Help with Reading Lumbar MRI--Back/Leg Pain
 

Hi, I want to post my MRI in the hopes that someone could help me understand the terminology. I had an injury to my lower back in January of 2012 and have had pain in my low back and both legs since that time. I have nerve pain that shoots down to both my feet at times, hip pain, numbness and tingling, muscle twitching and cramping (not all of these at on time but it moves in between and varies in intensity). The radiating nerve pain can really be unbearable at times when sitting or walking but then goes away. Its vary scary and I'm wondering what my MRI is showing and how bad it is. I see a pain management doctor, and I'm waiting to see a orthopedic doctor. Wondering if this will just go away in time.

MRI Lumbar : Low back pain/hip pain

Findings: Conus medullaris normal in size, morphology, and signal intensity, terminating at the L1 level. Normal Vertebral body height and anatomical allighnment. Minimal L4-5 disc space narrowing. Moderate L5-S1 disc space narrowing and desiccation and Modic type II marrow changes. Tiny Schmorl's node deformities L2-3 and T12-L1. No bone marrow signal abnormality. The pedicles are short in the lower lumbar spine, contributing to a congenitally small spinal canal.

T12-L1: unremarkable

L1-L2: unremarkable

L2-L3: unremarkable

L3-L4: Minimal bulge and endplate hypertrophic change. Short pedicles. Mild ligamentum flavum thickening. No central or lateral recess stenosis. Foramina appear mildly narrowed.

L4-5: small central disc protrusion. short pedicles. Mild ligamentum flavum thickiening bilaterally. Mild central and lateral recess narrowing. Mild bilateral foraminal narrowing.

L5-S1: Diffuse mild to moderate disk osteophyte complex with central focal disc herniation that is partially calcified. there is moderate central and lateral recess stenosis, greater on the left. Mild bilateral foraminal stenosis, greater on the left.

Impression:

1. Degenerative disc disease L5-S1 Partially calcified central disc herniation. there is moderate central and lateral recess stenosis, greater on the left and mild bilateral foraminal stenosis, greater on the left.

2. L4-L5 bulge with mild protrusion centrally. There is mild central and lateral recess stenosis and bilateral foraminal stenosis.

3. L3-L4 mild bulge and short pedicles with mild bilateral foraminal narrowing. No central or lateral recess stenosis.

Thank you for reading...

Ben

Hello Benny
 

Welcome to Neuro Talk. You will find alot of information on back issues. There are others who will be responding to you also about this. One of the good things about your MRI is that most of the wording says "Mild" or "moderate"
If it had said "severe" in any of the comments with your verterbre that would be a situation where sometimes sugery is needed. You don't want surgery, unless that is your only option. All therapies, would be good to look at now. Physical Therapy, can have a good effect. Also a second opinion is always a good idea. In the language of your MRI, look up each individual word. That will help you learn the language they use in describing your conditon. When you doctor next talks to you about it, you won't feel like you don't understand. There will be other folks who can describe more thoroughly each comment on your MRI. You will also find alot of support here and make a few friends. Welcome again to NT. ginnie

bennyvegas75, how did you injury your lower back? I was in car accident in 2008 when i got all my injuries. Where is your hip pain? I had hip and leg pain also. I also had hip labral tears in both of my hips that caused hip and leg and groin pain. The hip labral tears where the last injuries to be identified.
I dont believe hip labral tears are that common in auto accidents.

Thanks ginnie. I injured my back lifting at work. It has slowly gotten worse since then. My doctor had me try PT for two weeks but I would have worse pain after so he stopped it. I started on naproxen and Vicodin and now I'm on voltoren, neurontin, Percocet 3x a day. Last week I had my first epidural. Nothing happened and it actually flared up for a week after.

Hi Benny
 

If that first epidural doesn't work, don't do another. Try another approach. I had a Katemine infusion that did work. Little more to it, but it worked better than epidural. Do all conservative treatments you can do before you consider surgery. I had two cervical fusions, yes the second one worked, but Oh boy it was something to go through. I had no choice in my case. Hope you get relief, and that something works for you. I do wish you all the best with this. Back issues are no fun. ginnie

Hi Benny -- I'll try to decipher this for you but I don't know how much sense it will make. LOL

I'm going to go by the "impression" at the bottom, rather than explain the whole thing which would be VERY confusion. LOL

Degenerative disc disease is a "drying out" of the discs. This happens as we get older and everyone gets it. Some of us get it sooner than other. What happens is when the disks dry out, they 'flatten' and that makes them bulge out and sometimes herniate. That makes them push on nerves and that HURTS!! :eek: At L5-Sl you have a herniation. You also have some spinal stenosis, which is narrowing of the spinal canal. Right now this is mild to moderate, which is good. ;)

At L4-5 you have a disc BULGE, and also spinal stenosis which is MILD.

At L3-4 you have a disc BULGE with mild FORAMINAL narrowing. The foramen is the hole that the nerves pass thru to the spinal cord. Sometimes it narrow due to herniations, as well as the canal.

It says you have "short pedicles" -- pedicles are the basal part of each side of the neural arch of a vertebra. The Neural arch is the cartilaginous or bony arch enclosing the spinal cord on the back side of the vertebra.

I hope this made some sense. :eek: If you have any more questions, let me know. Take care & good luck! Hugs, Lee

Lee, thank you for responding....ginnie too! I work as a nurse and have for the last 8 years so my back is my livelyhood. I work in a different field and this is really the first time I'm the patient. I feel almost depressed about it and to top it of my employer thinks I'm faking it and the work comp insurer is difficult to say the least :-(. I've been of work for almost two months now and making 1/3 the wage I'm accustomed. I'm hoping this will go away I guess. From the MRI do you think this is nO big deal or something I will be dealing with for a long time?

I forgot to add, today my left leg is more numb than usual and feels weak. Should I call my doctor about this? Or is it expected? My symptoms vary so greatly from day to day.

If the symptoms are worsening, and numbness is involved, I would see the doctor. As to the MRI readings, simply put, the lower three discs are bulging which can put stress on the nerves. MRI also states some narrowing, which is common with bulging or herniated discs. This can also cause nerve issues. When the nerves rub or become compressed it results in the symptoms you are having. Hopefully PT works for you.

Hi Benny ~ Well, once again I'M NO DOCTOR -- and you should somehow get the opinion of a neurosurgeon. But from what I can tell, I doubt you'd be a surgical candidate at this time. Besides, surgery is the LAST thing you would want anyway. :eek: All conservative methods should be tried before you opt for surgery!!! Surgery only repairs mechanical problems and will not necessarily help the pain. Usually you're left with the same pain, or worse.

Studies have shown that patient's who have had surgery have no better results than those who have had physical therapy! So perhaps you could ask your doctor if you could try therapy. That just may relieve some of your symptoms. It can help ALOT. It's worth a try, for sure.

I wish you the very best! Let us know what happens, ok? God bless & take care. Hugs, Lee