Radiology/deciphering MRI

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QUESTION: Findings:  There are presumed to be five lumbar-type vertebrae with last fully formed disc space at L5-S1. The conus medullaris is normally positioned. lumbar vertebral height s and alignment are preserved. bone marrow signal is unremarkable.
At L4-5 there is disc desiccation with mild loss of disc space and height and mild diffuse disc bulge. The sagittal T2 and STIR images demonstrate a hyperintense annular tear in the right paracentral right foraminal region, and there is a small amount of soft tissue in the right lateral recess/right forminal region that is hypointense on the T2 images, of intermediate signal on T1 images and enhances. with previous laminectomy on the right at this level, this is most suggestive of scar tissue. right neural foraminal narrowing mild. at L5-S1 there is disc desiccation with mild diffuse bulge and no significant central canal or neural foraminal narrowing.
IMPRESSION:  1. POST-SURGICAL CHANGES ON THE RIGHT AT L4-5. THERE IS SOME SOFT TISSUE IN THE RIGHT LATERAL RECESS WHICH COULD POTENTIONALLY CONTRIBUTE TO RIGHT L5 RADICULOPATHY. THE SOFT TISSUE ENHANCES SUGGESTING SCAR TISSUE RATHER THAN RESIDUAL/RECURRANT DISC
2. MILD CHRONIC DISC BULGES AT L4-5 AND L5-S1.

PLEASE HELP ME TO UNDERSTAND THIS!!!

ANSWER: Hello, Deena.

Scar tissue from your previous spinal surgery may be pressing on a nerve on your right side. This could cause pain in your right buttocks and/or down your right leg.

You also have a couple of mild persistent disc bulges in your low back. Here is a good article about the difference between Bulging & Herniated: http://www.laserspineinstitute.com/herniated_disc/articles/herniated_vs_bulging/

I also found a great short video about disc dessication here: http://youtu.be/f6GUeygEw7o

Your doctor is the best person to advise you on treatment.

Hope this helps,
Delia White

---------- FOLLOW-UP ----------

QUESTION: I also have pain and numbness in my left leg and foot and when I am on my legs for a bit like doing dishes both my legs are so weak and even have pain in my back when walking to the point my legs will sometimes give out I never know when my legs are going to give out from under me.  its a bit scary. is this also related to my problem. and what scares me is I looked up that radiculopathy word and it talks about nerve disease ( could  cause) the disease and also that scar tissue problems from previous surgery even though successful at the time is considered a failed surgery and most surgeons will not accept that.  also do you know do I have to return to the same surgeon that did my surgery 3 yrs ago or can I see a new one?  I know I asked a lot of things and that this is just advice but it helps me make decisions that I am struggling with thank you again for your time and understanding, I greatly appreciate it. it helps me so I know what questions to ask drs and where to go to ask them. thank you again.

Answer
So sorry to hear about your troubles, Deena.

You do not have to return to the same surgeon if you don't want to. In fact, I'd recommend you interview a couple of surgeons to get a second and/or third opinion.

Alternately, you might find help at a pain management clinic.

Feel better soon,

Radiology

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Delia White

Expertise

I am not qualified to interpret diagnostic imaging or to diagnose disease. Please consult a physician for that information. I am the photographer. I can tell you what to expect during most MRI, CT and X-ray procedures.

Experience

I now have more than 30 years experience in diagnostic imaging. My specialty is MRI. I am also very familiar with CT and the way we used to take x-rays (everything's digital now)!

Education/Credentials
I received my Bachelor of Science degree in Radiologic Technology.

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