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Radiology/Back and Neck pain

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Question
Thank you for your time Michael K. I've experienced lower back and neck pain for years. In February of this year I left work because of intense pain in my growing and back. I've had an MRI of Lumbar and Cervical spine. I was 41 at the time of the MRI. My pain ranges from lower back, between shoulder blades, neck, and shoulders. Causes numbness in arms, legs, and loss of strength in all extremities.

Results Lumbar
Vertebral body height and alignment appears normal. Intervertebal disc space height normal. Mild desiccation of intervertebral disc L5-1. the conus is normal.
L1-2: Normal
L2-3: Normal
L3-4: Normal
L4-5: Ligamentum flavum cyst on the left side measuring 9*5 mm. It is posterior and causes some bulging of the ligamentum flavum with mild effacement of thecal sac. Otherwise no significant stenosis. Mild facet arthropathy.
L5-1: An 8*4 mm synovial or ligament flavum cyst on the right side with minimal effacement of thecal sac but no significant stenosis of lateral recess. No compression of passing nerves. Minimal bulging. Mild facet arthropathy. No significant stenosis.

Impression
1. Synovial or ligamentum flavum cyst right L5-1.
2. Ligamentum flavum cyst L4-5 inferiorly and minimal effacement of thecal sac. Mild facet arthropathy more left than right.
3. Mild to moderate facet arthropathy evident from L3 through S1 bilaterally.
4. No significant spinal stenosis.
5. Early degenerative disc disease L5-1.

Cervical
The study is limited due to extensive motion artifact and patient body habitus.
Vertebral body height, alignment and marrow signal appears normal. Minimal effacement of the thecal sac evident at some levels. The axial sequence 7 shows no significant spinal stenosis. The cord is not deformed. Some desiccation of intervertebral discs, but marrow signal is normal. No foraminal or spinal stenosis identified.

Answer
Hello Gordon,

Sorry for  the delay.

From MRI it looks like there is nothing significant from the disc degeneration. They mention no significant canal stenosis that would give you symptoms from cord compression.  Formaina where the nerve exists the spine to go to the muscles are also not significant.  The pain in the back may be from facet joint degenerative changes...

I would see a pain specialist who can do different injections and see what causes you pain.   They can do epidural vs facet vs nerve sleeve injections...This together with a good physical exam correlating your pain to certain levels may be of significant help to figure things out.

Hope this helps.

MK

Radiology

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Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

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