MRI RESULTS....What does this mean?

[CALLA]

I am a 29 yr old mom of 2. I had a 2 level decompression in 2004. Things were GREAT!! Then all of a sudden in September 2005, I started noticing pain in my low back, and almost like a 'popping' sound(feeling)?? I have continuous flare-ups, and lately it is really making my leg spasm???? But the pressure in my low back is UNBELIEVEABLE!!!!

This is a recent MRI I had, no idea what it all means, stands for etc....If there is anyone here who might be able to explain it in laymans terms I would appreciate it!!!! THANK YOU!!!

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RADIOLOGIC FINDINGS:
Assuming that there is a small non-mobile disc between S1 and S2, the level of the surgery (Laminectomy) is at L5.

T11-T12: There is a mild posterior disc bulge which is unchanged with no significant spinal stenosis.

T12-L1, L1-L2, L2-L3 and L3-L4, essentially normal.

L4-L5: There is no significant disc space narrowing, but there is a diffuse posterior disc bulge with associated moderate facet hypertrophy. These changes are responsible for a moderate spinal canal stenosis, as well as mild bilateral lateral foraminal stenosis.

L5-S1: There had been a prior Laminectomy. There is no significant disc space narrowing, but there is a diffuse posterior disc bulge with a superimposed posterocentral focal disc protrusion, which is unchanged. No significant spinal canal stenosis. Bilateral facet hypertrophy. Secondary, moderate bilateral lateral foraminal stenosis.

Vertebral alignment is preserved. The medullar conus is behind L1.

Artifacts were seen in the superficial soft tissue of the back, at the level of
L4-5, consistent with the prior surgery.

IMPRESSION:
L4-L5: Known moderate spinal canal stenosis at L4-5 due to diffuse posterior disc bulge, with associated mild bilateral lateral foraminal stenosis.

L5-S1: Prior L5 Laminectomy with residual posterior disc bulge and posterocentral disc protrusion. No significant spinal canal stenosis, but moderate bilateral lateral foraminal stenosis.

[mmglobal]

Key words are the adjectives. All of the pathology described may be benign if it were mild. (It could still be symptomatic too.) However, the list of 'moderates' lets you know that there are some clear issues. (They also could be asymptomatic, but much less likely.)

This is still a huge puzzle and it's difficult to tell exactly what the issues are. As you've already had spine surgery and are probably marching towards more, learn as much as you can about your problem and about your options. Do your homework, make informed decisions.

Mark

PS... it's nice that you don't have any "severe's."

[CALLA]

THANK YOU MARK!!! For your interest in my questions.

Hopefully, I won't DRIVE you TOO crazy. I just can't understand why I am having so much discomfort lately. This is a WSIB injury, they have stopped my benefits, explaining to me that my pain is of a "subjective" matter, and that I do not have anything to show that I have any form of a disability?? WHAT DOES THAT MEAN!!!!???

My doctor will not let me return to work!! Ugh!!!.......WHAT A MESS!!!

So, I have yet another question;

there is a diffuse posterior disc bulge with a superimposed posterocentral focal disc protrusion.

OK!!! What is the difference between a posterior disc bulge and a superimposed posterocentral focal disc protrusion??

I think I am REALLY EXTREMELY CONFUSED!!!!!

This is ALL a new language to me...Thankfully I found this site, hopefully I will be able to find peole to explain it too me more clearly..

Thank you agan Mark, really appreciate it!!

Calla

[mmglobal]

A bulge is a bulge in the annulus and ligament, much like a bump on a rubber ball that has been weakned... it's still intact, but compromised, so there is a bump.

A protrusion is where the disc annulus (like the outside of a jelly donut or the rubber exterior of a tire) is torn all the way through and some disc nucleus material (jelly of the donut), is extruded through the annulus and possibly the ligament too.

Mark