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Had a back injury and disc space narrowing and loss of T2 signal shown in MRI. What does it mean?

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Practicing since : 2001
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Hello my name is XXXXXXX I had an MRI last week and the result say the following which I am having trouble understanding. My doctor was very confusing and has suggested I see a neurosurgeon. I have had a back injury for 13 years now. With the symptoms getting worse in the last 12 months. Anyway here are the results of the MRI. The T2 - weighted sagittal acquisiton demonstrates disc space narrowing and loss of T2 signal at L4/5. A midline annular fissure is present with a focal protursion. The signal intensity of discs above L4 is preserved., The spinal canal apper capacious, the conus cord not impinged. The bone marrow signal is normal on T1 weighting.Slight facet arthopaathy is present at L3/4. The L4/5 disc is narrowed. L5 /S1 disc appears normal. Can you please explain this to me in plain english, thanks. XXXXXXX
Posted Sat, 30 Nov 2013 in Brain and Spine
Answered by Dr. Michelle Gibson James 29 minutes later
Brief Answer: arthritis and disc degeneration Detailed Answer: Hi, thanks for using healthcare magic The vertebra are different aspects, the facet joints (that are mentioned in relation to the L3 and L4 vertebra) are the parts where two vertebra meet or interface with one another. Like all the other joints in the body, the facet joints consist of bone, cartilage, synovial tissue. They play an important part in resisting stress to the vertebra. In your L3 and L4 vertebra there is slight facet arthopathy , this means that there is irregularity at the facet joints (where L3 and L4 are meeting). This usually implies that there are arthritis like changes to the facet joints. Between the vertebra are intervertebral discs. These discs are made up of two main parts; the outer ring is called the annulus fibrosus and the inner part is called the nucleus pulposus. These intervertebral disc act as shock absorbers, it is made up of a gel like substance. AS aging occurs these discs start to degenerate or break down, they lose some of the fluid in the gel and become disorganised and weaker.60% of persons over 40 have some degeneration of the disc. Because the disc is weaker and not as gel like then the disc space decreases , this is why there is narrowing between L4 and L5 because the disc is degenerated. The result also states that there is no problem between L5 and S1 and that the spinal cord itself is not being compressed by the vertebra. Summary- arthritis at the facet joints L3 and L4 degeneration of the disc between L 4 and L5 causing narrowing of the disc space This is mainly treated by pain medication and physiotherapy. I hope this helps, feel free to ask any thing else
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Follow-up: Had a back injury and disc space narrowing and loss of T2 signal shown in MRI. What does it mean? 2 days later
Thank you. Should I be seeing a neurosurgeon ( my doctors suggestion) as I am taking some very strong pain medications. Fentanyl patches 50mgs. Tramal 400 mgs, Lyrica 50 mgs and Advanza for depression. I injured my back at work 13 years ago. I suffer with a lot of pain in both legs and have trouble sitting or standing for long periods. I saw a phsyio for 3 years while the insurance company covered the costs. I have tried excersice, weight loss. Swimming, walking and I also had accupunture. Would it help to have a discectomy as my doctor has suggested or do I continue taking alll these pain killers. I have seen the same doctor. Should I see someone else?
Answered by Dr. Michelle Gibson James 2 hours later
Brief Answer: a pain management clinic Detailed Answer: HI Back pain can be excruciating for most persons. Because there is no impingement on the spinal cord, a neurosurgeon may not rush to perform any surgical procedure. A pain management clinic which would have access to different types of persons involved in pain care (like a pain doctor and therapists) may be the best option. They may consider a neurologist referral and would know when surgery was needed. Please free to ask any thing else
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