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Dr. Andrew Rynne

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MRI of my lumbar spine done. What does the report suggest?

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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

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Posted on Wed, 2 Jan 2013 in Bones, Muscles and Joints
Question: At 77 years of age, an MRI of my lumbar spine w/o contrast yielded the following impression:
# There is multilevel lumbar degerneration disk disease and facet degenerative hypertrophy.
# Grade 1 degenerative spondylolisthesis is observed at L3 -- L4; and
# mild degenerative retrolisthesis is observed at L-2 -- L3,
# Severe spinal at L3 -- L4 is present; as well as
# moderate spinal stenosis at L2 -- L3; and
# mild spinal stenosis at L1 -- L2;
# A mild left paracentral disk protrusion at L5 -- S1 is also present.
# Multilevel foraminal narrowing is present.
I would appreciate an interpretation of these findings. With thanks in advance,
doctor
Answered by Dr. Praveen Tayal 5 hours later
Hello,
Thanks for posting your query.
Your MRI is suggestive of age related degenerative changes at multiple levels in your spine. The disc protrusion, facet hypertrophy, foraminal narrowing, and spinal stenosis are these changes.
The spinal canal contains the nerves and a spinal stenosis causes compression of these nerves causing symptoms like pain going down your leg/legs, numbness or any abnormal sensation in your lower limbs.
You have a stenosis of spinal canal at L1,2,3,4 levels.
Facetal joint hypertrophy is a degenerative disease that affects the joints of the spine and is found in people > 65 years of age; first of all conservative methods using pain killers and steroids is tried and if they fail then steroid injections in the joint or sinu-vertebral nerve ablation which destroys nerves with electrical current may be an option. But this should be kept as last option.
Please consult an orthopedic surgeon/spine surgeon and discuss these treatment options with him. Till then, do a combination of strengthening, stretching and low-impact aerobic exercise after consulting a phsyiotherapist.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal 22 hours later
I'm disappointed that you did not explain the technical terms in the MRI diagnosis.

# degenerative spondylolisthesis observed at L3 -- L4; and
# degenerative retrolisthesis observed at L-2 -- L3,
# left paracentral disk protrusion at L5 -- S1

Perhaps I didn't directly request translation of the technical language, but I would like to have such explanations in clear everyday layman language or else I will stop payment on my credit card.
doctor
Answered by Dr. Praveen Tayal 3 hours later
Hello.
Thanks for writing again.
Degenerative spondylolisthesis is the slip of one vertebra on top of another due to arthritis in the lumbar facet joints. This is present in your case at L3-L4.
Retrolisthesis refers to a degenerative condition in which a single vertebra gets displaced and moves backwards onto the vertebra lying immediately below it.
Paracentral disc protrusion is same as disc herniation. The disc protrusion that is described between L 5-S1 also commonly seen in degeneration.The disc are present between the vertebra and they act as shock absorbers and cushions.
The disc are composed of an inner aspect and outer ring and normally contain a certain amount of fluid. When one of your discs (the jelly-like thing that you have between each two of your back bones) is somehow squeezed or pushed out of its natural position and touches a spinal nerve, it is protrusion and herniation.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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