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Could someone PLEASE interpret These findings into more layman-like terms.

This is very important because I need to be able to make an informed decision on whether or not to have surgery to correct the issues shown in the MRI's.
thank you to anyone who can help.


**This is the first MRI Report:**

MRI Spine Cervical WO: 7/5/2016 10:06 PM

CLINICAL INDICATION: Fall, neck pain

COMPARISON: 3/31/2016.


TECHNIQUE: Noninfused multiplanar MR images of the cervical spine were obtained on the closed
high-field magnet.

FINDINGS: The vertebral body heights and vertebral alignment is preserved. There is anterior
endplate spurring at C4-C5. No marrow signal abnormality to suggest occult fracture is seen.
There is no prevertebral edema. Grossly normal morphology of the spinal cord is demonstrated.

At C2-C3, no significant findings are seen.

At C3-C4, there is disc desiccation and minimal left posterior paracentral disc protrusion. No
significant stenosis is visualized.

At C4-C5, there is disc desiccation and small posterior central disc protrusion. This minimally
impresses upon ventral margins of the thecal sac. No significant stenosis is seen.

At C5-C6, no significant findings are seen.

At C6-C7, no significant findings are seen.

At C7-T1, no significant findings are seen.

IMPRESSION:
1. No evidence to suggest acute osseous abnormality. The spinal cord and canal is preserved.

***** Final *****

**This is the second Report:**

Reason for Exam
Pain, lumbar

Report
MRI Spine Thoracic WO: 7/5/2016 10:08 PM

CLINICAL INDICATION: Fall

COMPARISON: None.


TECHNIQUE: Noncontrast multiplanar MR images of the thoracic spine were obtained. Images were
acquired on the closed high-field magnet.

FINDINGS:

The vertebral body heights and vertebral alignment is preserved. Multilevel endplate spurring
and Schmorl's node formation is visualized. There is minimal fluid signal intensity along
the inferior endplate of T11, to the left of midline. Multilevel disc space narrowing is
visualized. There is a slight thoracic kyphosis. No spinal canal stenosis is visualized. The
cord signal is within normal limits.

IMPRESSION:
1. Degenerative changes within the thoracic spine, without evidence to suggest canal stenosis or
cord injury.
2. Fluid signal along the inferior endplate of T11 which may represent degenerative change or a
focal contusion/minimal compression fracture.
***** Final *****

**This is the third and final MRI report:**

Reason for Exam
Pain, lumbar

Report
MRI Spine Lumbar WO: 7/5/2016 10:08 PM

CLINICAL INDICATION: Back pain, fall

COMPARISON: 3/31/2016.


TECHNIQUE: Noncontrast multiplanar MR images of the lumbar spine were obtained. Images were
acquired on the closed high-field magnet.

FINDINGS:

The vertebral body heights and vertebral alignment is preserved. No marrow signal abnormality
to suggest occult fracture is seen. The intervertebral disc spacing is preserved. There is no
prevertebral edema. The tip of the conus terminates at L1-L2. Grossly normal morphology of the
distal portions of the spinal cord is demonstrated.

At L1-L2, no significant disc pathology or stenosis is seen..

At L2-L3, no significant disc pathology or stenosis is seen..

At L3-L4, no significant disc pathology or stenosis is seen..

At L4-L5, no significant disc pathology or stenosis is seen..

At L5-S1, there is disc desiccation, mild disc space narrowing, bilateral facet joint
hypertrophy, and posterior central disc extrusion annular tearing within the extruded disc
material is seen. There is mild narrowing of spinal canal and mild bilateral neural foramen
stenosis..

IMPRESSION:
1. No acute osseous abnormality.
2. Similar findings at L5-S1 as compared to 3/31/2016. Annular tear within extruding disc and
mild stenosis of canal and neural foramen.

***** Final *****

Please interpret These findings into more layman-like terms.
this is very important because I need to be able to make an informed decision on whether or not to have surgery to correct the issues shown in the MRI's.

Thank you to anyone who can help.
Welcome to the board. It would be helpful if we had some information about your symptoms and complaints. I gather there was a fall at some point.

It is important to know that the MRI is just one piece of the diagnostic puzzle. It is correlated with the results from a physical exam, a basic neurological exam and from listening to the person's description of symptoms and what impact they are having on day to day living. Trying to deduce anything from the MRI alone is asking for an inaccurate diagnosis.

That being said, if this were my MRI I would be a happy woman! There are some mild signs of disc degeneration which occurs to most human spines as we age. Disc desiccation refers to the intervertebral disc losing moisture and flattening. Discs are comprised of something like 93% moisture. As we age, they tend to dry out and lose moisture. If desiccation is severe, the disc space is narrowed and the vertebrae (bones) move closer together. When this happens, it starts amcascade of events that can include enlargement of the facet joints, stenosis, etc.

There are some discs that are beginning to show signs of desiccation and some small bulges. In the cervical spine, there are no signs of a fracture. The discs at C3-4- and C4-5 are slightly protruding, but this is not causing more than a small amount of stenosis.

Stenosis means narrowing. This occurs mainly in two places in the spine...the central canal and the neuro foraminal openings, also called foramina. The central canal contains the spinal cord and spinal fluid. The foramen is an opening located at each vertebral pairing that allows the spinal nerve to exit the spine to go out to the part of the body it innervates. When it is narrowed or even becomes blocked, the nerve cannot function normally. This results in pain that is felt at the site or it can radiate out along the path of the nerve. It can cause, pain, tingling, numbness. In severe cases it can cause loss of muscle movement as well.

The good news is that there is no spinal cord compression.

(More to follow...)
Good heavens! I think you should not be surprised to develop arthritis all over as you get older, but It doesn't appear to be happening yet, at least in the spine.

Sorry I didn't get back to you sooner. Sometimes I run out of time before I finish my thoughts.

Anyway, back to the MRIs...if this were my MRI I would feel pretty good about it in that nothing jumps out as requiring surgery. I would think the issues could be handled with conservative measures such as a course of physical therapy, perhaps a series of epidural steroid shots if you can have them, perhaps oral medications, etc.

There is some degenerative disc disease (DDD) throughout the spine, which is a little unusual for someone your age, but perhaps not considering your occupation. I don't know anyone in the landscape business who does not abuse his back, beginning at a young age.

The discs are comprised of around 90% "water." As we age, the discs tend to dry out and lose moisture. ( The discs do not have an efficient way to be fed as no vessels run into them. They absorb their nutrients from the vertebral end plates that butt up to the spinal intervertebral discs. Even in people who haven't fallen down any stairs or otherwise injured their backs have spines that begin this aging process in their 20s. If we took MRIs of the entire population, we would find that most show a little bit of disc disease...but it doesn't cause any symptoms.

The MRI always needs to be correlated with what is found upon physical and basic neurological exams, as the images alone present incomplete and sometimes faulty information.

If the cervical disc bulges worsen to the point that the spinal cord is being impacted, you could develop more serious issues.

The disc issues at L5-S1 appears to have the most significant disease. Here the disc has bulged to the point that some of the disc material is coming out from the disc and there is a tear in the annulus, which is the tough outer ring that contains the nucleus. ( This can be a pain generator as the nucleus contains chemicals that can be irritating to spinal nerves.). This material that spills out of the disc expands beyond the disc space, and narrows the foramina openings. This puts pressure on the spinal nerves at this L5-S1 level. (Referred to as foramina stenosis and it affects both the left and right side.). This is something that might heal naturally but you will have to avoid putting so much stress on your spine in order for this to have a chance of happening!

If the pressure is too much on these nerves, it may be necessary to surgically decompress these nerves. I hope you are consulting with either a fellowship-trained orthopedic spine or neuro surgeon. It is a good idea to have a specialist that you have seen at least one time and that you like in case you develop further issues in the future. You will be able to get an appointment sooner than if you were a new patient.

Good luck with all your health issues. I hope you find some pain relief soon.





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