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MRI report showing curved lumbar spine, hemangioma, disc bulge and degenerative disc disease. Can you explain?

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Spine Surgeon
Practicing since : 2002
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Good evening Dr. XXXXXXX I just picked up my MRI results from the hospital and unable to really make sense of it. My primary Dr. is currently on vacation and will not return for a few weeks. Could you please assist me on making sense of these? Thanks in advance. The following are copied and pasted MRI results:

Spinal AP alignment is normal. The vertebral body heights are
maintained. Mild left curve of the lumbar spine. There are 5
lumbar vertebrae. The bone marrow is diffusely low in T1 signal,
which may be related to anemia or other myelodysplastic
etiologies. There is a hemangioma within the L5 vertebral body.
Signal abnormality also in L3 suggesting small hemangioma. The
conus medullaris terminates at the L1 level and is normal in size
and signal. The cauda equina is normal.

L1-L2: No disc pathology or spinal canal or neural foraminal
stenosis. There are dysplastic changes of the posterior elements
at L1-2, which may be related to dysraphism.

L2-L3: No disc pathology or spinal canal or neural foraminal
stenosis.

L3-L4: No disc pathology or spinal canal or neural foraminal
stenosis.

L4-L5:There is a disc bulge with an asymmetric left paracentral
protrusion causing mild left and moderate right neural foraminal
stenosis. The disc protrusion abuts the left L5 nerve root. Facet
arthropathy.

L5-S1: Disc bulge with uncovering of the disc and disc
desiccation and causing severe left and moderate right neural
foraminal stenosis. Facet arthropathy.

IMPRESSION:

1. Degenerative disc disease and facet arthropathy at L4-5 and
L5-S1 causing varying degrees of neural foraminal stenosis, most
severe at L4-5 on the right and L5-S1 on the left.

2. Diffusely low bone marrow signal, which may be related to
anemia or myelodysplastic etiologies. Correlation with CBC is
recommended.

Posted Mon, 8 Apr 2013 in Osteoporosis
 
 
Answered by Dr. Krishna Kumar 1 hour later
Good evening,
Thank you for sharing your MRI with me.
Let me explain one by one of the abnormal things

1. The bone marrow is diffusely low in T1 signal, which may be related to anemia or other myelodysplasticetiologies. --This means the normal colour of the vertebral bone marrow has changed so it could be due to low haemoglobin in blood called as anemia, which can be easily found out by doing routine blood test (CBC -Complete Blood Count)

2.There is a hemangioma within the L5 vertebral body. Signal abnormality also in L3 suggesting small hemangioma. -Haemangiomas are blood vessels with pooling of blood in the vertebral body, and they are commonly seen in spine. No treatment is required for small haemangiomas.

3. There are dysplastic changes of the posterior elements at L1-2, which may be related to dysraphism- These are changes commonly seen in spine from birth and no treatment is required for them

4.L4-L5:There is a disc bulge with an asymmetric left paracentral protrusion causing mild left and moderate right neural foraminal stenosis. The disc protrusion abuts the left L5 nerve root. L5-S1: Disc bulge with uncovering of the disc and disc desiccation and causing severe left and moderate right neural
foraminal stenosis. -----So you have 2 disc bulges.Discs are situated between two bertebral bones which act as shock absorber, which has a jelly like material inside of it. And due to ageing the water content of it decreases and called as disc dessication which is a natural process.
When the disc bulges, the nerves going to the legs on either side may get compressed.These nerves go through a tunnel called neural foramina, so as the disc presses onto the nerve, it gets trapped in the tunnel and produces leg pain depending on the side.
In your case, left sided nerve is more compressed than right so you may be having both leg pain varying to some extend


5.Facet arthropathy- facet is a joint in the spine like knee joint in leg, so similar to knee arthritis or wear and tear; arthritis occurs at the facet as well, which could cause some back pain.

I hope I had been able to clarify your doubts.


Regards
Dr XXXXXXX
Spine and Scoliosis Surgeon


Above answer was peer-reviewed by
 
Follow-up: MRI report showing curved lumbar spine, hemangioma, disc bulge and degenerative disc disease. Can you explain? 52 minutes later
Yes. Thank you so much Dr. XXXXXXX I really appeciate your time and patience with looking into my situation. I have been dealing with this horribe pain for 6 years now and has become worse especially at night when I am lying down in bed. I won't say sleep cause I do very little of that due to the pain.

Would you suggest surgery to take care of this?
 
 
Answered by Dr. Krishna Kumar 4 minutes later
Hello,
Thank you for getting back.
Please try epidural steroid injection or transforaminal nerve root injections by a pain specialist before surgery.

If you do not get better with it, please consult a spine surgeon and get your x-rays in standing lateral forward and backward bending position. Then the surgeon would discuss which would be the best surgery for you.

Take care

Regards

Dr XXXXXXX
Spine and Scoliosis Surgeon
Above answer was peer-reviewed by
 
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