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Discussion on MRI results for back pain - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Back Pain
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   AAAAAAA I hope someone can help. I broke my back in 2001 17years from a fall. Had bed rest for 5 weeks and then a back brace for 3 months with no physiotherapy. After falling off my bed in July this year, I have suffered extreme pain. I have been doing physio and at one point saw a chiropractor, but nothing was alieving the pain. So finally I gave up waiting for the MRI I had booked in December with the NHS and had one privately.
So here are the results which I hope one of you can deterine what they mean. I have included the details of my CT Scan I had when I first broke my back.
CT SCAN APRIL 2001
There is a burst fracture of the body of L2. A fragment of bone is retropulsed and is causing some encroachment on the spinal canal. A fracture line runs from the left side of the body of L2 to the base of the right pedicle. I think it likely that this fracture is potentially unstable.
There is some depression of the superior aspect of L2 and disc has presumably herniated into this defect. There is fracture of the body of L3. The axial images suggest this is largely a fracture of the anterior portion of the body but the sagittal reformations suggest extension of a fracture line into the posterior part of the body of the vertebrae. The arch of L3 appears intact.
MRI REPORT OCTOBER 2010
Report: T1, T2 and STIR sagittal images of the lower thoracic and lumbar spine were performed followed by T2 weighted axial images through the L1 and L2 to the L5 S1 levels.
There is no soft tissue swelling.
There is some loss of the normal lumbar lordosis suggesting muscle spasm. Spinal alignment is otherwise normal, no evidence of spondylolysis.
Lower thoracic spine, lower thoracic cord and conus appear normal.
At L1 and L2 there is a very minor bulge of the posterior disc annulus in association with some partial collapse of the superior endplate ot L2 all in keeping
User :   with a post traumatic aetiology. It is leading to some minimal indentation of the anterior surface of the theca but there are no features of nerve root compromise. There are early secondary degenerative changes in the facet joints.
At L2 and L3 there are some irregularity of the superior endplate of L3 in assocciation with a prominent Schmorls node in keeping with a degenerative,post traumatic aetiology. There is no evidence of a disc protrusion. There are secondary degnerative changes in the facet joints.
At L3 L4 and L4 L5 the discs appear normal. There are minor secondary degenerative changes in the facet joints.
At L5 S1 there is a degenerate disc with a mild generalise annular disc bulge that is extending into the epidural fat with a slightly large focal right posterolateral component that is leading to some minimal posterior displacement of the right S1 nerve root within the confies of the canal. There is no evidence of any lateral extension. There are minor secondary degenerative changes in the facet joints.
Review of the retroperitoneum appears normal.
Conclusion: Chronic post traumatic change involving the superior endplates of L2 and L3. Degernerative L5 S1 disc as described above.
So does this give me an indication in what is causing the pain, and do you think I will need surgery for this?
Many thanks for your time!
Doctor :   Hi
Doctor :   Let me read the query.
User :   Hello
User :   Ok, that might take a while.. good luck!
Doctor :   May I know, how severe is the pain?
User :   about an 8 24/7
Doctor :   Ok
Doctor :   Let me brief you.
User :   Are you specialised in this area, can you understand what the mri says?
User :   ok
Doctor :   Vertebral fractures are treated by means of medical drugs.
Doctor :   Surgery is indicated if there is compression of the spinal cord or the spinal roots.
Doctor :   From the description of you second MRI, it appears that there are no significant spinal cord compression or the compression of the nerve roots,
Doctor :   hence the benefit of the surgery is doubtful.
Doctor :   However, a better opinion can be advised by physical examination.
User :   What does this bit mean, At L5 S1 there is a degenerate disc with a mild generalise annular disc bulge that is extending into the epidural fat with a slightly large focal right posterolateral component that is leading to some minimal posterior displacement of the right S1 nerve root within the confies of the canal.
Doctor :   The normal anatomy of the spinal cord is - you have a disc between two vertebral bones which provide cushion like effects.
Doctor :   In your case, due to the fracture there has been damage to both the vertebrae and the disc causing these changes.
User :   yes
User :   are u an expert in this field?
Doctor :   These changes and the remaining disc chich may have slipped out of its position due to the fall is seen in the soft tissues.
User :   as i know all of what u are saying but u are not really explaining what my mri means?
Doctor :   I am a general physician.
User :   Do you get a refund if you are unable to answer my question?
User :   ?
Doctor :   You may consider the option of specialist opinion, if you wish to discuss with a specialist.
User :   Good one
Doctor :   I shall arrange for a refund of the money of this package.
User :   is there a specialist on here?
Doctor :   Yes,
Doctor :   You can take an opinion from an orthopedician.
Doctor :   WWW.WWWW.WW Doctor :   This link shall guide you the the web page through which you can obtain an opinion from an orthopedician.
Doctor :   Have you followed?
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Doctor :   I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
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