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Posted this on the Pain Mgmt board, should have posted on Back Pain board. This is my moms MRI report...she had back surgery appr 12 years ago; no real problems until the last 6 months or so. The doc that ordered the MRI told her after reading the report that he does not think that this has caused such pain in her back & hip. We would be interested in anyones ideas as we really don't understand the medical terminology and what it means. Thanks

My mom did have back surgery appr 12 yrs ago. Had done well for many years until recently. This MRI was done this past Aug. and she has gotten progressively worse with the pain in the back & hip.


I apologize for any misspellings in here as many words are unfamilar to me.


S/MRI Lumbar Spine W/NO Contra

MRI OF THE LUMBAR SPINE WITH & WITHOUT GADOLINIUM 8-19-03
Comparison: Report of 8-19-91
Indication: Lumbar radicultopathy, right

TECHNIQUE: The lumbosacral spine is studied in the sagittal and axial plane utilizing fast spin-echo T2-wieghted, and spin-echo T-1 weighted pre- and posgadolinium sequences. additionally, a magittal postgadolinium T-1 weighted sequence was performed.

FINDINGS: the initial scount images demonstrate a large cyst arising from the inferior pole of the left kidney measuring approximately 6 cm in maximum dimension. There is multilevel degenerative disc disease but almost complete obliteration of the disc space at L1-2 and L2-3. There are multilevel degenerative disc changes. There is slight anterolisthesis of L4 relative to L5. The conus terminates at a normal level behind lower L1.

Even at the T12-L1 level there is a small disc herniation in the midline extending upwards behind T12. This abuts the conus, but does not significantly compress it. The foramina at this level are widely patent.

At L1-2 there is mild facet hypertrophy bilaterally, and very advanced reactive endplate changes. There are anterior and posterior osteophytes, and the cal sac is substantially narrowed. The right natural foramen is severely narrowed while the left is only moderately narrowed. The prioir examination of 1991 described a prominent midline and rightward disc herniation at this level . The majority of compromise is now from chronic osteophytes. The patient does not list and lumar surgery here, but there is clearly a laminectomy defect at this level.

At L2-3 there is also severe loss of disc height. There are some small osteophytes and some circumferential disc overriding the vertebral margins. This is also asymmetrically greater to the right side than left, and the inferior aspect of both neural foramin are narrowed. The right lateral recess is more significantly narrowed than the left. There is moderate facet hypertrophy on both sides. No herniated disc material is seen.

At L3-4 there is also evidence of a prior laminectomy at this level. There is a circumferential disc bulge with disc material severely narrowing the inferior aspect of the right neural foramen and mildly narrowing the inferior aspect of the left neural foramen. There is bilateral moderate facet hypertrophy. The central canal is only midly effaced.

At L4-5 along with the anterolisthesis there is advanced facet hypertrophy. The disc here is genally bulging, but has herniation of disc material into the left lateral recess elevating the left L4 nerve root upwards. The right neural foramen is surprisingly widely patent with no significant disc material present.

At L5-S1 there is moderately advanced facet hypertrophy. The maramina and canal remain generally patent.

IMPRESSION:

Evidence of multiple prior lumbar surgeries although the patient does not list any on her clinical resume. At the L1-2 level where there was previously a midline and rightward disc herniation, there is severe loss of disc height, and chronic bony spurring with resulttant right greater than left foraminal stenosis.

Severe loss of disc height at L2-3 with right greater than left moderate foraminal stenosisl.

Posoperative changes from a laminectomy at L3-4 with a circumferential disc bulge and right greater than left foraminal.

Anterolisthesis of L4 on 5 with advanced facet hypertrophy and left greater than right foraminal stenosis.

Small upwards midline disc herniation at T12-L1 without significant compromise.





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