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MRI Question
I had had sever back pain for years, recently I went for my followup thoracic and lumbar MRI and flexion/extension xray series. I would like some help understanding what I'm reading. I do have a followup appointment over the phone (I live in a different state than my doctor) but thats not for 3 more weeks.
[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.
[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.
[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.
What does this all mean and how is it treated? Is there hope that I could have less pain?
Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?
I appreciate any help you have to offer! Thanking for taking the time to read my post!
[B]Thoracic MRI Findings:[/B]
Subannular disc protrusion (extending 2-3mm beyond the endplates) at T10-T11 and T11-T12 which reaches the ventral suface of the thecal sac but does not displace the cord itself. Both of these disc protrusions are just to the righ of the midline. There is a smaller disc protrusion just to the right of midline at T7-T8, this does not reach the thoracic cord.
[B]Lumbar MRI Findings:[/B]
The tip of the cornus medullaris terminates at T12-L1 and conus morhphology is normal. There is a diffuse of annular disc bulge at L5-S1 just reaching the ventral surface of the thecal sac and touching the traversing S1 nerve roots in the lateral recess. There is a tear in the outer annulus. At L4-L5 there is a diffusely bulging disc lying close to but not displacing the traversing L5 nerve roots bilaterally. Conclusion: There are disc protrusion at L4-L5 and L5-S1. At L5-S1 the disc touches the traversing S1 nerve roots bilatterly. Please correlate for S1 radiculopathy.
[B]Flexion/Extension Xray Findings:[/B]
There is mild wedging of the T10-T11 vertebral bodies with accentuation of the throacic kyphosis at that level. There is disc space narrowing at L5-S1.
What does this all mean and how is it treated? Is there hope that I could have less pain?
Also when I looked up the wedging of my thoracic discs all I could find was info about compression/wedge fractures. Is my disc fractured or was it at some point? How is that treated?
I appreciate any help you have to offer! Thanking for taking the time to read my post!
Best Answer
Thank you so much for your response Dr. Kaul, that was very helpful. I've also been suffering from gastroparesis and constipation so there is some question as to whether some malfunction in my nerves are causing those issues. I had a phone follow up the other day with my neurosurgeon and they want me to do an EMG now. I have heard some pretty bad stories about EMGs so it's got me fairly nervous. I have no clue what they are hoping to gain by giving me this test but I hope it gets me one step closer to some kind of relief.
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The report describes
Intervertebral disc protrusions at T10/ T11 and T11/ T12 vertebral levels abutting the outer covering on the spinal cord, without any actual pressure on the cord and a mild disc protrusion at T7/ T8.
Intervertebral disc bulge at L5/ S1 abutting the outer covering of the spinal cord and the S1 nerve root.
Intervertebral disc bulge at L4/ L5 abutting the L5 nerve roots.
Wedging of the vertebral bodies usually occurs with fractures of the vertebra, though it can be seen normally in a few individuals at thoracic levels without trauma and may require detailed review to differentiate this from fractures/ trauma.
Well, the changes described in the report are mild to moderate and management may depend on the clinical symptoms i.e. presence or absence of S1 radiculopathy. While in the absence of radiculopathy, a conservative approach would be preferred; in the presence of a radiculopathy, surgical/ interventional procedures may be required. I would suggest discussing the situation and the suggested management plan in detail with your treating doctor.
Hope this is helpful.
Take care!