Radiology/MRI scan results
Hi, I am 62 year old male with constant lower back pain going into my legs and also my shoulders and neck. I previously had a CT Scan earlier this year which showed severe degenerative arthritis of the lumbar region. My specialist sent me for an MRI last week to see what was going on in further detail. I have the results but would like a second opinion on what it all means. thank you for any help you can provide.
MRI LUMBAR SPINE Clinical History: OA. Technique: T1 and T2 sequences were taken in axial and sagittal planes from L1 to S1
There is desiccation of the disc at L1/2, with no significant disc bulge seen. There is degenerative
change in the posterior apophyseal joints. The foramina are patent.
The disc is normal at L2/3.
At L3/4, there is circumferential disc bulging, effacing the anterior aspect of the thecal sac. The
foramina are patent on both sides.
At L4/5, there is circumferential disc bulging effacing the thecal sac, causing slight narrowing of the
canal. The foramina, however, are patent, and the nerve roots are leaving freely.
At L5/S1, there is a small annular tear with a small broad-based posterior disc protrusion, slightly
more marked on the right side effacing the theca and the anterior aspect of the S1 nerve roots.
The L5 nerve roots leave freely.
There are degenerative changes in the apophyseal joints at all levels.
1. There are degenerative changes in the apophyseal joints at all levels.
2.There is disc bulging with effacement of the thecal sac at L3/4 and L4/5.
3.There is a small broad-based disc protrusion at L5/S1, impinging upon the anterior aspect of the
theca, more marked on the right side.
There are plenty of technical terms here to describe the exact appearance of the spine.
Overall, there is nothing unexpected here for a 62 year old. We all have many changes like that. The important thing is to correlate carefully what type of pain and where you have it with what is seen on the MRI. Often many of the degenerative findings are completely silent. Your doctor should correlate if you have pain in the distribution of L5 nerve roots and if not then I wouldn't worry about what's on the MRI.
The best thing to do is to see a pain specialist who can do several types of injections into the facet (apophyseal) joints or around the nerves and see if these will help.
Hope this helps somewhat.
Sorry that my answer didn't meet your expectations. While the detailed meanings of all the terms can be elaborated on, I would rather stress the point that what is on MRI is often not the cause of symptoms. What I would like though is for people such as yourself is to get second and third opinions from doctors who can actually correlate physical exam findings to what can be seen on the MRI as a POTENTIAL cause. I also discourage any type of spine surgery for pain relief unless you feel that you are disabled from pain and medications or injections do not provide any pain.
I often answer questions in this forum regarding MRI of the spine. There are plenty of published answers by me that explain technical terms.
If you have any further concerns or specific questions, I would be happy to answer them.