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    What is L5-S1 bone marrow edema?

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Posted on Mon, 10 Nov 2014 in Brain and Spine
Question: What is L5-S1 bone marrow edema?
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Answered by Dr. Vinay Bhardwaj 2 hours later
Brief Answer:
Edema = Swelling & Fluid Build Up

Detailed Answer:
Hello there, Thanks for coming to HealthCareMagic.

I'm assuming you had an MRI of the lumbar spine where the radiologist gave you a report which included this finding.

An MRI is a scan which is very good at looking at soft tissues. The L5-S1 segment is the area of the lumbar spinal column bordering the lower back and the tail-bone.

The scan is capable of looking inside the bone. Inside these Vertebral Bones, you have soft tissue called Marrow. It has many functions, including helping make new blood cells and strengthening the bone which it lives in.

Here the edema means that fluid (water and salts mostly) has built up and saturated the marrow a bit. There are many causes, inflammation secondary to trauma, or muscle injury is quite common. Another cause could be infections, but those are quite rare. Then there are very rare causes like medications and radiation therapy.

So, basically, the marrow inside this vertebral segment is swollen up and filled with fluid. The million dollar question is "WHY?". You need to show this result to the doctor who ordered the scan and go over the possibilities.

If you would like, you can give me more information surrounding your health and why the scan was done and we can hypothesize as to the cause.

I look forward to your reply,

Vinay
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vinay Bhardwaj 23 minutes later
I was involved in a MVA on 7/25/14, I was the first car stopped at a red light, rear ended by a driving going 25-30mph. He admitted he "wasn't paying attention". I have had 2 cortisone injections that are not working and they injection gave me a spinal headache treated with a blood patch. I have 3 appts next week for opinions. This is all new to me and I want to know what the common next step is with this type of injury. I was told it is permanent.
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Answered by Dr. Vinay Bhardwaj 1 hour later
Brief Answer:
Could you upload the scan report?

Detailed Answer:
Hi there, thanks for following up. The sudden shock from being rear-ended could definitely be the cause of the marrow edema. But these things don't usually happen in isolation. I'm willing to bet that there was some damage to the disc at L5-S1 as well. There could have also been microfractures to the facet joints above that level.

The reason I mention all this is because, to know the next step, I need to know the full extent of the injury. It would also help to know your age and medical history as well.

I'm sorry to hear about your troubles with the steroid injections. In all but a few circumstances, that would have been my first recommendation as well (for isolated edema).

The entire idea behind figuring out what to do is to regain stability at that level. If there is a disc injury or there are any fractures.. that means every time you move.. the spinal column (the bone that encases the marrow) will.. jiggle (I wish I had a better word) slightly, these movements could be the cause of your edema.

Now, if the injuries are just to the soft tissue (ligaments, etc) then the extent of treatment would be something like physical therapy, lumbar supports, medication and time. If there is actual bony injury or disc injury... then we might need to discuss surgical repair (that is if you can tolerate surgery, that's why I need to know your other medical history).

I don't want to run too far out into the weeds with all this, it can just get confusing and unnecessary. So I would ask you to upload a scan of your MRI images (all of them, T1 sequence, T2, Flairs, etc) preferably, if that is too much, then uploading the radiologists written report would be a close second. That will help me be more useful to you.

Any other medical history you can give me, previous injuries, medications that you take regularly, medical conditions, your height weight and build, etc are all incredibly useful to know here.

So, again, I look forward to your reply. I hope I haven't bored you with all the medicalese..

Vin
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vinay Bhardwaj

Neurologist, Surgical

Practicing since :2006

Answered : 544 Questions

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