LeasakaymoParticipantJuly 16, 2020 at 5:15 pmPost count: 2
Lumbar MRI has this statement, The cauda equina and coronary shows some clumping of the elements, secondary to spinal stenosis. What does the term clumping mean and is this the same as Cauda Eqina Syndrome?Donald Corenman, MD, DCModeratorJuly 16, 2020 at 5:59 pmPost count: 8460
“Cauda Equina” translates from Latin to mean “horse’s tail” which is an accurate description of what the nerves look like descending after the spinal cord ends behind the vertebral body of L1. Cauda equina syndrome is a significant compression of all of these nerves in the canal typically due to a large disc herniation which you do not have. “Clumping” of these nerves can occasionally indicate arachnoiditis but it is unlikely you have this condition. You do have spinal stenosis or narrowing of the canal which could cause some symptoms.
Dr. CorenmanLeasakaymoParticipantJuly 16, 2020 at 8:11 pmPost count: 2
Thank you for the explanation. Below was rest of my MRI. I wasn’t sure if my pain was mainly due to clumping of nerves or other issues I seem to have. I wish there was something I could do to slow down or stop degenerative problems. My issues have gone on for 20 + years. Any recommendations for pain?
L2-3: A new large left far lateral disc protrusion is present
measuring 1.9 x 1.1 cm in the AP and transverse dimension measured on
series 12 image 24. This abuts and displaces the exited left L2 nerve
root. On the sagittal STIR sequence, adjacent prominence paravertebral
edema is noted circumferential to the disc protrusion. Please see
series 14 image two. Mild ligamentum flavum thickening. Mild left
L3-4: Disc bulge. Mild facet arthropathy and ligamentum flavum
thickening. Minimal bilateral foraminal stenosis.
L4-5: Disc bulge. A heterogeneous low T2 signal structure projects
contiguous with the disc in the right foraminal compartment superiorly
migrating from the disc anterior to the exiting right L4 nerve root.
Please see series 12 image 11 and series 9 image 15. This appears
similar to previous study. After the administration of contrast, some
of this tissue demonstrates enhancement and the material anterior to
the exiting disc superior to the disc space does not demonstrate
enhancement. Please see series 17 image 15 for example. The structure
measures 6.5 x 4.5 mm in the craniocaudal and AP dimension. Also see
series 18 image 13. Similar moderate right foraminal stenosis.
L5-S1: Disc osteophyte complex. Minimal stable left foraminal
stenosis.Donald Corenman, MD, DCModeratorJuly 17, 2020 at 6:43 amPost count: 8460
“I wish there was something I could do to slow down or stop degenerative problems”. If I had the answer to this, I would be walking down the red carpet in Sweden and they would place a gold medal around my neck. Unfortunately, degeneration is generally genetic (with trauma thrown in) and progression is not atypical.
You do have some significant findings on your MRI. “L2-3: A new large left far lateral disc protrusion is present measuring 1.9 x 1.1 cm ….This abuts and displaces the exited left L2 nerve root”. That would give you a left L2 radiculopathy.
“L4-5: Disc bulge. A heterogeneous low T2 signal structure projects contiguous with the disc in the right foraminal compartment superiorly migrating from the disc anterior to the exiting right L4 nerve root”. This is somewhat harder to interpret but might give you a right L4 radiculopathy.
See this to interpret how these two nerve roots manifest symptoms.
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