Help with MRI

billygee · 02-21-2013, 07:55 PM

Leesa question, i had was in a bad car wreck 40yrs ago.There might be disruption of the articulating facets between L3 and L4. What does disruption mean>Nerve damage?

Leesa · 02-23-2013, 06:55 PM

I guess it just means that the facet joints between L3-4 have been screwed up, possibly causing nerve damage. Whether or not it was caused by the wreck 40 years ago -- I really doubt it. You would have had alot of pain for the last 40 years, and i don't think you have, have you? So this hasn't been caused by that.

It had to have been caused by something else. Hugs, Lee

billygee · 02-24-2013, 02:02 PM

Leesa, i've always had back pain.Some days none other days alot.I remember i sometimes had leg twiching at night.It was just a thought and looking at all the possibiltys.I was on Simvastatin and one doctor mentioned timing was suspect.Also the neurosurgeon i was seeing mention the problem was with the axons. So i'll know more next month, i have alot more questions to ask.

btw my other injurys were from the car wreck-Compression fracture of the L2-L3-L4 lumbar vertebre were felt to be stable.Disc space's were all preserved.There was an additional fracuture through the right pedicle of the 3rd vertebre and the same fracture through the right 4th vertebre.Resulting widening of the interspace on the right side.With pedicle fracure of L2-L3. The pedicles L2-L3 were now noted to be intact.

billygee · 02-28-2013, 02:09 PM

Leesa, not sure what the "end plate" degenerative changes means. This is what i found online.intervertebral discs are aging./disc desiccation/
Endplates coat the top (superior) and bottom (inferior) parts of each vertebrae. Endplates blend into the intervertebral disc to help secure it in place.

Leesa · 02-28-2013, 03:15 PM

That tells me more about endplates than I could find. LOL If they're aging, it must mean that they too are drying out, or whatever happens to them when they age. Since they "coat" the top and bottom, I would THINK that it would be possible that they too could dry out. The disc dessication just means drying out too.

If those compression fractures were from the wreck, it sounds like they're pretty stable now. Bones have a way of healing themselves and growing more bone, so it's probably all healed now. Since L2 thru L4 are stable now, they must have healed.

That's GOOD!

That car wreck must have been pretty awful. I'm so glad you survived!! Hugs, Lee

billygee · 03-01-2013, 10:28 AM

Quote:

Originally Posted by Leesa

That tells me more about endplates than I could find. LOL If they're aging, it must mean that they too are drying out, or whatever happens to them when they age. Since they "coat" the top and bottom, I would THINK that it would be possible that they too could dry out. The disc dessication just means drying out too.

If those compression fractures were from the wreck, it sounds like they're pretty stable now. Bones have a way of healing themselves and growing more bone, so it's probably all healed now. Since L2 thru L4 are stable now, they must have healed.

That's GOOD!

That car wreck must have been pretty awful. I'm so glad you survived!! Hugs, Lee

Leesa, the car wreck was 40yrs ago, headon. i'm glad i survived too LOL I will ask if those injurys has any part in what going on and also talk more about what going on with the axons .

billygee · 03-10-2013, 10:42 AM

Quote:

Originally Posted by Leesa

I'll try to help Billy:

There are degenerative changes in the disc spaces in the mid and lower thoracic areas. This means that the discs are "flattening" and the vertebra are getting closer together, and since it's degenerative, its going to get worse.

There is moderate to SEVERE disc space and facet joint degenerative changes at L2-3 and L3-4. The facets are the 'wing-like' structures on each side of the spinal cord. If you hunch your back, you can feel them & even see them. There are moderate degenerative changes on the rest of the lumbar disc spaces. This means that all of the lumbar discs are flattening and the vertebra are all getting closer together. There are prominent bone spurs in the mid and lower thoracic vertebra. At the right T2-T3, there is prominent diseased facet with mild encroachment of the right rear of the spinal canal. This means that the facet is pushing on the rear of the spinal canal.

At L1-2 There is a prominent disc bulge and moderate facet disease. There is moderate to severe central canal stenosis. This means that the central spinal canal is getting narrow. Mild right foraminal narrowing is seen at L2-3 -- the foramen are the holes that the nerves pass thru to get to the spinal cord. At L2-3, the holes are narrowing. I'm not sure what the "end plate" degenerative changes means. There is a moderate disc bulge along with a right paracentral disc herniation which has increased from previous exam. There is moderate bilateral facet disease. Moderate central canal stenosis & mild bilateral foraminal narrowing.

L4-5 Moderate disc bulging with broad based with left paracentral disc herniation. Prominent bilateral facet disease. Moderate to severe central canal stenosis (narrowing of the canal) and moderate bilateral foraminal stenosis (narrowing of the foramen)

L5-S1 Moderate disc bulging & facet disease. Moderate degenerative changes of the disc spaces. (Again, the discs are flattening & the vertebra are getting closer together)

From the "Impression" the radiologist says that most of the trouble is the "persistent" encroachment in the lumbar spine, causing spinal canal stenosis. Since this is degenerative, it's not going to get any better and will probably get worse. I would take my films and get an opinion from at LEAST 3 NEUROSURGEONS, and see what they think should be done. You want to stay as CONSERVATIVE as you possibly can. Do NOT jump into surgery, as that should be your LAST RESORT. Surgery will NOT relieve all your pain. Surgery is ONLY for mechanical problems. After surgery, you will still have pain, and sometimes worse than before surgery. So make sure you have at least 3 opinions before opting for surgery as once you do it, you can't "undo" it.

I wish you the very best Billy and please let us know what you decide. God bless and take care. If you have any more questions, let us know. Hugs, Lee

Leesa, talked to my 2nd neurologist friday.He thinks my spinal canel and my back is causeing all my issues hes not 100% positive but he's seen worse,he also said back problems affects people differantlly.He also said no to another emg & nerve/Muscle biopsy.With my last nerve biopsy it shows inflamitory process & i have poly neroupthy.Something i didn't know is that when the nerves get sick & die so does the myelin sheath which what is happening with me.This doctor did say afew things that bothered me, 1st- wtf were you sent here, i said a second opinion.2nd we which i assume the vamc don't like to operate on people who smoke.Next step x-ray while i'm standing up called a Flexion & Extension of the lumbar.He did ask if i wanted to have a consultation with a surgen on 3/26 and i said yes.If i opt for surgery they would remove part of the disc which i think that would be called decompressive laminectomy.

Leesa · 03-10-2013, 04:45 PM

Keep in mind Billy, that the decomprression isn't going to get rid of all your pain. Plus it COULD cause the level above/below to fail. So I'm just warning you that you could be in for the same pain and more problems. Personally, unless I was in danger of permanent nerve damage and my spinal cord was being impinged, I wouldn't have surgery.

If he did tell you there was danger of the above, then go ahead. Otherwise, I'd have physical therapy. Take care Billy, Hugs, Lee

ginnie · 03-10-2013, 05:22 PM

What leesa told you is correct. I had the spinal fusion to start with, and wound up having more 6 years later. I am doing OK now, and the pain is less, so in my case that second surgery was the right thing to do. I did have the domino effect, where I failed above and below the first fusion. Try all therapy and do go see a few more neuro surgeons before you make any decision. I really hope that you can be helped. ginnie

billygee · 03-10-2013, 06:44 PM

Thanks leesa & Ginnie. We talked about that.It won't help the pain.It's up to the surgen what he thinks when i see him on the 26 + what the xray shows. If i have surgery it should stop the nerve damage and they would heal over time vs no surgery i'll end up in a wheel chair in 2-5 yrs??? maybe longer.On the mri 2 vertabre levels i forgot which ones theres no fluid around the spinal cord.I would rather do p/t but i have a funny feeling that won't help.If i opt for surgery i'll think about it long and hard.As far as nerve damage i know i have 1 nerve per foot thats dead from the emg tests and the rest were very slow.I'll have alot to think about.

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