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I had had severe back pain for years, recently I went for my followup thoracic and lumbar MRI and flexion/extension xray series. I would like some help understanding what I'm reading. I do have a followup appointment over the phone (I live in a different state than my doctor) but thats not for 3 more weeks.


[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.

[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.

[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.

What does this all mean and how is it treated? Is there hope that I could have less pain?

Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?

I appreciate any help you have to offer! Thanking for taking the time to read my post!
[QUOTE=Mags0131;5157016]I had had severe back pain for years, recently I went for my followup thoracic and lumbar MRI and flexion/extension xray series. I would like some help understanding what i am reading.
[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.
[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.
[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.
What does this all mean and how is it treated? Is there hope that I could have less pain?
Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?
I appreciate any help you have to offer! Thanking for taking the time to read my post![/QUOTE]

Hi mags,
According to the radiologist the disc bulge at L5-S1 in your very low back has an annular tear which can be painful in & of itself but disc material is not pressing on your spinal cord but is on both sides directly touching the S1 nerve root which could be causing nerve root compression or just irritation because it is just touching the nerve & the radiologist mentions @ the L4-L5 level that the nerve roots on both sides left & right are not displacing the nerve root but @ L5-S1 he doesnt mention if the nerve root is displaced or moved at all & the radiologist is asking your dr to correlate this finding with your symptoms. When looking at a dermatome map the path that the L5 & S1 nerve roots take going down the back, buttocks, leg & toes is drawn out clearly to see which nerve is possibly causing symptoms. There are other disc bulges one @ L4-5 that is near the nerve root but does not appear to cause cord or nerve compression & the thoracic bulge doesnt appear to cause this either according to ehat the radiologist says.. The spinal neurosurgeon or a spine only orthopedic surgeon has the most education, training & experience in disorders of the spine & lof course determines the diagnosis after looking @ testing, taking all you history, symptoms & does a neurological exam to determine a course of treatment that can include medications like NSAIDS, muscle relaxers, PT, TENS, epidural steroid injections, etc or as a last consideration back surgery but depends on the severity that the surgeon determines of usually nerve compression that might lead to nerve damage if not corrected. I do not know about the wedging other than it is mild & the disc space narrowing @ L5-S1 is all the radiologist can see on a plain xray of the disc problem that shows on the MRI. I hope that the problem causing your pain is found & that you can find relief soon! Welcome to healthboards & please update us on your progress.





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