Question
QUESTION: I had an MRI of the Lumbar Spine June 30, 2010. I just received a copy of the report and I dont understand how to read it. My doctor wants to send me to pain management, but I really want to know what is wrong.

Findings: No fracture or subluxation is seen. The conus terminates at the T12-L1 level. The pedicles do appear to be congenitally short at L3, L4 and L5.

Findings by Level:

L5-S1 level: Small midline disc protrusion. No evidence of nerve root impingement is seen. Mild facet joint hypertrophy is appreciated.

L4-L5 level:
Disc desiccation with a left paracentral disc protrusion with underlying annular tear. There is perhaps some mild nerve root impingement on the left due to this process.

L3-L4 Level:
Bilateral subarticular disc protrusions with very mild nerve root impingement at least on the left side.

L2-L3 Level:
Normal

L1-l2 Level:
Normal

IMPRESSION: Abnormalities noted at L4-L5 and, to a lesser extent, at L3-L4. The findings are probably slightly accentuated by some slight congenital shortness of the pedicles bilaterally.

ANSWER: Ksha,

Below I have changed the findings from doctor speak to patient understanding



Findings: No fracture or subluxation is seen. The conus terminates at the T12-L1 level. The pedicles do appear to be congenitally short at L3, L4 and L5.

This means your spinal cord ends at the 12th vertabra in your spinal column this is a normal finding. The pedicles are a structure that holds the front of the vertebra called the body of the vertebra to the back of the vertebra called the neural arch. This means that you have a spinal stenosis which means the tubelike compartment that your spinal cord travels through is a much tighter fit than is considered normal. This means that minor changes in your disc or in the way your spine aligns up or mis-aligns has a much more profound neurological affect. Your saving grace at the levels metioned is that spinal cord at that area turns into the cauda equina which literally means horse tail. So that means your spinal cord is more hair like at those levels and therefore can fit better into your smaller than normal tube as described above.

Findings by Level:

L5-S1 level: Small midline disc protrusion. . Mild facet joint hypertrophy is appreciated.

Think of a a jelly doughnut and some of the jelly is pushing its way out but only a small portion of the jelly has come out as a matter of fact a very small portion.

No evidence of nerve root impingement is seen.

This means the nerve comming out from in between your vertebra is not pinched.


Mild facet joint hypertrophy is appreciated.

This means the joints of the vertebrae have been beat up a little bit and it is showing the signs of the beging of arthritis.



L4-L5 level:
Disc desiccation with a left paracentral disc protrusion with underlying annular tear. There is perhaps some mild nerve root impingement on the left due to this process.


This means your jelly doughnut has more jelly comming out than the previous disc and tere is some drying out of this doughnut like it was left out of the package to long and is stale. The stale part is a weaker area of the disc and this has allowed your disc to let go of its jelly.This disc is causing definate pinched nerves which is the source of your pain. Also the facet or joint of the vertebra is also causing you pain.

L3-L4 Level:
Bilateral subarticular disc protrusions with very mild nerve root impingement at least on the left side.

This jelly doughnut has jelly sticking out in two different areas and towarde the bottom of the doughnut rather than just on the side and is causing a pinched nerve probably on both sides but mostly on the left.

L2-L3 Level:
Normal

Thank God

L1-l2 Level:
Normal
Thank God
IMPRESSION: Abnormalities noted at L4-L5 and, to a lesser extent, at L3-L4. The findings are probably slightly accentuated by some slight congenital shortness of the pedicles bilaterally.

IMpression is just away of putting everything I just said but in one or two doctor speak sentences.

I would never tell you not to go to pain management but they are going to put you on heavy pain pills and anti inflammatories and suggest spinal injections. I am not a needle guy so please realise what this procedure is exactly what it says spinal injections.

You are a good candidate for a chiropractic workup for spinal decompression and or manipulation under anesthesia. These are two very specific chiropractic techniques and you will ahve to find a chiropractor in your area who practices one or both of these in your area.

I hope this has shed some light on your health concerns. If you like this explanation please give me a favorable review if you didnt understand something please resubmit it to me. This was a very good question I sincerely hope the answer was.

Thanks for picking my profile to answer this question.

Dr John Q Quackenbush
Chiropractic Physcian Phoenix AZ
www.drqdc.com

---------- FOLLOW-UP ----------

QUESTION: Could this be the reason why I have had so many problems with my neck as well? It is awful and to put it mildly, hurts so badly. I acutally think that it would feel better if it were broken at times.

Answer
Ksha ,

Anything is possible with the human body and health. The problems you have in the lower back could be a contributing factor but it would be pertinent to have an exam of your neck and at least a set of x rays to determine what might be wrong with your neck.

DR Quackenbush