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What Does My MRI Scan Test Report Indicate?

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Posted on Tue, 14 Jul 2015
Question: What does this MRI mean? How serious are these compression fractures? Do they require surgery? Or will PRN Norco 10/325 every 4 hours alone be enough to treat these fractures?

RESULT: There are compression fractures of T11, T12 and L1 vertebral bodies. There is a fracture collapse through T11 visualized. Mild edema within the T11 vertebral body and posterior elements on the left. There is mild retropulsion of the posterior superior aspect of T11. There is greater than 75% loss of vertebral body height. Compression fracture of T12 appears mildly progressed. There is approximately 50% loss of height maximally without significant osseous displacement- There is also a severe compression deformity of L1 with retropulsion of the posterior superior aspect of L1. This appears chronic. There is moderate levoconvex scoliosis of the lumbar spine. There are degenerative endplate changes at T12-L1 and L1-L2. The signal intensity and morphology of the spinal cord and cauda equina is unremarkable. Conus medullaris terminates at the L1 level.
INDIVIDUAL LEVELS:
T10-T11: No significant disc bulge, central canal or neural foraminal stenosis.
T11 is mildly retropulsed and effaces the ventral thecal sac.
T11-T12: Moderate degenerative facet joint changes with moderate bilateral neural foraminal stenosis. There is no significant narrowing of the central canal.
T12-11: There is large disc osteophyte complex, effacing the ventral thecal sac and contributing to moderate to severe narrowing of the central canal at this level. There is moderate bilateral neural foraminal stenosis.
L1-L2: Disc osteophyte complex, effacing the ventral thecal sac with moderate bilateral neural foraminal stenosis, There is no significant narrowing of the central canal.
L2-L3: Moderate degenerative facet joint changes with moderate bilateral neural foraminal narrowing and mild narrowing of the central canal
L3-14: Disc osteophyte complex, effacing the ventral thecal sec. There is severe narrowing of the central canal at this level with mild to moderate bilateral neural foraminal narrowing.
L4-L5: Broad base disc bulge effacing the ventral thecal sac. There are moderate degenerative facet joint changes. There is severe narrowing of the central canal and moderate bilateral neural foraminal stenosis.
L5-S1: Degenerative facet joint changes with severe right and moderate left neural foraminal stenosis. There is no significant narrowing of the central canal.
The remaining visualized structures demonstrate small bilateral effusions and atelectasis. There is aneurysmal dilatation of the abdominal aorta, which measures approximately 6.0 x 6.0 cm.
IMPRESSION:
1. Subacute compression deformity of T11 , which appears progressed from the CT abdomen and pelvis from 2 weeks ago. There is greater than 75% loss of vertebral body height and mild retropulsion of the posterior superior aspect of T11 . There are chronic appearing compression deformities of T12 and L1 with severe compression deformity of L1.
2. Advanced multilevel degenerative changes are detailed above. There is a large disc osteophyte complex at the T12-L1 level, which contributes to moderate narrowing of the central canal at this level. There is also severe narrowing of the central canal at L3-L4 and L4-L5.
3. Multilevel moderate neural foraminal stenosis and severe right neural foraminal narrowing at L5-S1.
4. Significant aneurysmal dilatation of the abdominal aorta measuring up to 6 cm.
5. Small bilateral pleural effusions and opacities at the lung bases, which most likely reflect atelectatic changes versus infiltrates.
6. Prior vertebroplasty changes at L1.
doctor
Answered by Dr. Neeraj Kumar (30 minutes later)
Brief Answer:
Less option for surgical remedy, require proper evaluation.

Detailed Answer:
Hello XXXX,
I have gone through your query and reports.
According to me the problem is osteoporotic degenerative changes in spine involving lumbar spine more than lower thoracic spine. There are significant narrowing of spinal canal and foramina at various levels. Also vertebral body height is reduced with osteophytes.
She need to be investigated for serum Calcium, Phosphate, SALP, Vitamin D3 , DEXA scan, Serum immunoelectrophoresis for myeloma. May require workup for malignancy if some suggestion present.
At this age and with this picture of spine surgical option is less beneficial. Physiotherapy with proper supplementation of calcium and vitamin D 3 and other pain modulators may be of help.
I will advice you to consult a neurosurgeon for surgical opinion also.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Neeraj Kumar (1 hour later)
Could a heart attack result from UNDERTREATED BACK PAIN DUE TO UNTREATED COMPRESSION FRACTURES? She was diagnosed with chronic CHF. Could the chronic hypoxia be related to the CHF and the CHF be related to a heart attack? Because the hypoxia (on room air) started when the undertreated 10/10 back pain occurred. (See uploaded image) If the pain meds are NOT working do you suggest surgery? Please review uploaded image of actual events while the patient was a resident of a Nursing Home.

doctor
Answered by Dr. Neeraj Kumar (49 minutes later)
Brief Answer:
Heart attack may occur due to cumulative effect of factors

Detailed Answer:
Hello dear,
I have gone through your question and understand your concerns.
Heart attack may be precipitated by many causes like underlying CHF, anxiety, emotional surge, undue exertion, extreme pain.
Back pain leading to heart attack may be very unlikely possibility and other associated factors may also have played some role.

For severe pain associated with backache you can consult anesthesia or neurosurgeon. They will have to examine you neurologically, to look for any immediate methods to control your pain.

Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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What Does My MRI Scan Test Report Indicate?

Brief Answer: Less option for surgical remedy, require proper evaluation. Detailed Answer: Hello XXXX, I have gone through your query and reports. According to me the problem is osteoporotic degenerative changes in spine involving lumbar spine more than lower thoracic spine. There are significant narrowing of spinal canal and foramina at various levels. Also vertebral body height is reduced with osteophytes. She need to be investigated for serum Calcium, Phosphate, SALP, Vitamin D3 , DEXA scan, Serum immunoelectrophoresis for myeloma. May require workup for malignancy if some suggestion present. At this age and with this picture of spine surgical option is less beneficial. Physiotherapy with proper supplementation of calcium and vitamin D 3 and other pain modulators may be of help. I will advice you to consult a neurosurgeon for surgical opinion also. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr Neeraj Kumar