[epitts1945]

#26060

This is my MRI results…My pain is in my lower back right above my behind in the middle, for the lack of better description, above my crack…and then beginning right above, in the middle and below where my bra comes across, it burns terribly…sometimes like a hot coal of fire. The burning never stops, it increases and decreases but never stops. I’ve been to two Ortho doctors and I’m waiting on the referral to the neuro surgeon to roll around but not knowing if they can help me is driving me crazy. These are my results…
Lumbar results
GENERAL:
Lumbar alignment is normal. Severe chronic central compression fracture of L2 status post kyphoplasty with extension of methylmethacrylate into L2-3 disc space. Mild-moderate chronic central compression fracture of L4 status post kyphoplasty. Interspinous T2/STIR hyperintensity present at L4-5. No evidence of acute fracture or abnormal marrow replacing lesion.

Bilateral peripelvic renal cysts are seen. Common duct measures at the upper limits of normal.

L1-2:
No disc herniation, central stenosis, or foraminal stenosis.

L2-3:
Mild retropulsion of the inferior aspect of L2, mild bulging disc-osteophyte complex, mild thickening of the ligamentum flavum, and mild bilateral left facet arthrosis. No central stenosis or neural foraminal narrowing.

L3-4:
Minimal retrolisthesis of L3 on L4, mild bulging disc, mild thickening of the ligamentum flavum, and mild left facet arthrosis. No central stenosis or neural foraminal narrowing.

L4-5:
Mild bulging disc, very small left subarticular-foraminal disc extrusion with mild cranial migration, mild thickening of the ligamentum flavum, and mild-moderate left and mild right facet arthrosis with mild-moderate left and mild right distention of facet joints with fluid. No central stenosis or neural foraminal narrowing.

L5-S1:
Small central disc extrusion with minimal caudal migration, prominent right and mild left facet arthrosis, without central stenosis or neural foraminal narrowing. No contact of descending nerve roots.

CONUS AND INTRASPINAL:
The conus is normal in position and appearance. No intraspinal lesions.

IMPRESSION:

1. Chronic severe L2 and mild-moderate L4 central compression fractures status post kyphoplasty with extension of methylmethacrylate into L2-3 disc space. No evidence of acute fracture.
2. Very small left subarticular-foraminal L4-5 disc extrusion with mild cranial migration without narrowing of left subarticular zone or left neural foramen.
3. Interspinous T2 hyperintensity at L4-5 possibly representing interspinous bursitis.
4. Small central L5-S1 disc extrusion with minimal caudal migration without central stenosis or contact of descending nerve roots. Prominent right L5-S1 facet arthrosis without neural foraminal narrowing.
Thoracic results
GENERAL:
Mild dextraconvex curvature of the thoracic spine and levoconvex curvature of the cervical spine seen. Moderate exaggerated thoracic kyphosis with apex centered at T5. Mild chronic anterior superior endplate compression fracture of T2, chronic mild anterior wedge compression fracture of T5, and chronic mild-moderate anterior compression fracture of C5. No acute fracture or abnormal marrow replacing lesion

Susceptibility signal in the right shoulder and compatible with right shoulder replacement. Moderate sliding hiatal hernia present. Bilateral renal peripelvic cysts present.

T4-5: Tiny right central disc protrusion with mild flattening of the right hemi cord without central stenosis.

C5-6: Very small central disc protrusion without flattening of the cord or central stenosis

T6-7: Very small right central disc protrusion mildly flattens the right hemi cord without central stenosis.

T7-8: Small central disc protrusion mildly flattens the midline cord without central stenosis.

The remaining thoracic spine levels are unremarkable.

CORD AND INTRASPINAL:
No thoracic cord or intraspinal lesions.

IMPRESSION:
1. Chronic mild anterior wedge compression fractures of T2 and T5. Mild-moderate anterior compression fracture of C5.
2. Multilevel small central disc protrusions mildly flattening the cord at several levels without central stenosis.
3. Moderate sliding hiatal hernia.

Thank you for any advice you might be able to give.

[Donald Corenman, MD, DC]

#26179

First thought is that you have significant osteoporosis. You have two compression fractures in the lumbar spine which unless you had a significant trauma, is an indicator of osteoporosis. The statement “T2/STIR hyperintensity present at L4-5” is an indicator of a newer fracture and this could cause pain where you describe. You also have “Chronic mild anterior wedge compression fractures of T2 and T5”.

Your reading of “mild-moderate left and mild right distention of facet joints with fluid” is an indicator of a degenerative spondylolisthesis at L4-5. See “https://neckandback.com/conditions/degenerative-spondylolisthesis-or-spondlylolysthesis/”. This can also cause your pain.

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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