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Thread: Advice on Mri report

  1. #1

    Post Advice on Mri report

    Hi all glad to have found this site and sorry for this long winded explanation, I have been suffering from back pain and spasms on and off for the last 4 years until march of this year when everything just started to get extremely bad, spasms started to come more frequently and the pain across my lower back buttocks and down my legs became nearly unbearable April 2007 my DR sent me for xrays which showed I had mild scolisos in the middle of my spine she tried me on 3 different medication to no effect and injection to relax the spasms in April she sent me to physical therapy finally in august I went to see an orthopedic surgeon who sent me for an mri and told me that I had stenosis and suggested that I try spinal injection, the same week a client that I was painting for who is a neurosurgeon at the Lahey Clinic took a look at my mri and said yes it did look like I had stenisos but that I also had a ruptured disc at L5/S1 and some other things going on he didn't go into detail and surgery would help but told to come see him on a professional bases as he would like to go over the mri’s in more detail and the radiology report which I did not have at the time with his colleague before recommending anything and possibly a new mri as it will be 4 months since I had the mri when I see him in December.
    Here is the info on the mri any advise or questions I should ask when I go to see the neurosurgeon would be really appreciated

    Technique: Multiplanar multisequence Mri of the lumbar spine without IV contrast including following sequences: 3 plane localizers, sagittal T1/T2, and stir sequences, axial T1/T2

    Finding are seen at the following levels

    T12-L1 No disc bulge, central canal stenosis, or neural formaminal narrowing seen.
    L1-L2 There is mild diffuse broad-based disc bulging, without loss of the dorsal concavity. No central canal stenisos or neural foraminal narrowing.
    L2-L3 There is mild diffuse broad-based disc bulging, without loss of the dorsal concavity. There is mild central canal stenisos without neural foraminal narrowing.
    L3-L4 There is moderate diffuse broad-based disc-bulging with far left lateral component and mild facet arthropathy with minimal inward bulging of the ligamentum flava, in combination with a significant amount of dorsal epidural fat causing moderate central canal stenisos. There is left neural foraminal narrowing.
    L4-L5 There is moderate diffuse broad-based disc-bulging and moderate facet arthropathy with minimal inward bulging of the ligamentum flava right greater than left in combination with a significant amount of dorsal epidural fat causing moderate central canal stenisos. There is moderate left and mild right neural foraminal narrowing.
    L5-S1 Posterior disc bulging predominant on the left with narrowing of the left lateral recess possibly exerting mass effect on the left traversing S1 nerve root. Prominent epidural fat causing severe central canal stenisos. Perineural cyst in S1


    Once again thank you for any help and sorry again for the long question.

  2. #2
    I'd wonder why he says the disc is ruptured, and the MRI says it's bulging.

  3. #3
    Hi tam63 I'm not really sure but when he look over the mri he point out the bulging in the other discs but said because shape an the way it protrudes out against the left nerve that it's more likely ruptured than just bulging

  4. #4
    OK, so he apparently disagrees with the radiologist. Fair enough.

    I guess in general, with surgery, you would want to know what he proposes to do exactly. I can think of a number of questions.

    What does he expect the benefits to be?
    What are the risks? What % of time do problems occur?
    What are the odds of success?
    What are the alternative surgeries, if any? Why did he chose what he did?
    What is likely to happen if you don't have surgery?
    What should you expect after succesful surgery, and what can happen down the road.
    How will they manage pain post-surgically?
    Will you need rehab?
    Depending upon your insurance, is everyone in-network?

  5. #5
    Thank you Tam for the response and the suggested questions

  6. #6
    You're welcome. Please come back and let us know what he says.

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