Can someone experienced with reading MRI results translate in layman;s terms for me. My primary care said the MRI didn't show much. Another doctor says it shows a lot and I just want to confirm what the MRI shows. I appreciate any feedback on what it shows and possible treatments since PT didn't work. I believe the next step is an epidural steroid injection since it has been almost six months of pain. Summary is as follows:
Symptoms: Moderate to severe pain predominately in right lower back, buttocks, hip and thigh. Mild tingling sensation to foot along with the feeling of continuous vibrations going through foot. Can’t sit for a period longer than ten minutes or standing for more than a half hour without causing intense back pain. Laying down with legs up is the only tolerable position.

Symptoms have been ongoing since mid July 2011 and a six-week course of PT was completed in October 2011 without any improvement.


MRI LUMBAR SPINE WITHOUT CONTRAST

Technique:
Sagittal T1 weighted spin echo, STIR sagittal and T2 weighted TSE (4mm) images for the lumbar spine are obtained. In addition, axial TSE T2 weighted angle images through the disc at L3-S1 and axial spin echo T1 weighted straight images from L3-S1 are acquired.

Comments:
Evaluation of the lumbar spine demonstrates straightening of the lordosis without any acute compression fracture deformity. There is no spinal stenosis. The conus terminates normally at L1. The STIR images do not demonstrate any discrete vertebral body lesions or bone marrow edema. There is relative decrease in the amount of bone marrow fat seen on T1 and T2 weighted images. This could be related to the high portions of hematopoietic marrow in the lumbar spine.
Evaluation of the axial images demonstrate the following:

At the level of L3-4, there is a small disc protrusion without any neural foraminal narrowing. There is moderate facet joint disease.

At the level of L4-5, there is no neural foraminal narrowing. There is a small disc protrusion with a posterior midline annular tear, which is in close proximity to the exiting nerve root of the lower level without any mass effect. There is moderate facet joint disease. This protrusion is indenting the ventral aspect of the thecal sac with borderline spinal stenosis.

At the level of L5-S1, there is mild to bilateral neural foraminal narrowing caused by a combination of disc protrusion and facet joint arthropathy.

Impression:
Mild degenerative discogenic disease and facet joint arthropathy of the lumbar spine. More so in the mid and lower levels. Especially at L5-S1. There is borderline spinal stenosis at L4-5.

Thanks in advance

I took the advice from other posts to look up terms and basically answered my own question. I am posting to help others.
Comments:
Evaluation of the lumbar spine demonstrates [U]straightening of the lordosis [/U](Straightening of the lordosis is when the spine does not have it's normal slight curvature. The straightening is usually caused by muscle spasms or pain.) without any acute compression fracture deformity. There is no spinal stenosis. The conus terminates normally at L1. The STIR images do not demonstrate any discrete vertebral body lesions or bone marrow edema. There is relative decrease in the amount of bone marrow fat seen on T1 and T2 weighted images. This could be related to the high portions of hematopoietic marrow in the lumbar spine.
Evaluation of the axial images demonstrate the following:

At the level of L3-4, there is a small disc protrusion without any neural foraminal narrowing. There is moderate facet joint disease.

At the level of L4-5, there is no neural foraminal narrowing. There is a small disc protrusion (herniation of intervertebral disk: protrusion of the nucleus pulposus or anulus fibrosus of the disk, which may impinge on nerve roots.) with a posterior midline [U]annular tear [/U](occurs when the tough exterior (or the annulus fibrosus) on an intervertebral disc rips or tears.) which is in close proximity to the exiting nerve root of the lower level without any mass effect. There is moderate facet joint disease (small stabilizing joints located between and behind adjacent vertebrae. When the facets are affected in the lumbar region, a person can experience lower back pain that can go to the buttocks and upper thigh area. Significant lower back pain is rarely caused by facet disease because most patients who suffer from facet disease will often have other conditions contributing to their symptoms.) This protrusion is indenting the ventral aspect of the thecal sac (a membrane of dura mater that surrounds the spinal cord and the cauda equina. This thecal sac is filed with cerebral spinal fluid.) with borderline spinal stenosis (Spinal stenosis is any narrowing of the spinal canal that causes compression of the spinal nerve cord. Spinal stenosis causes pain and may cause loss of some body functions.)
At the level of L5-S1, there is mild to bilateral neural foraminal narrowing (Not only are the L5 and S1 nerve roots the most commonly pinched nerves in the lower back, but these nerves also feed into the sciatic nerve – a long nerve that travels from the lower back, down each leg, and into the feet. When foraminal stenosis, or narrowing, is present in the L5 and S1 spinal segments, the sciatic nerve can become pinched or pressured, leading to sciatica, meaning pain that starts in the lower back and travels through the pelvic region, buttocks, and typically down one leg to the bottom of the feet.) caused by a combination of disc protrusion and facet joint arthropathy.

Is there anyone else with similar results? The occupational medicine doctor said in a nutshell I have disc protrusion with an annual tear hitting the spinal cord which is why I am in so much pain. Next step is to see an orthopedic doctor for evaluation and probably get an epidural steroid injection (ESI) since physical therapy did not improve my condition. Just wondering about other's experiences.

Maybe, but it's kinda like there being "similar" fingerprints - no two are identical, and while there may be some similarities in generalities, patterns, and even some details, there's no way to tell between a saint and a serial killer (a person in no pain can look almost identical to a person abject pain) so it may or may not be of any help.

Doc

You did fantastic in looking up your MRI. It is better to know what is going on, then to be left in the dark and wondering. Since your condition is mild to moderate, going to another doctor for an opinion is a good idea. A neruologist can also give you a good opinion concerning the pressure on the cord. The injections also are a help. I was fused C3-7, my second surgry. I received Katamine infusions which greatly helped before my surgery. Surgery is always a LAST resort, and it doesn't sound to me like your condition warrents that kind of intervention. I really hope the injections work for you, what ever kind the doctor wants to give you. I had no pain with the proceedure of Katamine infussions. Not during or after did I get any negative side effects. The pain help lasted for about two months. I would investigate a pain management physician to admisister spinal injections. I felt more comfortable with this area of expertise rather than my neruo or osteo physician. I do wish for you all the best. I hope you get a good reduction in your pain. You did really well in your homework for the back condition, we all have to do this at some point. Take care of yourself, and let us know how you are doing. ginnie

Hah! Great analogy! Thanks

Doew anyone know how to read an MRI ? Such as: L5-S1: Broad-based 3.8 mm left posterolateral foraminal disc protrusion narrows the left lateral recess. Facet arthrosis contributes to moderate left foraminal narowing. The disc protrusion impinges upon the left S1 nerve root which is displaced posteriorly. HUH i'm clueless

Welcome to Neuro Talk. I can remember when I came here with the same kind of questions. I can help just a bit. Your MRI does warrant another opinion, no matter what treatment options have been talked about with you and your Neurologist. The one thing that stands out is the disc protrusion that impinges on left S1 nerve root. This means the disk is pushing against the nerve and that hurts. Sometimes to the point where medications no longer are effective. All conservative treatment options should be explored. Next time you go in, bring a friend with you so you don't miss anything the doctor says to you. Surgery is always a last resort. I so did not want to do my own surgery, but in the end it was the best decision I could have made. I hope you find some options that work for you. Let me know how you do. I will keep you in my thoughts. ginnie