Need alittle help with MRI
 

I everyone.I was wondering if anyone could help with this mri report and tell me what The usual -- and some unusual stenosis is. and again Thank you

Findings: There is a mild levo curvature. Mild endplate
compression of lumbar vertebral bodies is grossly unchanged.
Marrow signal is within normal limits, other than end plate
degenerative changes, for the patient's age. The visualized
spinal cord is within normal limits. The conus ends at T12-L1.

Moderate degenerative changes of the disc spaces seen in the mid
and lower thoracic disc spaces.
Moderate to severe disc space and
facet joint degenerative changes seen at L2-L3, L3-L4.
Moderate degenerative changes seen on the rest of the lumbar disc spaces.
There has been no significant interval change in the lumbar spine
from 1/18/2012.

In the thoracic disc spaces, mild-to-moderate endplate
degenerative changes seen. Prominent bridging anterior
osteophytes seen in the mid and lower thoracic vertebral bodies.

At right T2-T3, there is a prominent facet arthropathy with mild
encroachment of the right posterior aspect of central canal. No
other areas of significant central canal narrowing seen.
L1-2: Prominent disc bulging and moderate facet arthropathy seen.
Moderate severe central canal stenosis. Mild right foraminal
narrowing seen.
L2-3: Marked end plate degenerative changes
present. Moderate disc bulging present. Right paracentral disc
protrusion has increased from the previous exam. Moderate
bilateral facet arthropathy. Moderate severe central canal
encroachment. Mild right foraminal narrowing.
L3-4: Marked
endplate degenerative changes. Moderate disc bulging and facet
arthropathy. Moderate central canal stenosis. Mild bilateral
foraminal narrowing. L4-5: Moderate endplate degenerative
changes. Moderate disc bulging with broad-based left paracentral
disc protrusion. Prominent bilateral facet arthropathy. Moderate
severe central canal stenosis. Moderate bilateral foraminal
stenosis.
L5-S1: Moderate disc bulging and facet arthropathy. No
significant stenosis.

Impression:
Moderate degenerative changes of the disc spaces seen in the mid
and lower thoracic disc spaces. Moderate to severe disc space and
facet joint degenerative changes seen in the lumbar disc spaces.
There has been a slight change in the lumbar spine from
1/18/2012.

At L2-L3, increased moderate severe central canal encroachment
seen due to slightly increased disc bulging and right paracentral
disc protrusion.
The rest of the lumbar disc spaces demonstrate persistent
moderate severe central canal encroachment at L1-L2, L3-L4, at
L4-L5 as detailed above.
No significant spinal canal narrowing in the thoracic disc
spaces.

I will bold some important things that I notice, but I don't know the exact definitions for them..I hope bolding the main terms is helpful for you.

Often these reports are very wordy, and it helps to cut to the basics to better understand what applies for you.

Hi Billygee
 

I can help a bit. There are key words to look for in a MRI. The vertebra you are having trouble with is L2-4, "MODERATE to SEVERE: disk space and facet joint degerative problem. The disk is flattening out, this may be due to arthritis.
However you also have a prominent disk bulging or herniation at L1-2. This says moderate to severe, central canal stenosis. This means the cord is being pushed against and that hurts! All the others mentioned are moderate changes.

When an MRI starts to say severe, that key word, do go for another opinion OK? This is really important to do. Surgery is always a last resort after all other things have been tried. Look up each set of words, and that gives you the condition of the spine as a whole. It is best to have all the language of it down pat. That way when you go to the doctors' there won't be anything they say that you will not understand.
You do have some issues, and no doubt some pain with this. Seek a neuro surgeon for a second opinion if you can. Bring someone with you so that you don't miss anything that is said to you.
Have you had any type of injections? I had something called Ketamine infusions, which helped way more than any steriod or epidural did. The infusion lasted months at a time. I hope that you can find some resolution to this, to where you are not in pain as much. My own surgery turned out good, so there can be a happy outcome. ginnie:hug:

Thank you.I'm also dealing with bilateral dropfoot. severe central canal encroachment was measured at 6.8mm, forgot which level. 1st neurosurgeon I saw listed it as Unspecified idiopathic peripheral neuropathy so he sent me to see a 2nd neurosurgeon and this is what he thinks. Its long.

60 yo man with progressive distal weakness of his legs for about five years. He has had an extensive work-up for polyneuropathy, including a nerve biopsy, without a diagnosis emerging. Nerve conduction data apparently showed axonal neuropathy and the biopsy showed axonal loss without inflammation or vasculopathy. Lumbar MRI shows rather severe, but not catastrophic, canal stenosis at L1-2 and L2-3. The usual -- and some unusual -- lab studies were normal.He has had only slow progression in the last year, but he requires bilateral braces for his foot drop. He also has chronic back pain that worsens with prolonged standing. He does not describe claudication-like symptoms; and prolonged standing does not worsen the weakness or sensory loss in his legs. He had cervical spine surgery in 2001, with good results, and he has some mild residual sensory loss on the ulnar side of the hands, without hand or arm weakness.P.E. shows no weakness of the arms or hands, no atrophy of the hand muscles and only minor loss of appreciation of pin in the 5th fingers bilaterally. Thigh strength and bulk appear to be normal, but there is obvious and weakness of the anterior tibial muscles and both calves. Knee jerks are present, ankle jerks absent, plantar responses absent. Sensory loss to temperature and vibration in a stocking pattern.Impression:1st neurologist did not think that the lumbar stenosis was severe enough to account for the patientss findings. I think we have all seen patients with this degree of stenosis who have no disability, so I understand his caution on this point. I am nevertheless inclined to attribute his syndrome to lumbar stenosis. The normal hand function is a point against polneuropathy, as are the preserved knee jerks. Certainly lumbar stenosis can account for the nerve conduction and biopsy results, via wallerian degneration of nerve fibers.

Hi Billygee
 

You really do have some issues Billy. It sounds like the doc. isn't sure what is causing all your symptoms, just some of them. Very complicated DX. Have you gone as far as a teaching hospital? Sometimes the DX from places like this are more conclusive. It also didn't say that surgery was recommended. The drop foot is neurological, and so is less nerve input to the tibial and foot. PN can cause numbness like that too.
I really wish I knew more. Most of the information I get is from the MD Web site. I am sorry you are having to deal with all this. what kind of pain level do you have? Are you on any type of medications? I am here to listen anytime. Good that you have gotten more than one opinion. Let me know how you are doing as things go along. Jo*Mar one of our moderators, knows quite a bit more than I do, and may be better than I am with the terminology. Our best at MRI's is out sick. I miss her guidance. I try to walk in her footsteps and learn all I can.
Keep in touch Billy, I do care. ginnie:grouphug:

Ginnie,yes it is very complicated.No meds i haven't asked.I have pain in the back and legs and sometimes in my butt but its not sharpe pain. I'm dealing with it & I just take it easy. and when I walk sometimes it feels like my calfs & thighs are tightening up and it makes harder to walk. i'm dealing with it & I just take it easy.I'm a disable vet- injurys of the L2-L3-L4 along time ago. so the two vamc I been too have some of the best neurology depts.And i did see a surgeon and surgery won't help and had i'd knew what the 2nd neurosurgeon thought I would of had a lot of questions.I think i'm at the point I need to see the 1st neurosurgeon and have a chat with him.Jo*mar Thank you for highlighting my mri report.I have a compensation physical this Monday and this will help me- I Hope .LOL Ginnie are you talking about Leesa she has helped me a lot a few months ago.

Hi Billy
 

Yes I am talking about Leesa. I promised her that I would try my best to help folks. I pray for her every day. Miss her knowledge more than she ever could know.
. She was the one who read my MRI when I came to the site freaking out. She calmed me down, explained things to me, even went on chat line to help me to calm down. She is one of the nicest people I have ever met on this site. I don't have near the knowledge that she does. Never tried so hard before to learn all the terms. Jo*mar is tops too. There are a lot of people who do come here very afraid, in pain, and don't know any of the terms on the MRI. I remember very clearly how much better I felt after talking to her multiple times. She was a gift to this site, and I hope that recovery is in the hand she has been dealt. I miss her.
Billy this back stuff is hard on a person, I know it as I have been through a bunch too. We all need some TLC when we face these things. I wish there was a solution to your back problems, I really do. I care, and will be here any time to talk to. I was lucky with my own fusions, much better considering how bad I really was. Keep in touch with me OK? Have a good night, and less pain. ginnie

Leesa has helped me a lot and no worry your doing a Great job following her foot steps.I'll say a pray for Leesa.