[Susan]

#5487

Dear Dr. Corenman,
I am a 61 year old woman with questions about a recent MRI I had due to an acute lumbar strain that caused excruciating pain in my left lower back/buttocks area making it difficult to get up from bed or a chair or to lower myself into a chair. I also had random spasms that tore across my lower back that took my breath away and brought tears to my eyes. I don’t know what caused this but fortunately with some rest, flexeril & advil and a great physical therapist I am doing better as the orthopedic doctor promised I would be in a few weeks.

What I am concerned about is what I see in the MRI report that the doctor did not mention to me at my follow-up appointment or in the “office note” that he sent to my PCP. Because of an error in the past (not with this doctor or hospital) I requested and received a copy of the MRI report from the hospital not from him.

1) “A large hemangioma is present at T12 involving the posterior vertebral body and right posterior elements. Osseous Hemangiomas are also noted within the vertebral bodies of L3, L4 and right posterior vertebral body of L5 extending into the right posterior elements”. Can you tell me if I should be concerned and if any follow-up is necessary?

2) There is disc desiccation throughout the lumbar spine and mild to moderate loss of disc height is present. Also mild diffuse disc bulge at L2-L3, L3-L4, L4-L5, and L5-S1. None exhibit spinal canal stenosis. At L4-L% and L5-S1 there is minimal grade retrolisthesis in association with facet arthropathy. Is there anything I should be doing to prevent this from getting worse?

3) There is mention of possible cysts in both kidneys. I understand my kidneys are not his concern as an orthopedic surgeon but shouldn’t he be making me or my PCP about this?

I apologize if this is too lengthy and Thank you in advance for your time and assistance.

[Donald Corenman, MD, DC]

#5489

Hemangiomas are ubiquitous in the spine. When MRI was first developed, we thought many people had tumors in their spine. Some physicians biopsied these “tumors” and found them to be benign hemangiomas. It turns out the these “tumors” are common and typical and are really part of our genetic makeup. It just turns out that we did not know they were present until the MRI made them stand out.

Large hemangiomas are most likely benign and I see them all the time but they might need to be watched. None of them are generally malignant but some can expand and weaken the bone.

As for your discs and facets, you have CBS. That is “crappy back syndrome”. That is what I tell my patients jokingly and it takes the fear out of these degenerative changes. This condition Is not uncommon and can cause intermittent or even constant back pain. According to the MRI report (and understand that I don’t trust someone else reading my MRIs for me most of the time), your back is benign.

Care of this requires core strength, an understanding of ergonomics and the mechanics of lifting. See my TV-8 videos on the website for an understanding of what I mean.

Cysts in the kidneys are generally quite common as we age. I cannot tell you that they are all benign but in your case, if the radiologist is not concerned, there is probably not a big problem.

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.

[Susan]

#5490

Thank you for your quick and most helpful reply.

I had read on the web that spinal hemangiomas were usually benign but was concerned that perhaps they needed watching. I would not want them to “expand and weaken the bone”. Would this be a problem if you have osteopenia? I was diagnosed with osteopenia 4 years ago after my first bone density scan and my second scan 2 years ago showed more deterioration.

My doctor basically just told me there is nothing serious showing on your MRI & you don’t need surgery and it is just going to take time to feel better. And for that I am very grateful. I do however prefer your diagnosis of CBS!

I plan to bring a copy of the MRI report to my PCP to see what he thinks about the possible cysts.

I understand that as a result of all the scans and MRI’s etc that we now have access to it is possible to sometimes find an “issue” that we were not even looking for in the first place that may cause more concern than needed.

Again thank you for your answer. It is much appreciated!

[Author]

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