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Back Problems Message Board

Back Problems Board Index

OK, I'm going to try this for the third time! I have a new laptop and I must accidentally rest my wrist or something because it ends up making my writing vanish.

As I have said repeatedly, members do not have medical training, so keep that in mind as you read anything on a forum such as this. I can define some terms for you that will help you understand your MRI well-enough that when the doctor tells you about it, you can ask questions. At least, that is my goal.

Stenosis is a narrowing. In the spine, there are two main areas where stenosis occurs: in the central canal, and in the foramen. These are sometimes referred to as neuroforaminal openings and they are the openings through which the spinal nerves must past as they exit the spine and go out into the body. The spinal cord, which is the main neural "conductor" inside the central canal from the neck down to about the Lumbar 1 level. Beyond this, the nerves bundle together, forming the cauda equina, which runs the rest of the way.

If either of these areas has something encroaching on the opening, thereby making it smaller, the result is that one or more nerves become compressed (gets squished) resulting in pain that can be felt at the site or it can radiate out along the path of the nerve.

Neural foramen can be narrowed by disc herniations, bone spurs from the edge of the vertebral body, or spurs or osteophytes from the facet joints.

You will notice on the report that you have neural foraminal stenosis mentioned at the L2-3 and L5-S1 segments.

At both L3-L4 and L4-L5 it appears that the central canal is smaller than on most people, but it is NOT because of stenosis. Probably you were just born this way.

There is another somewhat unique feature you were born with and that would be the lumbarization of S1 that is mentioned in the first paragraph of the report.

The spine consists of 5 lumbar and 5 sacral vertebrae in most people. Usually the five sacral vertebrae are fused into one large bone mass. In your case there is some division of the S1 vertebra and there is a little bit of disc space between S1 and S2. Usually this does not result in any problems or pain. It is simply mentioned because it makes your spine a bit different from the average.

You will note that you have Facet hypertrophic changes at L3-L4, L4-L5 and L5-S1. The facet joints are synovial joints that allow the spine to bend forward, backward and to the side, and they connect the vertebrae one to another. They tend to develop degenerative or arthritic changes from wear and tear. Sometimes they dry out; sometimes there are bone spurs that form. Cartilage breaks down. Hypertrophic changes are what these changes are called and, they can be a major cause of lower back pain.

And finally you have some mild disc bulging at all levels of the lumbar spine. Bulging discs occur gradually and when mild are usually not a pain generator. Again, these happen as we age, from wear and tear on the spine, and would be a sign of some degenerative changes.

All in all, your report doesn't indicate anything that would throw up a red flag. You have several issues of a degenerative nature that indicate your spine is not brand-new, but it looks like everything can be handled conservatively without the need for surgical intervention. Probably a course of PT and some oral medications should help.

I see no reason why you would need a MRI with contrast. That is usually done if there is metal in the spine that throws off "artifact" which can make the images hard to interpret.

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