Back and Neck Injury/MRI Results


I want a better description of my MRI results, can you help?
It says: Mild posterior protrusion of disc at the levels of L4-L5 AND L5-S1 causing mild narrowing of the neural foramen bilaterally.
L4-5 Disc height is relatively well maintained the there is a decreased signal on T2 weighted imaging.  There is the  2.5 mm posterior protrusion of the disc which is symmetrical.  No significant facet hypertrophy.  Ligament flavum is measuring 2 mm.  Combination of finding causing a mild central spinal stenosis with mild narrowing of both neural foramen.
L5-S1: Disc height is well maintained.  There is a 2 mm posterior central protrusion of the disc.  No significant faucet hypertrophy.  Ligament flavum measuring 2 mm.  The disc is causing mild flattening of the thecal sac with minimal narrowing of the neural foramen.

Hi Tyra,

Thanks for the question!

I am not sure if I can help, but I'll try. I can't give you a better description of your MRI films because I would have to see them and I'm not as good as a radiologist. What I can try to do is give you a description of the report by the radiologist from the MRI films.

I can not relate this in terms of any history or symptoms, nor can I correlate it to any physical or other examination findings. All this comes into play regarding a clinical picture of what is actually happening.

Having said that:

It would seem the summary of the Radiologists findings are in the first sentence. A protrusion is a descriptive term, often meaning a disc bulge as opposed to a herniation. There is a big difference; but there is no single standard in terminology, therefore, I would assume it is disc bulging as opposed to being herniated. Like a jelly doughnut, a bulge is similar to the jelly pushing against out the inner part of the doughnut, where a herniation is the jelly actually outside the doughnut through a tear in the outer part of the doughnut.

At both spinal levels in your lower back, the bulging can cause less space through which nerves (neural) exit the holes between the bones (foramen).

The disc between L4 spinal bone and L5 spinal bone (L4-L5) has a loss of fluid (decreased signal) on a particular MRI film (T2 weighted imaging). The disc is bulging towards the back (posterior protrusion) where the nerves are, and this bulging is spread out evenly (symmetrical). There is no indication of any significant outgrowth of the joints in the back portion of the bones (facet hypertrophy). This is usually a degenerative type of finding in the joints that help with gliding motion as when bending forward or backward. The (Ligament flavum) is a ligament that runs along the bone inside the spinal canal. This ligament can thicken or buckle and along with the disc bulging, can leave less room in the spinal canal (central spinal stenosis) where the spinal cord goes through and cause the ligament to press into the covering of the spinal cord (thecal sac), which is more in the middle of the spinal canal (central).

I hope this helps and doesn't confuse things any further.

All the best!

Dr. Steve

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Dr. Steve Ornstein


I can answer questions regarding neck and back pain treatment and general musculoskeletal conditions. Acute, chronic and degenerative conditions using various methods; exercise, rehabilitation, traction. Pain relief methods and professional quality products via website at which can be used at home.


Graduated Chiropractic College in 1987, working in numerous clinics within two states using a variety of manual and physiological therapies. Involved in martial arts for 20 years.

Chiropractor Sherman College, Certified in Physiological Therapeutics from National Chiropractic College, Certified Peer Review Consultant from New York Chiropractic College, Studied with Dr. Cox using Flexion Distraction Technique, Studied with Dr. Leahy using Active Release Technique. Myofascial Release with Dr. Rockwell - Parker Chiropractic College. Certified in Modic Antibiotic Spinal Therapy.

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