PCP telling you these things; it's the doctor/technician who read and interpreted your MRI. (Your PCP just interpreted the report into English, if that. ;) )

A second opinion is probably only warranted if somebody is suggesting/recommending surgery, which should be the last resort after all other therapies have failed. It sounds to me like you have quite a few other things to try in the meantime.

Generally, in cases like these, they do just what they are doing. They begin with the most conservative measures, and progress from there until they find something that allows you enough comfort to function. The expectation is/should not be to be pain-free (stinks, I know, but that's the politics of pain). The goal is to reduce the sense of suffering and improve the quality of life. A next logical step would be physical therapy, osteopathic manipulation and/or chiropractic (depending on location). Physical therapy helps a great many people with similar conditions.

If those don't work, there are still many more before surgery should be contemplated. Surgery may sound like a quick fix; it is not, does not guarantee an end to pain, and can cause more complications further down the road, especially in a younger person (e.g. Domino Effect, Failed Back (Surgery) Syndrome).

http://en.wikipedia.org/wiki/Failed_back_syndrome

At some point, if these conservative approaches do not help (and we should be hoping they do) you may need to ask to be referred to Pain Management, which can include a LOT of other therapies.

There is definitely hope, but realistically (no BS), it may take some time (and frustration) in finding/getting it. It may help to view this as a journey rather than an event. Part of why we're all here is helping each other along the way.

BTW, Ford or Chrysler/Dodge?

Doc

chevysucks 03-18-2012 10:21 PM

I am a Dodge guy lol! Thanks for the advice this all happened from a work injury in late 22010, have been going to physical therapy, have had 2 epidural injections, radio frequency liaison done on c3,c4,c5,c7. And the pain has just gotten worse

Dr. Smith 03-19-2012 12:55 AM

Quote:

Originally Posted by chevysucks (Post 862109)
have been going to physical therapy, have had 2 epidural injections, radio frequency liaison done on c3,c4,c5,c7. And the pain has just gotten worse

Keeping a positive outlook and from the "journey" perspective, you've found some things that haven't worked. Did your PT happen to include any traction? (I find it helps me from time to time. I also have a TENS unit).

Are you in Pain Management yet?

Doc
('05 Magnum RT 5.7L Hemi V8 - I LOVE this car! :cool2: IT ROCKS! :yahoo:)

chevysucks 03-19-2012 01:06 AM

My primary doctor referred me to a pain management clinic, traction on my neck makes things worse, i also have a tens unit that workmens comp paid for. I see an orthopedic doctor this week that i was referred to about some shoulder pain i have along with my left knee. My doctor thinks there related to my head, neck, back injury?



Have a 76 power wagon with a 440/4spd. I lost my 05 Ram after i couldn't afford it after my injury


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