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Confusimg Lower Back MRI results

Started by Phil on 12/27/2010 11:21pm

I've been having problems for years and it just got so bad that I had see a specialist when I couldn't sit or stand on both legs. My local hick doctor misdiagnosed me and said I had a hernia and told me to see a surgon, thus the specialist. The MRI report seems very confusing to me and I dont know if all these conditions are problerms or just normal wear and tear. I had thought the radiologist was just nit picking on every little thing on the 2 page report but my specialist says there are a lot of problems. Before I had the MRI, he did 2 steroid injections which worked great for a few weeks and then the pain started coming back, but nowhere near the original level and the leg pain or numbess hasn't returned. I'm now on pain pills 3-4 times a day and they really helpy, but want to avoid using meds long term unless absolutely necessary. The specialist says there is a lot wrong, a long list, and wants to "see what happens over the next few weeks".

I've done a lot of research on the radiologiost's findings and it seems like most conditions I have are degenerative and caused by abuse over the years. I'm only 53 and a little guy (5'-7") and the kind of person that would never ask for help moving that fridge or furnature around. Is everyone over-reacting to my conditions or are they serious?.

Here's a brief description. I know what most of this stuff means now after doing some research

L1-L2. small,left paracentral/left protrosion combined with facet/ligmentum flavum hytertrophy
mild foraminal narrowing on the left and mild lateral recess narrowing on the left with at least crowding of the cauda equna in the ventral left aspect of the thecal sac.

L2-l3 mild foraminal narrowing due to eccentric disc bulge, mild facet hypertropy. small distal right foraminal protrosion/extraforaminal protrusion causing mild foraminal narrowing on the right

L3-L4 mild bilateral foraminal narrowing due to broad based disc bulge with mild hypertropy

L4-L5 mild foraminal narrowing on the right with moderate foraminal narrowing on the left. mild bilateral latera; recess narrowing due to eccentric disc bulge, endplate osteophyte and facet/ligamentum flavum hypertropy

L5-S1 mild bilateral foraminal narrowing on the left due to eccentric disc bulge and mild facet hypertropy

The list of "IMPRESSIONS" from the radiologist is equally long. words like "Multilevel degerative spondylosis"

Is this just normal wear and tear. everything says mild and nothing marked as "severe", but there sure seems to be a bunch of "stuff" here...that's why I'm thinking the radiologist is maybe exagerrating and never finds a normal back condition.....or should I say "grossly unremarkable"

Thanks
Phil

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sorry about the spelling...using a micro keyboard and typing is difficult

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Hey Phil - no one here takes points off for spelling or grammar, if they did ... I'd be in a butt load of trouble.

Since I don't know just how "hick" of a town you're living in, have you considered a second reading of the MRI? I know both my MRI's came to me on a DVD disc, and I was able to have an outside dr review the findings when my confidence level was low in the work comp doctor. Thankfully I am not seeing that doctor any longer, and the dr I have now I'm thrilled with.

Its just a thought. I do know the word "mild" is a lot better than "significant" or "sever" .... those are the words I had on mine. I hope you're able to get some resolution. I know in my case, it was due to an injury, I'm only 45 years old and in very good physical condition, or at least I was prior to Nov. 2009 - my injury date. I'll be going in for surgery in 44 days.

I know there are alot of people here far more knowledgeable on lower back issues than I am. I wish you well.

Jenn

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Jenn,
Just to clarify, the hick doctor is the original doc that diagnosed me with a hernia, referred me to a surgeon, and sent me on my way. I then took the initiative to research some docs and came up with a great guy in NYC that set me up with an office visit and did injections the very next day and ordered the MRI which his follow up call stated "let's keep an eye on it for a few weeks". I have absolutely no problem with his recommended course of action and don't intend to go doctor shopping or looking for 2nd opinions because my back is doing really good now.

I'm just trying to draw an analogy to bringing a 10 year old car to a mechanic and asking him to check it out. Obvousely he will find a lot of problems, but you need judgement and understanding of which problems need attention and which problems can be ignored as normal wear and tear. Some people have said normally there is 1 serious problem with 1 certain area and I have 3 or 4 mild/moderate problems witin 3 and 4 different areas.

I guess the end result is something is seriousely wrong because before the visit I couldn't sit or walk properly, just wondering where to go from here. I'm also an engineer and have been looking at the DICOM images with a viewer the lab provided and see some really weird discs. The ends of L1-L4 are either bulging or squeezed on the ends.

Thanks for taking the time to reply and good luck and God bless you with the upcoming surgery

Phil

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Makes sense. I'm glad the injections have been beneficial for you, I wish I'd had the same luck. Also hopeful that you can able to get some answers now.

I'd gotten an injections and PT about 20 years ago for a bulging disc at C-3/C-4 with great success, in fact that disc area still looks fine on the MRI/CT now. I do remember that it took a few months (5-7) to get back on track.

Best of luck to you.

Jenn

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Hey Phil!!!! :) I DO know what you mean!!!! I have hAD MY LAST 2 mri'S DONE AT THE SAME PLACE, AND i do BELIEVE THAT A preschooler COULD HAVE DONE A BETTER JOB!!!!! Just a couple of examples; in March- this last one, I had an MRI of the spine. Although my back is suddenly BENT in the middle and the films are HORRIFYING, (my ex's words-he's an MD.) this ding-dong acted like EVERYTHING was "Grossly Unremarkeable"!!! LOL!! I had an MRI of the Rt. Hip last week, and asked that they also add the Spinal films mentioned above. I read the report to my Boy Friend, Josh, and, it was an ENTIRELY DIFFERENT REPORT!!! I was SO upset!!! I was looking at PERMANENT PERALYSIS!!! A Wheelchair, like, NOW!!!! AND- to top it OFF- he kept reffering to me as "52"!!! I am NOT enjoying being 50 AT ALL, so I thought this QUITE rude!! Then Josh said, "Well, "Constance". I wouldn't get just TOO upset yet..." I said, "WHAT?!?" It's TRUE- they gave me SOMEONE ELSE"S REPORT!!!! AND- to top it ALL OFF- in regards to the HIP films, where he found everything BUT a fracture, I had 2 other radiologists look at them, along w/ my ex, and guess what? YEP!!! You got it- the Ball part of the joint is COMPLETELY cracked down the ENTIRE middle, AND... DOWN THE FEMUR!! The REALLY funny thing, tho- was that my 13 yr. old son, Sam, was the one the FIRST pointed it out!!! On FIVE different views!!!! LOL!!!!
By the way, Phil, the last of the "impressions" on my Spinal films reads, " Multilevel facet degenerative change and bulging discs contribute to mild narrowing to moderate stenoses nerve root foramina most notably on the right at L4-5 as detailed above"..BUT- mu FAV.? "At L2-3 there is a BROAD BULGING DISC AND BROAD CENTRAL PROTRUSION (HUH?!?!?) resulting in thecal sac stenosis". Uh, yeah........ok......got it. RIIIIIIIIIIIIIIIIIIIIIIIIIIGHT!
I MEANT to be helpful-I dont THINK that I was, BUT....THANK YOU!!!!! That SURE HELPED ME!!!!! :) Good luck, phil-I THINK that we are actually aging, and it AIN'T for SISSIES!!!!!!!! :) Take care- let me know how it goes!!!! XO, Becky

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Actually, Phil, I TOO, MUST apologise for MY spelling!!! Same reason!!! :) Becky

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Becky,
Thanks for the response and comments. I have no problem if my results are simply degenerative and a result of aging, and not serious, just wish possibly there was some ortho or spine doc reading this on his lunch hour and might offer a professional comment on my MRI results at the top of this thread (hint, hint). It's a little uncomfortable just waiting around to "see what happens" as my doc suggested.

The latest now is that I feel a little crack, click, clunk when I bend down and crack, click, clunk when I stand upright. Feels like when you crack your knuckles. I know that cracking knuckles is a resut of trapped air between the finger joints, but not sure why my back is now doing it. Feels like between L1-L2 or L2-L4, but doesn't hurt. Just don't want to make the situation worse by ignoring it.

I guess I'll see what happens.

Thanks,
Phil

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Hi Phil!! I KNOW that alarming sound!! I HATE it!! LOL-That's the one Chiropractors LIVE for!!!
I ALSO know how hard it is to await results.....or anything ELSE!! (Mt Dr. STILL hasn't called re: my MRI of the Hip!!) AND- I WISH that ANY Doctor would read and respond!!! (Another Hint!!:) I DO know that the Thecal sac holds your Spinal Cord,Fluid, Nerves,etc... and it does seem that (according to my ex-husband, who IS a MD.) that you have narrowing of the space that the sac runs thru, and that you apparently have a Herniated Disc that is "poking into" the sac, causing you great pain, and would also be reponsible for your refferred pain to the Legs and buttocks. This, according to HIM, would indicate an inury (fridg.??), and NOT just "normal aging". The degenerative changes probably ARE due to age, and POSSIBLY, "Degenerative Disc Disease". Of course, this is JUST ONE Dr.'s, opinion, and-he's an Anesthesiologist- NOT Radiologist. That having been said, he's the one that the Pain Mngmnt. Docs call to Interpret their patients MRI's. Hope that this helps!! Let us know what YOUR Doc says!! :) Becky

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Hey Phil
Go to webmd.com and look up each word you dont understand, educate yourself.
your report sounds thorough. Some will give a full report and some are rushed and dont care...what they say is MILD is usually severe to us...I know....I had my first neck surgery in 1982.....last lumbar surgery 10 years ago...it doesnt get better...trust me
they would order a CT scan, MRI, Mylogram with die before making a descision on surgery.

I keep on doing things and then have to take time out for the BAD EPISODES....and yes hardware can be painful and make you worse especially if they get loose....i just went though 6 days with a cane to get around...i felt it pop and crack when it did i know it was coming...took 2 days for the EXCRUCIATING PAIN to start and i was bad for 6 days....i stopped going to doctors and emergency rooms ..some think your drug seeking...and the 6th day I fet it pop back in place and the pain was gone.just some weakness.
LUMBAR SURGERY IT HORRIBLE...IT WILL AGE YOU 15 YRS.i was in a body brace for 18 months...i wished id never gone through those

I hurt like hell and no one cares....you know why??? because im nothing more than a FAILED BACK SYNDROME to them.
beware of doctors and get many second opinions..

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Checked out a few sites trying to understand the lingo and actually feel confident I know what the report says now. I also have the MRI sequences and some software that combines the 3 different spine views into a 3D spine I can rotate n the screen. Pretty cool.

I'm just getting old and abused my back for too long. Most people have back problems from accidents and possible a single severe issue, I've got mild/moderate issues with all areas, so I'll be more careful and just live with it.

I also lucked out with the right doctor who took the time to listen and explain. He was out o f network and my insurance co. came up $1200 short on a $3800 procedure but he said he's more interested on how I feel that getting paid and acctepted the partial payment, and this is a guy with Manhattan NYC practice...unvelieveable

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