T Nation

Can Anyone Read a Spine MRI ?


#1


Hi guys, I have to wait a week to see the doctor. In the meantime I'm curious just how bad these discs are. I attached L4/L5 and L5/S1.


#2

Go back to the radiology clinic and get a copy of the report.


#3

If I had any clue…I’d def help, however I don’t


#4

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#5

[quote]bushidobadboy wrote:
Need to see the sagittal plane view, not this axial plane view, sorry.

BBB[/quote]

Thanks BBB, here is the central sagittal view.


#6

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#7

The one thing I can say is that you do not have a herniated disc.


#8

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#9

[quote]bushidobadboy wrote:
OK on cenrtal saggital view we can see that both the L4/L5 and the L5/S1 intervertebral discs are dark/have low signal intensity, indicating a lack of fluid in the nucleus pulposus. This is in contrast to the other IVDs which show good hydration, indicating an intact nucleus. I’m guessing that you are relatively young. I’ll take a punt at 25 or less.

No posterior herniation is apparent in any of the IVDs, including the darkened ones. Since this is a ‘central’ saggital, and no disc bulge or frank herniations are seen, I suggest that the herniations (if there are any) ar in the more common ‘posterolateral’ position, and not central.

Are there likely to be herniations? IMO yes, because you don’t usually get a marked loss of signal (water) in two discs without some reason for it. Posterolateral herniations are more common than central herniations, for sound engineering reasons, i.e. the tighter radius curve of the posterior corner of the kidney-shaped disc creates an area of weakness, for the fluid pressure to exploit.

So if you can get the ‘off central’ saggital views, I can have a look.

BBB[/quote]

Damn. Beat me to it.


#10

[quote]Vicomte wrote:
bushidobadboy wrote:
OK on cenrtal saggital view we can see that both the L4/L5 and the L5/S1 intervertebral discs are dark/have low signal intensity, indicating a lack of fluid in the nucleus pulposus. This is in contrast to the other IVDs which show good hydration, indicating an intact nucleus. I’m guessing that you are relatively young. I’ll take a punt at 25 or less.

No posterior herniation is apparent in any of the IVDs, including the darkened ones. Since this is a ‘central’ saggital, and no disc bulge or frank herniations are seen, I suggest that the herniations (if there are any) ar in the more common ‘posterolateral’ position, and not central.

Are there likely to be herniations? IMO yes, because you don’t usually get a marked loss of signal (water) in two discs without some reason for it. Posterolateral herniations are more common than central herniations, for sound engineering reasons, i.e. the tighter radius curve of the posterior corner of the kidney-shaped disc creates an area of weakness, for the fluid pressure to exploit.

So if you can get the ‘off central’ saggital views, I can have a look.

BBB

Damn. Beat me to it.[/quote]

LMAO!


#11

[quote]seekonk wrote:
bushidobadboy wrote:
Need to see the sagittal plane view, not this axial plane view, sorry.

BBB

Thanks BBB, here is the central sagittal view.
[/quote]

So what kind of symptoms are you having? Just general low back pain, or are you experiencing nerve pain? I’m no doctor but I’ve had 2 MRIs on my lumbar and had a micro on my L4L5. I would be interested in hearing what your report says.


#12

[quote]Vicomte wrote:
bushidobadboy wrote:
OK on cenrtal saggital view we can see that both the L4/L5 and the L5/S1 intervertebral discs are dark/have low signal intensity, indicating a lack of fluid in the nucleus pulposus. This is in contrast to the other IVDs which show good hydration, indicating an intact nucleus. I’m guessing that you are relatively young. I’ll take a punt at 25 or less.

No posterior herniation is apparent in any of the IVDs, including the darkened ones. Since this is a ‘central’ saggital, and no disc bulge or frank herniations are seen, I suggest that the herniations (if there are any) ar in the more common ‘posterolateral’ position, and not central.

Are there likely to be herniations? IMO yes, because you don’t usually get a marked loss of signal (water) in two discs without some reason for it. Posterolateral herniations are more common than central herniations, for sound engineering reasons, i.e. the tighter radius curve of the posterior corner of the kidney-shaped disc creates an area of weakness, for the fluid pressure to exploit.

So if you can get the ‘off central’ saggital views, I can have a look.

BBB

Damn. Beat me to it.[/quote]

Ugh. Beat me to it.


#13

[quote]bushidobadboy wrote:
OK on cenrtal saggital view we can see that both the L4/L5 and the L5/S1 intervertebral discs are dark/have low signal intensity, indicating a lack of fluid in the nucleus pulposus. This is in contrast to the other IVDs which show good hydration, indicating an intact nucleus. I’m guessing that you are relatively young. I’ll take a punt at 25 or less.

No posterior herniation is apparent in any of the IVDs, including the darkened ones. Since this is a ‘central’ saggital, and no disc bulge or frank herniations are seen, I suggest that the herniations (if there are any) ar in the more common ‘posterolateral’ position, and not central.

Are there likely to be herniations? IMO yes, because you don’t usually get a marked loss of signal (water) in two discs without some reason for it. Posterolateral herniations are more common than central herniations, for sound engineering reasons, i.e. the tighter radius curve of the posterior corner of the kidney-shaped disc creates an area of weakness, for the fluid pressure to exploit.

So if you can get the ‘off central’ saggital views, I can have a look.

BBB[/quote]

I lol’d golf clap


#14

[quote]bushidobadboy wrote:

So if you can get the ‘off central’ saggital views, I can have a look.
[/quote]

Thank you, BBB, much appreciated. Here are the off-center sagittals.


#15

[quote]ku2u wrote:
So what kind of symptoms are you having? Just general low back pain, or are you experiencing nerve pain? I’m no doctor but I’ve had 2 MRIs on my lumbar and had a micro on my L4L5. I would be interested in hearing what your report says.[/quote]

Really bad back pain, mostly on left. No improvement for five months, rather the opposite. Difficult to sit or lie down, especially on side. Vehicles are torture. Walking is only relief.

Some radiculitis on left leg/foot, especially lying down, that started after a badly done epidural cortisone injection.


#16

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#17

I agree with BBB, but there does look like some posterior disc bulging. It might not be clinically significant, but seeing the report would help. Post a copy when you get it please. Also between L5 and S1 you have some damage tot he vertebral end plates. This could be from long term stuff or short term such as a fall.

nothing to freak out over, but the more you find, the more the symptoms often make sense. You could be simply suffering from a muscular issue that could be fixed quickly with ART and this means nothing. Remember, the map is not the territory.


#18

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#19

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#20

Thanks guys for your opinions. You are spot-on BBB with your prediction of symptoms. In addition, I have to say the most annoying is that lying on my side is excruciating, and has been for five months. In addition, according to the PT and the physiatrist, I should have been doing cartwheels long ago. Instead, after five months my symptoms are worse than when it started.

I had a previous MRI 3 months ago, and the only thing that changed (to my untrained eye) is further atrophy and fatty infiltration of the multifidus. My understanding is that this is not unusual with chronic back pain. I am trying to counteract it with bird-dogs etc.

The report for those earlier MRIs, which are IMO still visible and unchanged in the new ones three moths later (the axial views of my first post above), were:

  • mild to moderate disc protrusion on left at L4/L5, with questionable abutment
    of the nerve root.
  • central posterior annular tear on L5/S1 with mild disc bulge. No nerve root abutment.
  • what you said about the degenerative discs.

I am speaking from memory - the written report got left behind at the doctor’s office last week by mistake.

I am 43. I am also getting desperate. I might have to give up my job because the commute absolutely kills me. I may also have to hire a gigolo to keep the GF satisfied.