Are the 2 MRI different results and why do they mean?

[Momof4_loveit]

The first MRI WAS DONE JUNE 1, 2021 after a car accident in January of that year. Not from the findings in this MRI. But I have had a SI joint fusion in Sept 2021 and an ACDF at C5/C6 from the accident. I am still having back pain, pain in my left leg and foot. Weakness and numbness and tingling. Insurance would not approve for a nerve ablation to see if that was the cause of the pain. I’m scheduled for an epidural injection but he ordered another MRI. I posted the results of both because I’m lost and it’s almost a month before I go back in. Just wondering what’s going on and why the first says herniated disk and the second says bulging. The MRI were done is different types of machines, could that make a difference. The first one was an open on that I sat in and the second was a closed one that I laid down in.

JUNE 1,2021 MRI

At L1-2, there is no evidence for disc herniation, canal stenosis or neural foraminal stenosis.
At L2-3, there is a left foraminal disc herniation resulting in mild to moderate left neural foraminal
stenosis. There is abutment of the exiting left L3 nerve. There is disc bulge and osteophytes;
however, the disc herniation extends beyond the borders of the posterior osteophytes. The spinal canal and right neural foramen are patent.
At L3-4, there is no evidence for disc herniation, canal stenosis or neural foraminal stenosis.
At L4-5, there is bulging of the disc. This results in an anterior impression on the thecal sac.
There is no central canal stenosis or foraminal stenosis.
At L5-S1, there is a posterior disc herniation with increased signal extending more towards the
left. There is abutment of the left S1 nerve root. There is mild spinal stenosis. There is mild to
moderate left neural foraminal stenosis. The right neural foramen is patent.

IMPRESSION:
At L2-3, there is a left foraminal disc herniation resulting in mild to moderate left neural
foraminal stenosis. There is abutment of the exiting left L3 nerve. There is disc bulge and
osteophytes; however, the disc herniation extends beyond the borders of the posterior
osteophytes.
At L4-5, there is bulging of the disc. This results in an anterior impression on the thecal sac.
At L5-S1, there is a posterior disc herniation with increased signal extending more towards
the left. There is abutment of the left S1 nerve root. There is mild spinal stenosis. There is
mild to moderate left neural foraminal stenosis.

AUGUST 2,2022 MRI

FINDINGS:
Vertebral column:
There are 5 lumbar vertebral bodies without ribs, as seen on the comparison CT mentioned above. Lumbar
vertebral bodies are normally aligned. Vertebral body heights are normal. Bone marrow signal is within normal
limits for age. There is mild degenerative disc height and signal loss at a few levels including L2-L3 and L5-51.
Cord and epidural space:
The tip of the conus medullaris terminates at the lower L1 level, within normal limits. The visualized conus
medullaris is normal in signal intensity. Nerve roots of the cauda equina are normal in course and caliber. There is
no epidural fluid collection or mass.
T12-L1: Normal
L1-2: There is mild bilateral facet degeneration. The disc is normal, with no thecal sac or foraminal stenosis.
L2-3: There is mild bilateral L2-L3 facet degeneration, with a slightly bulging disc. The thecal sac and foramina are patent.
L3-4: There is mild bilateral L3-L4 facet joint degeneration, with a slightly bulging disc. The thecal sac is patent.
The left neural foramen is mildly stenotic but the right is patent.
L4- 5: There is mild bilateral L4-L5 facet degeneration with a very slight disc bulge. The thecal sac and
neuroforamina are patent.
L5-S1: There is mild bilateral facet joint degeneration. Disc space degeneration includes a small broad left
paracentral protrusion that narrows the left lateral recess and may slightly contact the transiting left S1 nerve root,without nerve root compression or displacement. The neuroforamina are patent bilaterally.
Soft tissues:
No definite pathology is seen in the visualized soft tissues of the abdomen or pelvis on this nondedicated exam.
There is relatively mild overall fatty atrophy of the posterior paraspinous musculature, greatest near the level of the lumbosacral junction.
On the lowest axial images, there is susceptibility artifact extending across the left sacroiliac joint, suggestive of
fusion hardware that was not present on the comparison CT from September 3, 2021.
IMPRESSION:
1. A small broad left paracentral L5-S1 disc protrusion slightly contacts the transiting left S1 nerve root in the lateral recess, without nerve root compression or displacement.
2. Otherwise, disc space and facet joint degeneration in the lumbar region is mild and described above. No other
disc herniations are seen and there are no sites of thecal sac stenosis. There is mild degenerative narrowing of the left L3-L4 neural foramen but other lumbar foramina are patent diffusely and bilaterally.
3. At the margins of this exam there is susceptibility artifact from apparent left sacroiliac joint fusion hardware,
incompletely seen here and not present on the comparison lumbar spine CT of September 3, 2021.