Herniated Disc Questions and Answers Archive 2011 Part 1

This Q&A section is not intended to diagnose or treat any medical condition. Any medical condition should be referred to a qualified medical professional.

Q: Hello Adam. Just found this site and was wondering if you can shed some light on my MRI. I had a ruptured disc back in 1998 when I was 19. Cause unknown. I'm now 32 and think I may need another surgery. If you can let me know how serious this diagnosis is. MRI. There appears to be previous surgery at the L5-S1. There is a gradient artifact within the superficial soft tissues of the posterior back at this level. There is mild grade 1 anterolisthesis of L5 on S1. Otherwise the alignment at the remaining levels is maintained. The vertebral body heights are grossly preserved. There are herniated Schmorl's nodes within the endplates at all levels from L3-S1. There are no compression deformities. There are small anterior osteophytes at multiple lower lumbar levels. There are mild degenerative reactive endplate changes from L3-L4 through L5-S1. there is no definite evidence for marrow replacement. There is loss of T2 signal within the L5-S1 disc compatible with degeneration. The remaining lumbar discs are grossly intact. There is prominent diffuse underlying congenital narrowing of the visualized lumbar and spinal canal. At T10-T11 and T11-T12 there are incidental shallow generalized disc bulges as well as prominent facet and ligamentum flavum thickening at these levels. These levels are not well evaluated on this study. This appears to contribute to at least mild bilateral neural foraminal stenosis. At L1-L2, there is a shallow bilobed disc bulge which combines with prominent facet hypertrophy to produce mild bilateral neural foraminal stenosis. The central canal is patent. There is fluid within the facets. At L2-L3 and L3-L4, there are mild diffuse generalized disc bulges which combine with prominent facet and ligamentum flavum hypertrophy to produce mild central canal and mild to moderate bilateral neural foraminal stenosis within the inferior portions. There is fluid in the facet joints. At L4-L5, There is a mild diffuse generalized disc bulge with a superimposed broad-based central disc protrusion . This measures 2mm in AP diameter. There is also posterior endplate spurring. This may encroach upon the bilateral L5 nerve roots and possibly the bilateral L4 nerves. At L5-S1 there is a diffuse underlying generalized disc bulge with a superimposed bulky broad-based central/right paracentral residual or recurrent disc protrusion. This measures 5mm in AP diameter. There is also posterior endplate spurring. This impinges upon the bilateral S1 nerve roots greater on the right and the bilateral exiting L5 nerves, also greater on the right. This combines with facet hypertrophy to produce moderate stenosis of the central canal greater on the right, marked right and moderate left lateral recess stenosis as well as bilateral neural foraminal stenosis. Before I had surgery I had pain down the left leg. Now I have pain down my right leg. As we speak it feels like someone is pulling down on my hips and someone is standing with one foot in the middle of my back. Wondering if I should get surgery again? Thanks, Michael

Q: Hi Adam. I injured my neck throwing a fishing cast net 18 months ago and after chiropractic and physio treatment as well as rest it came right after about 8 weeks. About 9 months later I injured it again arm wrestling with my son. This time after chiropractic and physio and rest it took 5 months to feel like it had healed. Then about 3 weeks ago I hurt it again by simply lifting a boat battery. So I went in for an MRI and two neurosurgeons suggested urgent surgery (fusion and discectomy)because the spinal cord and some nerves are almost completely compressed with several herniations, and the really bad one at C5/C6. There was bad pain in the neck and shoulder. I have rested it for three weeks - really rested it because I could hardly move - and today there is a big improvement. The pain is not so severe but its still there. I am considering endoscopic surgery rather than fusion and full discectomy. Experience has shown me that the neck injures much more easily and takes much longer to "come right". However any sane person would rather not have any kind of surgery if there was any chance of recovery with conservative treatment. The doctors I have seen indicate that there is a good chance that I might permanently damage the spinal cord if I don't go for surgery. I would very much appreciate your thoughts. Regards. Jack

Q: I had an MRI of my lower back recently, and do not understand what it means. The doctors usually just tell me that it shows there is a reason for my chronic back pain. There are a few phrases that I don't understand. 1) At L4-5, there is disc desiccation with a broad posterior bulge and evidence of minimal annular tear. There is mild facet joint osteoarthropathy and ligamentum flavum hypertrophy on the left. There is mild to moderate bilateral lateral recess narrowing with questionable slight compression of the L5 nerve roots. There is mild left and minimal right foraminal narrowing with no nerve root compression. 2) At L5-S1, there is spondylosis with a broad posterior bulge and focal central to right paracentral inferior disc extrusion extending approx. 5 mm below the superior endplate of S1. This measures approx. 1.3 cm in transverse dimension and approx. 6-7 mm in AP dimension. 3) There is minimal central canal narrowing with mild bilateral lateral recess narrowing.4) At the visualized thoracic levels, there are minimal posterior bulges with no significant facet joint osteoarthropathy or narrowing. There may be minimal mass effect on the spinal cord at the T10-11 level. Can you put this in English please? lol Thank you for your time. Angela

Q: Hi! Please help. I am 6 weeks post-op discectomy. I have had persistent burning,searing pain in lower left back pre and post surgery.my quad muscle is weak but slightly improved and my knee buckles when least expecting it.My burn is there when I sit or ly down and it can come and go in waves depending on my hip movement,but never really goes away. I have not seen my neurosurgeon post op yet and will not be seeing him until 9 weeks postop. I signed consent for microdiscectomy but I haven't spoke to Dr. yet. Do you think it wasn't my problem to begin as I still have that burning in lower back. I do feel the numbness in lower front of leg and aching quad muscle is improving though. Thanks for your opinion. Debra

Q: I have an MRI report that I don't really understand:At the L5-S1 disc space level, disc bulge is noted deforming the anterior epidual fat and the anterial margin of the thecal sac with extension to the lateral recess or neural foramen - Loss off disc signal. At L4-5 central disc herniation is noted deforming the thecal sac with extension to the lateral recess or neural foramina. Mild facet and ligamentous hypetropic changes are noted. L2-3 and L3-4 left neural foraminal dis hernation at both levels abutting the left L2 nerve root at the L2-3 disc space level and abutting the exiting left L3 nerve root at the L3-4 disc level, with associated left-sided neural foraminal narrowing at both levels. No evidence of deformity of the thecal sac on the midline sagittal image. Right paracental component is noted within the proximal neural foramina without evidence of neural foraminal compromise. Impression: L4-5 central disc herniation. L2-3 and L3-4 left neurall foraminal disc herniation at both levels abutting the exiting nerve roots with associated left-sided neural formal narrowing. L5-S1 disc bulge. I have sharp and burning pain in my back and left buttocks. Some numbness and tingling and pins and needles in my left leg. Thank you, Linda

Q: What does it mean 1. Two to 3 mm right lateral protrusion of the L3-4 disk and tenting the exit of the right L3-4 neural foramen. a. Slight displacement of the existing right L3 rootb. This protrusion contains a high intensity zone consistent with tearing of the peripheral fibers of the annulus. 2. 2-3mm central protrusion L5-S1 without evidence of displacement of the nerve roots 3. Degenerative changes in the L2-3, L3-4, and L5-s1 I went to the doctor after an injury and continued Left groin and testicular pain. He indicates the MRI results do not correlate with my symptoms. Thanks very much for your time! Mike

Q: Last 2 years I am suffering by neck pain.I consulted with many dr. But still i am getting pain. Here is my MRI SCAN REPORT. Please check and give your advice.MRI OF CERVICAL SPINE: SEQUENCES USED WERE (T1W1 SAGITTAL AND T2WI GRADIENT ECHO AXIAL) * Apparent dilatation of the central canal fo the spinal cord seen at the leavel of C4-C5 Disc. * C5-C6:Central bulge with smooth indentation of the thecal sac seen.Both neural canal are preserved. * C6-C7:Posterior focal fibrous annular tear seen.Both neural canala are preserved.* The cervical spines look normal in height alignment and signal intensity. No focal bony lesion could be seen.Normal lordotic curvature mild degenerative changes of the cervical spines are seen with osteophyte formation.* The cervial end plates look normal .No sign of degeneration.* The cervical discs maintain normal height and signal intensity. No sign of degeneration.*The rest of the cervical discs are confined to the outlines of the corresponding end plates and vertebral bodies.no sign of disc prolapse.*Normal looking cranio-cervical junction area.No fooal pathology could be seen.* Normal looking ligament flavum and facet joints.* Normal posterior epidural space. No focal Pathology could be seen.IMPRESSION:* The MRI findings are in line with apparent dilatation of the central canal of the spinal cord seen at C4-C5 disc level measuring less than 3mm in diameter suggestive.* Central bulge at C5-C6 disc with no compression of the exiting nerve roots. MS

Q: Hello, I was wondering if you could review the finding and dumb it down for me. I have moderate thoracic pain and electrical impulses daily. Sitting for periods of time is almost impossible. I am a dental hygienist as well. My thoracic pain has been present for approx. 4 years. Finally requested an MRI after an acute pain and stiffness attack in my neck halfway through a work day. MRI results are as follows......Findings, There is a straightening of the usual cervical lordosis with perhaps slight kyphosis. The cerebellar tonsils are borderline low-lying, esp. on the left, but no Chiari malformations or syrinx is detected. Congenital cervical spinal canal stenosis results from short pedicles.C3-4 Asymmetrical left uncovertebral joint spurring causes mild left foraminal stenosis. C5-6 Disk herniation of the extrusion type begins in the post. midline and ascends along the left post. margin of the C5 vertebral body for 10 mm to the level of the left C5 pedicle. Herniated disc material and assoc. inflammatory tissue measures up to 9x4 mm transverse (mediolateral x anteroposterior) with flattening of the left anterior thecal sac and cord. Disk material compresses the left C6 nerve root in the foramen. C6-7- minor disc bulge barely flattens the anterior thecal sac. Asymmetric left uncovertebral joint spurring causes mild left foraminal stenosis.IMPRESSION: 1. Disc herniation of the extrusion type at C5-6 ascends along the left posterior C5 vertebral body with moderate sac and cord flattening and compression of the left C6 nerve root in the foramen. 2. Congenital cervical spinal canal stenosis due to short pedicles. 3. Additional mild left foraminal stenosis at C3-4 and C6-7. I feel like my pain is mostly in my thoracic back. I also have limited motion of my right shoulder. Expl. putting on a coat with that arm really hurts. Also my rt. arm gets prematurely tired and feels heavy. Approx. 2 yrs ago xrays showed that I had moderate osteoarthritis and degenerative disc disease and some bone spurs in the thoracic back but MRI did not show anything other that a minor disc bulge at T10-11 that barely flattens the anterior thecal sac. What is likely to come of this. I have been referred to a spine surgeon. Thank you so much for your time! Olivia

Q: I have an MRI image that shows L5-S1 A 5mm central disc extrusion is seen with annular tear with slight caudal migration. There is a mild narrowing of the caudal aspect of the neural foramen bilaterally due to superimposed disc bulged. there is a bilateral facet antrhopathy. There is mild central spinal canal stenosis.Impression: A 5-mm central disc extrusion is seen at L5-S1.I've had pain in buttocks and it goes down to my heels with a burning sensation and my feet are cold, and now I urinate quite frequently. Each time that I bend slightly i get a pain in the lower upper back of the spine, also when standing or walking it feels something opens. In mornings when walking or standing after bed I get cramps in my upper back. I have received 3 Epidural injections and has sent me to take another MRI and in the other image is says L5-S1 disc level shows a 4 to 5 mm. Posterior disc protrusion present. Disc dessication is present. Moderate hypertrophic facet changes are present. Neural foramina appear patent. There is no evidence of spinal stenosis.I had taken an exam for the lower back nerves and the result was No electrodiagnostic evidence of focal/generalized perpheral neuropathy in either lower extremity. I have been taking physical therapy and have not seen a neurologist. My big question is if 5mm is not a big deal it's been a year and up to date the pain does not let him work, difficult time standing up, or even walking. If 5mm is not a big deal what should I do? tell the doctor to do a cat scan or what? I am lost on what I should do, it's been more of their doings and I am just lost on what and how I should take care of this problem. Thank you for this and see if I can get back to the normal life. All of this started when falling on butt during work and the symptoms have been worst. Adriana

Q: Recent MRI shows c3/4 mild broad base disc bulge. Large disc herniation on the left c6/7smaller disc herniations on left c3/4 and c/5. and a broad base disc bulge eccentric to the right at c5/6. c/7 is compressing my nerve, hence the pain and discomfort. wearing neck collar and taking motrin at this point. Follow up in a few days with neuro. Could therapy and possible traction be in my future? Just any advice would be helpful. Thanks, Dennis

Q: From past one week i have tingling both legs but don't have any back pain and my doctor suggested to go for MRI, below is the MRI report INTERVERTEBRAL DISCS L1 - L2 to L5 - S1 discs show minimal bulge indenting thecal sac. IMPRESSION MRI OF LUMBOSACRAL SPINE SHOWS 1. MILD DECREASE IN HEIGHT OF L3 VERTEBRAE WITH LARGE SCHMORL'S NODE. 2. SMALL SCHMORL'S NODES IN OTHER VERTEBRAE. 3. MILD CANAL STENOSIS AT L2 TO L4 LEVEL.4. MINIMAL BULGE OF L1 - L2 TO L5 - S1 DISCS INDENTING THECAL SAC. Is it minor problem? Is it can be controlled with medicine Request you provide your suggestion. Thanks, Sethu

Q: Hi Adam,I was in an auto accident a year ago and have had pain that is unimaginable. I have a very high tolerance for pain (15 root canals for example and 4 surgeries in the past, not back related) and am now on my last straw. I have done everything from cortisone shots that sent my body into adrenal deficiencies to nerve blocks as well as nerve burnings on both sides of my back. I am on severe pain meds and am willing to do anything to find out how/what will help me. I was hit by an 18 wheeler in my car last year that sent me into a 360 and that is when this all began. I have a past of lower back issues, stenosis etc, bulging disks in L4 L5, but they have taken a back seat to this pain that is primarily right behind my heart. I have MRI's every 3 months and the pain has only become worse.These are the findings from my latest MRI on 12*29*10Thoracic: Comparison is made to a study done on July 27 2000No evidence of subluxation or dislocation. There is minimal wedgecompression deformity of T11 without any marrow signal abnormality. Schmorl's nodes are present along the superior and inferior endplate of T12. There is no marrow signal abnormality in any of the vertebral bodies. The soft tissues are also within normal limits. At T6-T7, there is a smaller right central focal disc protrusion which contacts the cord without compression.At T7-T8, there is a small central posterior disc protrusion witheffacement of anterior CSF. No cord compression.Minimal disc bulge is also present at T11-T12 without significantcanal stenosis. There is no signal abnormality in the cord.Conclusion: Degenerative changes in the discs at T6-T7, T7-T8 with small disc protrusions which contact the cord without compression. Minimal wedge compression deformity of T11 which could be within normal limits for this vertebral body. Cervical;Final Report MRI of the cervical spineHistory: History of MVA. Chronic pain. Decreased range of motion. Comparison: Study done on October 10, 2009Findings: No subluxation or dislocation. There is no evidence of tonsillar herniation. The vertebral bodies and the disc heights are maintained. The pre- and postvertebral soft tissues are within normal limits. C2-C3, normal canal and the foramina.At C3-C4, normal canal and the foramina.At C4-C5, there is a mild right foraminal narrowing due tohypertrophic changes. The canal and the left foramen are normal.At C5-C6, the canal and the foramina are normal. There is a smallposterior osteophyte.At C6-C7 and C7-T1, the canal and the foramina are unremarkable.There is no signal abnormality in the cord.Incidental note is made of a benign small perineural cysts in theneural foramina at the C5-C6 through C7-T1.Conclusion:Stable mild degenerative changes. Mild right foramina stenosis atC4-C5. No significant canal stenosis. With new pain now between my shoulder blades and in my neck they did another C MRI, and this is what they found! Any thoughts or advice you have, I am all ears..drugs are NOT working and I would like to have my life back. Many thanks in advance for your time and energy. Nancy

Q: Dear Sensei Adam, This site has been a blessing. I am very thankful that people like you exist that help others with their knowledge. Here is my case, male 34 yrs, 180lbs, 5' 10" otherwise healthy individual. Including MRI below. Pain started after doing vertical leg press about 10 months ago. The pain was very severe for couple of weeks and then came down to discomfort level and has been like for the past 9 months. Had an MRI which showed disc herniation at L5-S1. However after reading materials on your website it should have healed in 6-7 weeks but in my case my pain has gone on for 10 months. My questions are:1) Is disc herniation likely to be cause of my pain (low back extending into right buttock, very little to no pain in the leg)?2) From the MRI report is the nerve impinged?3) What should be best course for treatment. MRI REPORT Findings: Slight retrolisthesis L5-S1, mild congenital narrowing of lower spinal canal. No significant spondylosis, suspicious osseous lesion or fracture. Mild disc degenration L5-S1.L5-S1 mild disc bugle with a superimposed broad-based medium-sized central disc herniation, slightly more pronounced right of midline with compression, mild thecal sac and moderate right descending S1 nerve root, which is also posteriorly displaced; mild/moderate spinal stenosis L4-S5.Conus medullaris terminates normally at T12-L1. Subarachnoid space is unremarkable. No evidence of paraspinal mass. Aorta maintains its normal caliber. Impression: 1. L5-S1 broad based medium sized central disc herniation, slightly more pronounced right of midline with compression, mild thecal sac and moderate right descending S1 nerve root, which is also posteriorly displaced. 2. Congenital narrowing of the lower spinal canal and mild spinal stenosis at L4-L5. Mild/moderal spinal stenosis is also noted L5-S1. Abhinav

Comment: MRI OF CERVICAL SPINE: SEQUENCES USED WERE (T1W1 SAGITTAL AND T2WI GRADIENT ECHO AXIAL) * Apparent dilatation of the central canal fo the spinal cord seen at the leavel of C4-C5 Disc. * C5-C6:Central bulge with smooth indentation of the thecal sac seen.Both neural canal are preserved. * C6-C7:Posterior focal fibrous annular tear seen.Both neural canala are preserved.* The cervical spines look normal in height alignment and signal intensity. No focal bony lesion could be seen.Normal lordotic curvature mild degenerative changes of the cervical spines are seen with osteophyte formation.* The cervial end plates look normal .No sign of degeneration.* The cervical discs maintain normal height and signal intensity. No sign of degeneration.*The rest of the cervical discs are confined to the outlines of the corresponding end plates and vertebral bodies.no sign of disc prolapse.*Normal looking cranio-cervical junction area.No fooal pathology could be seen.* Normal looking ligament flavum and facet joints.* Normal posterior epidural space. No focal Pathology could be seen.IMPRESSION:* The MRI findings are in line with apparent dilatation of the central canal of the spinal cord seen at C4-C5 disc level measuring less than 3mm in diameter suggestive.* Central bulge at C5-C6 disc with no compression of the exiting nerve roots. MS

Q: I am all to familiar with back pain as I have had a multi level discectomy done back in march of 06. I am back for round two it seems. I have my MRI report in front of me and am looking for the meaning of a "parasagital anterior epidural soft tissue abnormality extending from L4-5 to L5 S1" I understand that L4 etc are the disc numbers, It is the other that I do not understand. Any clarity that you can pass along to me would be greatly appreciated. Thank you again, Robin

Q: I have been told I need a Fusion on the #5 lumbar. I had a operation and moved the sciatica and trimmed the bone 2 years ago, now the gel is more collapsed and the bone is hitting when I lean forward. it is extremely painful when I do. Is there anything that can be done instead of fusing. The doc said there wasn't. thanks, John

Q: I was involved in a car accident that caused a 1-2mm herniation on disc c2-c3, and c5-c6. Also their was a bulging annulus at c6-c7 with flattening of the interior aspect of the thecal sac. My question is if it still safe for me to weight lift and and play sports? I'm young, and i love to be physical when playing sports. I don't feel any pain anywhere, and I feel like i've always felt. also, could my conditions get worst with time? hope you can give me some advice. Thanks, Cristian

Q: Can you explain exactly what my MRI results mean and how "bad" the results are? It says: small broad-based bulge at C4-5 which narrows the ventral epidural space. There is a small disc bulge at C5-6. There is a broad-based bulge with left lateral herniation at C6-7. Disc herniation extends into the left lateral recess and abuts the nerve rootlet. Cindy

Q: Hey! Awesome site, you're quite knowledgeable, which is admirable. So, with that being said, is there any way you could please, please help explain to me what these Lumbar MRI films mean?? I'm SO confused. Nobody explained anything to me, I just got the MRI films after MRI was taken & was sent on my way, no explanation. (I realize I need to wait for the report, but my doc is closed until Mon, and that's 4 days away, I would LOVE to know NOW what the results are!!) Perhaps YOU could help me, PLEASE?!?! Ok, so there are all of these numbers and abbreviations throughout the 5 sep. pages of films. What do they mean? Some examples include: N 2 F 30.0 TR 1374.0 TE 110.0 M 245x245 V 1.22x1.22x4.5= 6.75FONAR 0.6 T (Directly across (to the right)from the above jibberish, are these numbers) (listed below): pMRI=Ver -4.1 S -62.4 A -15.9 L sag Then at the end of the pictures are these things; SEQUENCE..... fsesp20 DESCRIPTOR... DrvnEq FSE: Hz/pix=91.02. Et=9. ES=22.0. EOff=0 RECVR COIL... Quad Planar TUNING....... C-PG V=(2.2.2.6) PA=47(44) CG=(4.3) FG=(247.212) FILTER....... IDS_A02 PAT ORIENT... HFS pMRI=VerPE FT SIZE... 429 DISPLAY MATRIX.. 245 SITE: 358 OP: MO REL: 7.1.4 What in the world does ANY of that even mean??? If you could shed some light on this I'd be forever indebted to you! I could even scan the film/s and email them to you too, so you could have the actual images to go along with all the weird caveman drawings, lol. Thank you for your time!!! Rosemary

Q: Here's report went to Ortho guy today and he wants to do epidural cortisone for spondylosis at the lumbar region... what about the middle back pain? is that the T11-12?CLINICAL INFORMATION: 50-year-old female with complaints of low back pain. Bilateral leg pain with weakness and numbness in the lower extremities greater on the right. Chronic symptoms over the past year with no specific injury or trauma. No history of lumbar surgery with no prior imaging for comparison. TECHNICAL INFORMATION: All sequences were performed on a 1.5T high-field scanner. T1-weighted sagittal, T2-weighted FSE sagittal, STIR sagittal and non-angled T2-weighted FSE axial sequences were performed of the lumbar spine. Selected angled T2-weighted FSE axial images were also obtained through the pertinent intervertebral discs. INTERPRETATION: The lumbar lordosis is maintained. There is however Grade I, 6 mm of degenerative anterolisthesis at L4-5. Moderate multilevel anterior and lateral osteophytic spurring throughout the lumbar spine. Several scattered intraosseous hemangiomas are identified with patchy areas of fatty marrow conversion. No compression deformity within the lumbar spine. The conus terminates at T12-L1 and is grossly normal in appearance. Diminished AP canal diameter throughout the lumbar spine related to congenitally short pedicles. The visualized sacrum appears intact with mild anterior osteophytic spurring along the SI articulation. The following disc levels are evaluated. L5-S1: Mild to moderate disc desiccation with mild loss of disc height. Generalized annular bulge with broad-based left paracentral/subarticular protrusion measuring 6 mm in AP diameter deforms the left ventral thecal sac. Lateral recess stenosis with posterior displacement and mass effect on the descending left S1 nerve root (axial T2 image 7 of series 6). No right-sided S1 impingement is present. Moderate facet joint degeneration with foraminal stenosis related to prominent marginal spurring. The L5 nerve roots appear to traverse without definitive impingement. L4-5: Mild to moderate desiccation and loss of disc height with uncovering of the posterior disc margin related to degenerative anterolisthesis. Annular bulge deforms the ventral thecal sac. Ligamentum flavum hypertrophy with moderately severe facet joint arthropathy and congenital stenosis results in moderate central canal stenosis (axial T2 image 6 of series 7). Lateral recess narrowing greater on the left without clearly defined descending L5 impingement. Gaping facet effusion is present on the right with foraminal deformity related to anterolisthesis and lateral bulging. The L4 nerve roots appear to traverse without impingement. L3-4: Mild desiccation and loss of disc height with generalized annular bulge. Mild congenital canal narrowing without herniation or impingement. Mild right and mild to moderate left facet degenerative arthropathy with inferior foraminal narrowing related to prominent marginal spurring without exiting L3 impingement. L2-3: Mild desiccation and loss of disc height with annular bulge. Mild congenital canal narrowing without herniation or impingement. Mild facet joint arthropathy with inferior foraminal narrowing but no exiting impingement. L1-2: Disc desiccation with subtle annular bulge. No herniation or impingement with inferior foraminal narrowing but no exiting impingement. T12-L1: Grossly normal disc morphology without herniation or impingement. No significant foraminal compromise. T11-12: Disc desiccation with annular bulge. Evidence of central disc herniation with cephalad migration as seen on sagittal T2 image 8 of series 2 results in deformity of the ventral thecal sac. Suggestion of ventral cord flattening without clearly defined suspicious cord changes. The study was not performed for dedicated evaluation of the lower thoracic spine. CONCLUSION: 1. Broad-based left paracentral/subarticular disc protrusion at L5-S1 results in lateral recess stenosis with descending left S1 impingement. 2. Moderate degenerative and congenital canal stenosis at L4-5 with lateral recess stenosis but no definitive L5 impingement. 3. Grade I, 6 mm of degenerative anterolisthesis at L4-5 secondary to moderately severe facet arthropathy. 4. Mild degenerative and congenital narrowing L2-3 and L3-4 with disc bulge but no additional herniation or descending impingement. 5. Multilevel foraminal deformity without definitive exiting impingement with chronic-appearing disc herniation at T11-12 as described. Kim

Q: HI, I AM RAJESH 40 YEARS MY MIR report is normal only one thing is about cervical spine reveal that SPONDYLOTIC CHANGES WITH DISC DEGENERATION AND SMALL POSTERIOR DISC BULGES ABUTTING THE THECAL SAC What it means and what i should for it? Rajesh

Q: Hi, i am really at odds at how to decipher my mri report. My neurologist says i have a very bad back and will try physio and weight loss which if not successful then surgery is second option. I am 36 yrs and have done jobs in the past which involved lifting. I didn't realize there was a problem till i started getting numbness and tingling in arms and face. The report says there is loss of lordosis in cervical spine. C5/6 small posterior disc osteophyte bar encroaches on spinal canal but no neurological compromise. C6/7 posterior and left lateral disc protrusion that extends into the left neural foramen compressing exiting left root.Disc degeneration with small disc osteophyte bars at T5/6, T6/7, T7/8. AT T7/8 there is a disc osteophyte bar extending into left juxta foraminal recess impinging marginally onto the spinal canal but not causing direct compromise of the cord of exiting roots.Lastly L4/5 posterior disc osteophyte bar and a tiny annular tear, with hypertrophy of the ligamentum flavum on both sides. It seems like a whole lot of back issues and i feel so bad for letting it get to this stage through my carelessness. Please help to interpret the report, i just want to know the real situation with my back. Thank you for all the effort you've put in this blog. Anita

Q: I have severe leg pain for last week. the MRI says "moderate left foraminal stenosis at L5-S1, secondary to a foraminal disk protrusion superimposed on osteophyte formation. what does this mean? How serious is it? Is there anything i can do to prevent it from happening/worsening? thanks much, Suzanne

Q: Hi! I'm female 45 years.On the MRI of the cervical spine... I will like to understand what this impression means: C3-4 central disc herniation causing no cord or nerve root impingement. C4-5 disc herniation- osteophyte complex causing borderline central spinal stenosis and slight cord deformity. C5-6 disc bulging and vertebral osteophytes causing mild central spinal stenosis with no cord compression. mild bilateral C6 foraminal stenosis.Thanks for your help, Lila

Q: hi following years of lumbar spine problems and multiple surgeries i now have cervical spine problems. have just had mri and don't fully understand report. " at c4-c5, c5-c6, c6-c7 levels, disc osteophyte bars are noted narrowing the anterior thecal space at these levels. at c6-c7 there is a broad disc osteophyte bulge narrowing the lateral recess and the exit foramen on the left side. no evidence of spinal cord compression " would be grateful if you could explain the terms osteophyte in particular. thank you, Susan

Q: I had an MRI in December showing: disc degeneration at L3, L4 and L5.1, mild scoliosis, straightening of the lumber spine (not sure if due to muscle tightening) bulging disc at L3/4, herniated disc at L4/5. He said that he would recommend a full L4, possible partial superior L5 laminectomy and discectomy given the size of my disc herniation. He said when the disc herniation is small or off to one side more than the other, he favors a unilateral approach but in my case he is concerned about leaving residual disc material approaching from one side only. They have scheduled surgery for later this month. I was going to get a second opinion but they said I would have to cancel my surgery in order for them to make another appt. with another neurosurgeon. I don't want to make my surgery any further out so I didn't get a second opinion. Currently I can barely walk due to sciatic nerve pain down my right leg and numbing in my toes. Even pain killer don't help too much. I am most comfortable leaning over a shopping cart. I also can't stand straight and have to lean to the left and forward at all times. He plans on doing a full laminectomy on L4, disectomy and possible partial laminectomy on L5. He said I will be in the hospital for 3 days and out of work 2-6 weeks. Is this a common surgery and is mild scoliosis cause any additional problems that you are aware of? Susan

Q: My mri scan says at T9-T10, there is posterior disc protrusion on the left,which . A moderate degree of asymmetric neural foraminal stenosis is present on the left.also effaces the dural sac but does not result in cord flattening. A moderate degree of asymmetric neural foraminal stenosis is present on the left. What does this mean? James

Q: i have diffuse bulging with superimposed tiny disc protrusion centrally minimally impinging upon the thecal sac. mild facet hypertrophy and small annual tear.@ L4-L5. it says no nerve root impingement. i feel sharp shooting pain its like nerves are being pressed.also numbness in both sides of butt when i sit or stand too long. mostly sitting at these times i have pain down right leg to knee and at times to heel. EVEN THOUGH IT SAYS NO NERVE ROOT IMPINGEMENT SEEN. CAN IT STILL BE HAPPENING? I FEEL THEY DON'T BELIEVE ME. THAT I HAVE THIS KIND OF PAIN. I FELL FROM A RAIL CAR IN JULY, ABOUT 12 FT DROP, ALL ON MY RIGHT SIDE. OTHER PROBLEMS WITH NECK ETC. THANK YOU FOR YOUR TIME Nadine

Q: I recently had a L4-5 Fusion with discectomy about 6 months ago. I continue to have major headaches from my spine when my spine seems to misalign. I am greatly concerned about these headaches as they cause a lot of pain and agony while things are out of alignment. After a few days of pain meds and trying to relax my spine (it pops and readjust) the headache goes away. Is this coming from the below issues. I recently had an MRI with the following reading. C4-5 mildly impresses on the thecal sac. C5-6: Moderate disc desiccation is noted. The disc height is mildly decreased. There is a 3.6 mm broad-based disc protrusion which moderately impresses on the thecal sac and appears to contact the ventral surface of the cervical cord. C6-7: Moderate disc desiccation is noted. The disc height is moderately decrease. There is a 3.0 mm broad-base disc protrusion which mildly impresses on the thecal sac. Mild left neural foraminal narrowing is appreciated. The right neural foramen appears patent.Thanks, MJ

Q: Hi! I'm sure you have heard this before, so forgive me if you are subjected to the same issues yet again! I teach Medical Assisting and work 11 hour days. I had a MRI 4 years ago that showed bulging discs from L1-S1. The past 6 months have brought on the loss of sensation and I have been falling a lot. My Dr. Ordered another MRI and it states the following (sorry this is a very long report. Never a good sign!) : Interosseous hemangiomas in L1 and L3 vertebral bodies once again seen. Loss of usual lordosis noted as before. Conus terminates normally at L1 level. Dramatic interval changes in signal involving especially entirely of L4 and L5 vertebral bodies and inferior aspect of L3 and superior aspect of S1 vertebrae as well. These areas demonstrate low signal on T1 and high signal intensity on T2-weighed images. However, the L3-L4, L4-L5 and L5-S1 discs continue to have low signal on T2 and inversion recovery sequences as before, there is slight retrolisthesis of L3 on L4, L4 on L5, and L5 on S1. No evidence for spondylolysis. The abnormal high signal also involves the L4 and L5 pedicles bilaterallly. No definite pathological vertebral body compression deformities are seen. It goes on but those are the finding. As I stated I teach, but this is way out of my scope of practice as a MA. Could you please explain to me what this means. My doctor made an appointment for me at a neurosurgeon. His comment was "that must hurt". Sorry but duh...... Does this sound like I'm a surgical candidate for a fusion? The pain is getting out of control. Any answer or suggestions would be greatly appreciated. Thank you, Sue

Q: Pain in hips, knee and foot when standing or sitting long terms. Knee pain is new. Foot and hips for a year.Need MRI results translated. Impression Only: 1. Mild degenerrative disc didease L3-L4 2. Mild diffuse disc bulge w/superimposed small right paracentral disc extrusion at L4-L5 migrating inferiorly causing indentation on ventral CSF. Moderate bilaterlfacet joint hypertrophy causing narrowing of bilateral neural foramen at L4-L5. 3.Small central annular tear with mild disc bulge at L3-L4. No spinal cord narrowing at any level. B

Q: Hey there, I just had an MRI proformed and I am not to sure what to make of a couple of things on there, I am hoping you can explain for me please. 1) Ligamentum flavum hypertrophy and facet change is seen at the L3-4 and L4-5 levels. Mild changes are seen at the L5-S1 level. Then it also says that at the L3-L4 level a bit more prominent ligamentum flavum hypertrophy and facet changes noted. L4-L5 There is however, Lateral disc protrusion into the inferior margins of the neural foramen with inferior annular tearing noted. Minimal contact with the exiting left L5 nerve roots maybe present. No gross displacement is noted, the Lateral disc protrusions into the inferior margins of the neural foramen with annular tearing as seen axial images At the L5-S1 level, the AP diameter of the thecal sac centrally measures 1.48cm. Inferior annular tearing laterally is noted. the neural foramen is nnot compromised. Facet Arthropathy and Ligamentum flavum hypertrophy are noted. Correlation with the patients clinical exam along the L4 nerve root distribution is suggested. Then on the Cervical it says these things. Disc Desiccation is seen through out the cervical spine. Degenerative facet changes are seen distal to the C2 level. Nonenlarged lymph nodes are seen in the anterior and posterior margins of the neck.On further review of the soft tissues of the neck, along the left superior jugular lymph node change just posterior to the submandibular gland there is a prominent lymph node at 1.2cm but there it has a normal fatty hilus. Thanks for looking this over and giving me your opinion. Just to note I am 38 yr old female that has been having burning and tingling on the left side and especially the left foot. I also get numbness in the left hand. Again, I look forward to your response. Teresa

Q: 36 yr old male. i've had serious back/shoulder/arm pain for the past month. Just had an MRI: C6-C7 diffuse posterior disc complex. obliteration of ventral csf space. abatement of anterior spinal cord and moderate to severe left foraminal narrowing. Neurosurgeon is less than chatty. Basically all he said is i need surgery right away. Wade

Q: I had back surgery 10 months ago I'm in a lot of pain Can you please explain my L4/L5 & L5/S1 MRI report to me?Can someone please help me understand what I have going on with my back please? I had a MRI done this week and I have the MRI report but I don't completely understand some of the terminology that's on the report. My doctor is on vacation for a few weeks and I would love to know exactly what my MRI report is stating in basic terminologyy. I had a Discectomy and a laminectomy surgery done 10 months ago on levels; L4/L5 & L5/S1. Ever since my surgery, I have been in so much pain that the pain is worse than it was before I had my surgery. My leg and back pain just keeps on getting worse and worse. I have a lot of pain in my lower back and a lot of pain that goes down my right leg. The pain in my leg is a very sharp shooting pain that goes up and down my leg, I have pins and needles in my leg. I have numbness in my leg, and my leg sometimes feels like its heavy. I just had a MRI done and the findings are as follows; There are Postsurgical changes related to right L4-L5 and right L5-S1 hemilaminotomies. At L4-L5 there is disc desiccation with a broad-based disc bulge. There is no high-grade spinal canal or neuroforaminal narrowing. At L5-S1 there is a disc desiccation with a right paracentral disc extrusion compressing the transiting right S1 nerve root and effacing the thecal sac. There is no high-grade neuroforaminal narrowing. IMPRESSION: 1. There are postsurgical changes related to right L4-L5 and right L5-S1 hemilaminotomies. 2. Right paracentral L5-S1 disc extrusion causing compression of the transiting right S1 nerve root. I would appreciate it very much if someone can help me understand and know what I have going on with my back because living with this pain on a daily basis is very, very, very tough to deal with. Thank You very much and Have a Happy New Year. Scott

Q: I was rear ended in August of this year. I've undergone 4 mths of physical therapy for severe neck&back pain that somedays seems worse. pain radiates up my skull, down my arms,sides and occasionally legs. I'm scheduled to see a Neurosurgeon but scared of what to expect to happen?I'm 29.Here is the result of my MRI:Examination demonstrates decreased signal at T10-11 disc space. There is a paracentral disc herniation to the right of midline with impingement on the spinal cord. There is no significant narrowing of the lateral recess. The left lateral recess is patent. The remainder of the disc spaces are preserved with normal signal and height. The spinal cord has normal configuration and signal. The bone marrow has normal signal. CONCLUSION: 1. Evidence of right paracentral disc herniation at T10-11 with impingement on the spinal cord to the right of midline. ~Any help will be greatly appreciated! Brandie

Q: i have severe pain on my mid lower spine that shoots down my right leg.when i stand or sit too long feels like its being compressed however mri says i have disc dessication of l4/5 and slight bulge at l5/s1 with anterior fat effacement. my primary dr says mri doesn't match up with my symptoms however i know what the pain is. i worked on ambulance for over 13 yrs. i'll be 33 in 2 weeks. am i imagining this pain? daniel

Q: Hello, I am a 40 year old male that in the last two years has developed back pain. I work in the HVAC industry and do manual labor. I recently had an MRI performed and received the results, which are like reading a foreign language. Can you please explain what the following means:Technical Factors:1.There is diffuse loss of signal within the vertebral bodies suggesting red marrow hyperplasia. 2.There is no significant compression deformity or subluxation. 3.L1-L2 and L2-L3 is within normal limits. 4.At L3-L4, there is diffuse disc bulging. There is a left lateral disc protusion extending into the left neural foramen with impingement upon the nerve root within the left neural foramen with left neural foraminal narrowing. Right neural formen is patent. 5. At L4-L5, there is mild disc bulging posteriorly. There is a right lateral disc protrusion with an annular tear with impingement upon the nerve root within the right neural foramen. The spinal canal is patent. 6. At L5-S1, the disc is within normal limits. The spinal canal and neural foramen are patent. 7.There are no paraspinal masses. Impression: Disc bulging and left lateral dis protrusion at L3-L4 with impingement upon the nerve root within the left neural foramen with left neural foraminal narrowing.Disc bulging and right lateral disc protrusion with associated annular tear at L4-L5 with impingement upon the right nerve root within the right neural foramen. This is directly from my MRI report. Please explain to me what this means. I am in pain in my lower back area and my left leg down to my knee. I can barely walk. My doctor has referred me to an orthopedic surgeon and also recommends physical therapy. Thank you for your time.Hector

Q: Hi, I had a ct scan, here are the findings I was wondering if you could translate this for me and give me some possible options. Large right paramedian and foraminal disc protrusion at c5-c6 causes sever right foraminal stenosis and moderate spinal stenosis, with perhaps mild cord compression, with deformity of the anterior right lateral aspect of the cord, and displacement postero-laterally toward the left. Thanks Alesha

Q: I am experiencing severe pain in my left butt/hip. I have not received a straight answer from my doctors about the results of my MRI and was hoping you could help. I am 31 years old and have been experiencing the same type of pain on and off since I was 18. FINDINGS: S-shaped scoliosis seen, with levorotatory scoliosis centered at the mid lumbar spine. Chronic Schmorl nodes identified. Prominent hemangioma of L1. The conus terminates at the mid aspect of L1. L1-2: Unremarkable on the sagittal images. L2-3: Tiny posterior disc bulge, with left foraminal disc herniation and facet disease causing no significant spinal stenosis. Mild left foraminal narrowing. L3-4: Posterior disc bulge, with a tiny central disc herniation and facet disease causes mild spinal stenosis at this level. Mild bilateral foraminal stenosis. L4-5: Left eccentric posterior disc bulge, with a right paracentral through left subarticular disc extrusion, with inferior migration, measuring 1.8 x 0.4 cm. This causes moderate-severe spinal stenosis at this level and probable mass effect/impingement upon the traversing left L5 nerve root. Mild left foraminal narrowing. L5-S1: Posterior disc bulge, together with facet disease causes no significant spinal stenosis. Mild encroachment on the left subarticular recess. Lamina appear patent. Thank you, Christine

Q: This is my 33 yr. old son's mri from 1 week ago. He has suffered from severe and constant nightly headaches for over 3 years. He is in terrible neck pain, more so these past 4 months. What does the mri mean and how can I best help him through this? Will this require surgery? Are there other options he should look into? Should we see an osteosurgeon or a neurosurgeon if surgery is indicated? He also had a stroke 4 years ago. C2-3 Negative C3-4 Posterior disc maring intact. Minimal osteo phytic ridging. No significan central spinal canal stenosis. Neural foramina patent.C4-5 Post disc margin intact. Minimal osteophytosis left laterally extending out into the left unconvertebral joint which is hypertrophied. This creates a small left neural foamina but is not felt to be stenotic. Not central spinal canal or enrual formina compromise seen. C5-6: There is disc degeneration with a left paracentral and lateral focal disc protrusion with associated osteophytic ridging. Protruding disc measures 8 mm across and when compared with the osteophyte extends back 2.5 mm. Slightly effaces the l. ventral lateral cervical cord causing a mild l. lateralizing central spinal canal steonsis. Left unconvertebral joint is hypertrophied creating a small left neural foramine not believed to be stenotic. R. neural foramina is patent. C6-7- T1. Negative. Widely patent. Certvical cord slightly effaced at C5-6. No abnormal T2 hyperintensity seen in the cord to suggest edema or mylomlacia. Paravetebral soft tissues felt to be normal. Thank you for your time most sincerely, Barbara

Q: C2/3: disc shows a small, 1-2 mm broad-based central disc protrusion associated with a small annular fissure. Please explain, what does this mean? Can it cause any problems? I am experiencing neck (more on right neck area) and shoulder blade pain radiating down my right arm. Some days the pain is worst. Marjorie


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