Does anybody here understand an MRI impression?

[upstateNY]

Trying to understand the results and impression of my most recent lower lumbar MRI,  and not having much luck interpreting data I can find via google.

Any medical experts on here?

[kittyluv1]

I think you are on the right track.  In fact you are more active than most people with similar findings.  Sorry that the activity you are able to perform doesn't translate into an ability to resume your prior job duties.

Obtaining SSDI is rather like running a maze blind-folded.  Most applications are denied on the first submission, but I am personally aware of individuals who (after having progression of their situation) reapplied and were subsequently approved.

If your functional capacity eval supports a >percentage of disability, I hope that it is sufficient for you.  I was given SSDI in 2003, but it was a struggle with the enormous amount of paperwork and documentation they required.  Now that I am approaching regular retirement age I believe that my disability income converts to regular Social Security benefits.  Guess I'll need to see how that is computed.  I hope the best for you.

Your new doctor(s) are obviously making efforts to help you as much as possible.
Good luck in everything ----

[upstateNY]

Thanks for your reply.  I was orginally diagnosed with the degenerative disc disease back in 2002 and had some extrusion protruding against my thecal sac.   Had sciaticca often.  NYS Disability (denied me in 2002, I had no lawyer) summarized I was capable of standing up to 2 hours per day and lifting 5 to 10 lbs repetitively.

I opted for no surgery but daily walking and physical therapy instead at that time.  But I blacktopped for a living and that "summary" was pretty much a death sentence to my livelihood and earnings.

I have barely been able to work much since that time, I have no degrees to fall back on and depended on my strength and physicality to make money all my life.

Recently I was diagnosed with type 2 diabetes and now I eat a moderate restricted carb/calorie diet and walk 4 miles per day.  Have resumed physical therapy and have lost 40 lbs.

Decided to get another MRI as I have occasional intense pain and I can never sleep well (its been 7 yrs).  My new doctors say this most recent MRI is quite a bit worse then the one from 2002.

My spine is starting to straighten somewhat too, lumbar lordosis.

My new doctor(s) have set me up with the PT and a functional capacity evaluation soon (the next 3-4 weeks).  To determine the % of my disability.

[kittyluv1]

Here is an interpretation of the MRI impression.  I'll start with some terminology.

Spondylosis:  degenerative arthritis of the vertebrae and adjacent tissue which, if severe, can cause compression of the nerve roots and cause pain and/or sensory changes in the extremities.

Disc bulging:  the cushion between the vertebrae is the intervertebral disc which has a strong outer covering called the annulus.  As the disc degenerates it loses water content and becomes more brittle.  It can lead to tears or breaks in the annulus allowing disc material (nucleus polposis) to protrude.  A bulge indicates that some disc material is pushing against the annulus, but has not completely torn through the annulus. Depending on the size and location of the bulge, it can also create compression of the spinal nerve roots.

Posterior facet arthrosis:  the facet joints are bones at the back of the vertebrae which act as hinges and connect the vertebrae directly above and below creating a joint that allows movement of the spine.  Arthrosis indicates a degenerative process of the joint which affects the cartilage and synovial fluid (lubricant) and may lead to increased friction as the bones move causing pain and stiffness.

Central canal:  contains the spinal cord,  Narrowing or stenosis of the central canal can create pressure on the outer area of the spinal cord and result in pain and sensory changes.  If stenosis is increased significantly the cord itself may be altered in alignment.

Neural foramen: opening in the vertebrae that the spinal nerve roots travel.

The results indicate that you have a congenital (at birth) narrowing of the central canal combined with bilateral narrowing of the neural foramen secondary to the degenerative changes of the facet joints and disc bulges.  This is seen at L3-L4 as mild to moderate narrowing and at L4-L5 as moderate narrowing.
There is no indication in this impression that the spinal cord is affected, but the narrowing of the bilateral neural foramen is possibly affecting the spinal nerve roots causing pain and sensory changes (numbness and tingling).

There is generalized spondylosis in the lower thoracic and the lumbar spine. Mild disc bulges are noted at multiple levels and generalized facet joint arthrosis indicating degenerative changes affecting the lumbar spine.

The degenerative changes occur as a natural process of the wear and tear on the spine as we age.  Many symptoms related to these changes can be treated effectively with conservative measures such as anti-inflammatory medications and physical therapy.
If no significant relief of subjective symptoms is obtained, more options are available such as facet joint injections, steroid injections etc.

Your doctor can review the results of the imaging films in greater detail and discuss the treatment options available.  If you have any additional questions or concerns don't hesitate to request further assistance.

Keep us posted on your progress ----

[upstateNY]

Have checked back on numerous occasions in hopes of your response.

[upstateNY]

bump

[upstateNY]

IMPRESSION:

1) Mild generalized lower thoracic and lumbar spondylosis, minor multilevel disc bulging, generalized posterior facet arthrosis.

2) At L4-5, there is moderate combined central canal, bilateral lateral recess, and moderate bilateral foraminal/peripheral stenosis.  This is secondary to disc bulging (primaily foraminal), posterior facet arthrosis, and congenitally small central canal with shortened pedicles.

3) At L3-4 there is mild to moderate framinal/peripheral stenosis secondary to foraminal disc bulging and posterior facet arthrosis.


There is also a results page with twice as much to type.  Can you interpret the impression?

[kittyluv1]

Interpreting the medical language written by the radiologist into understandable layman's terms is possible if the findings are posted in entirety as seen on the MRI report.

No diagnostic interpretation is given as all results need to be correlated with your subjective symptoms and a comprehensive medical exam.  The definitive diagnosis and treatment options are best discussed with your treating medical provider.

Post the MRI findings and we will provide assistance in understanding the report.