Please help me understand my recent MRI findings
 

Hello all, I have been experiencing bad lower back pain with radiating pain down my right leg for 3 months now.

Findings:
The conus medullaris terminates at T 12. marrow changes along the superior endplate of L4 likely related to degenrative disease. There is a distinct cortigated structure in this area question residual of old injury. Spinal cord demonstrates normal signal.
T11/12 visualized on the sagittal images only. mild narrowing and dessication. There appears to be a mild disc bulge without definate protrusion,central stenosis or narrowing.

L2/3: Disc is normal height and hydratin. Mild disc bulge. No protrusion, central stenosis or neuroforaminal narrowing. Mild facet changes are seen.

L3/4: There is mild diffuse disc bulge. There is mild disc desiccation. Marrow changes are noted along the superior endplate of L4, likely related to degenerative disease. Mild facet changes are noted bilaterally. No disc protrusion,central stenosis or neuroforaminal narrowing.

L4/5: Disc is normal in height and hydration. No protrusion,central stenosis or neuroforaminal narrowing. Mild facet changes are noted

L5/S1: There is diffuse diffuse disc bulge with superimposed 1.5 mm right para central disc protrusion. Mild facet changes are noted bilaterally. No central stenosis or neuroforaminal narrowing.

Impression:

1. 1.5 mm right para central protrusion at the L5/S1 level. This does not cause central stenosis or neuroforaminal narrowing.
2.Degenerative disc disease at the L3/4 level
3.Well cortigated structure along the entrance superior aspect of L4, which may be from old injury or represent accessory growth center.

Thank you.

I'll try to help:

T11-12 - there's a mild disc bulge. There's also some narrowing and dessication. Dessication is drying out of the discs (degenerative disc disease)

L2 -3 There is a mild disc bulge, and also mild facet changes. The facets are the "wing-like" structures on each side of your spinal cord.

L3 - 4 There is Mild disc bulge and mild dessication. There are marrow changes likely related to degenerative disc disease. Mild facet changes bilaterally.

L4 - 5 Mild facet changes as noted.

L5 - S1 There is a disc bulge with superimposed protrusion. Mild facet changes bilaterally.


The pain you're describing is sciatica, and is no doubt caused by the L5-S1 disc herniation. I know how painful that is, as I've had sciatica for 27 YEARS. It's miserable. :( It would be a good idea to ask for a referral to a pain management doctor. Believe me, you want to avoid surgery at ALL COSTS unless you're in danger of spinal cord injury or permanent nerve damage, and i don't see any evidence of this but you need a 2nd opinion. I'M NOT A DOCTOR so get another doctor to look at these findings.

Surgery will NOT relieve pain. Surgery is only for mechanical problems. Most doctors don't tell their patients this. After surgery, usually you're left with the same pain or worse. Also there is the danger of the "domino effect." This is where the levels above or below the surgery fail, because they have to take on more of the load. So surgery begets more surgery. Latest studies have shown that people who have just had physical therapy have the same results as people who have had surgery!!! So stay as conservative as you can. Get a referral to pain management. They have lots of options for pain relief without having to do surgery. I wish I had known that, but my surgeries were long before the internet. LOL Best of luck and let us know what happens, okay? God bless. Hugs, Lee :)

First off I'd like to thank you for taking the time to help me better understand my MRI as it has been taking over my thoughts lately. I started PT mid November for 2x3 week sessions with no success. My doctor referred me out to a spine surgery consult, so hopefully he give me his honest opinion. What confused me about the findings in L5/S1 is that it states no central stenosis or neuroforaminal narrowing, so I though that meant no nerve involvement and was wondering what is causing the sciatica.

Believe me, when you have a disc protrusion, you're going to have nerve involvement! And at THAT level, it's most assuredly going to be the sciatic nerve, since that's the largest nerve in the body. :rolleyes:

You don't have to have stenosis or foraminal narrowing to have nerve involvement, believe me. Sometimes it's even scar tissue. There can be all sorts of things to cause nerve involvement.

So rest assured. You HAVE nerve involvement. LOL God bless. Hugs, Lee

Thank you so much for clearing that up for me. There has to be some nerve involvement with the sciatic nerve. I hope it is not scar tissue, as my body has a tendency to produce too much of it.

Yeah, me too. Right now, I have a bunch of scar tissue wrapped around the L4-5 nerve root and there's nothing they can do about it. They tried the Racz procedure years ago, but it didn't work. And you can't do surgery cause that just causes more scar tissue. :confused: So -- you live with pain. NUTS.

Take care! Hugs, Lee