[Kell]

#9589

Ok I am a 43 year old female, I have already had 1 back surgery 2 years ago which was a spinal laminectomy ( which is being called a failed surgery) here is the results of my latest MRI, my Doctor says I need a spinal fusion and in 3 years will need a second one. Can you please tell me what this MRI means in plain english and do I really need a spinal fusion?..

FINDINGS: Straightening of the normal tumbar lordosìs. Moderate L3-4 and L4-S disc desìocatìon with moderate to severe disc height loss at both levels. The disc height loss has increased slìghtly at both levels. Mild L5-S1 disc desiccation and disc height loss, which has increased since the prior examination. At the thoracolumbar junction, there is mild disc desiccation with moderate endplate degenerative sclerosis, irregularity and Schmori’s node formation, which have increased slightly since the prior examination. There is mild scattered endplate reactive edema, particularly at L3-4 and L4-5. No fracture. No spondylolisthesis with the patient in this static position. A normal appearing conus terminates near L2. No intradural mass. No obvious evidence of ligamentous injury. 3 mm cystic structure within the posterior right hepatic lobe, similar to the prior examìnation.
T11-12: Circumfenantìal disc bulge with 1 mm broad-based posterior disc bulge, similar to before. No neural foramìnal narrowing or compressed nerve roots. Mild left facet sclerosis.
T12-Ll: Cìrcumferentìal disc bulge with 1 mm posterior component, similar to before. No neural foraminal narrowing or compressed nerve roots. Moderate left facet sclerosis with mild hypertrophy.
L1-2 No disc bulge. Normal neural Foramìna. No obvious ìmpingement: of the exiting dorsal root ganglia. No canal stenosis. No significant Facet pathology.
L2-3: No dlsc bulge. Normal neural foramina. No obvious impingement of the exiting dorsal root ganglia . No canal stenosis. Mild right facet sclerosis.
L3-4: Circumferential disc: bulge with a 4 mm posterior component which has increased slightly since the prior examination. Mild to moderate bilateral neural foraminal narrowing without exiting nerve root compression. Mild bilateral fluid with mild to moderate facet sclerosis and hypertrophy- There is mild edema of the right facet with moderate edema within the adjacent soft tissues
L4-5: circumferential disc bulge a posterior component measuring up to 6 mm which has increased since the prior examination. There is an associated annular tear. Posteriorly, there is minimal displacement of the left L5 nerve root, which was not seen previously. Moderate right and mild to moderate left neural foramìnal narrowing without compression of the exiting nerve roots. Moderate bilateral facet sclerosis with moderate right facet fluid. Mild to moderate bìlateral facet hypertrophy. Moderate edema of the right facet and adjacent soft tissues, new since the prior examination.

L5-S1: 2mm broad-based posterior disc bulge. No neural foraminal narrowing of compressed nerve roots. Moderate bilateral facet sclerosis with mild to moderate left and mild right facet hypertrophy.
There is a 3mm Synovial cyst associated with the lateral aspect of left facet. Moderate edema of the left facet and adjacent soft tissues. Mild edema of the right facet with mild to moderate edema of the adjacent soft tissues.

Mild to moderate bilateral S1 joint degenerative sclerosis. There is new mild to moderate edema of the proximal right psoas muscle. No tear identified.

Impression
1. Increased disc bulges at L2-3 through L4-5 resulting in minimal displacement of the left L5 nerve root at L4-5.
2. Multilevel lower lumbar spine facet and adjacent soft tissue edema increased or new since the prior examination. Multilevel lower lumbar spine facet arthropathy.
3. New mild edema/strain of the proximal right psoas muscle without tear.

[Donald Corenman, MD, DC]

#9628

MRIs do not by themselves have an answer for your symptoms. You first need to describe your symptoms so that a correlation can be made between the MRI and your complaints. See the section on “How to describe symptoms” to fully describe your complaints.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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