New to forum- MRI Questions

[mary.mary]

Hello,

I am new to this Forum, I just had an MRI done and have the results, I am not familiar with ANY of this stuff, medical lingo etc...

If there is anyone who might be able to help me out with it I would be extremely THANKFUL!!

Findings: There is a transitional vertebra at the lumbosacral junction. The numbering system used on today's study should be confirmed prior to intervention. The convention utilized on today's study is that L1 is at the level of the conus and there is a lumbarized S1 segment.

T11-12: There is a minor central disc bulge. There is minimal effacement of the subarachnoid fluid space.

L3-4: The spinal canal does have a congenitally narrow Ap diameter. Hypertrophic facet arthritis of moderate to severe severity is present and there is hypertrophy of the ligamentum flavum with resultant central spinal stenosis of mild severity. Ther neural foramina are patent.

L4-5: Central spinal stenosis of moderate to severe severity is present due to diffuse bulging of the disc as well as hypertrophic facet arthritis. Disc does bulge into the inferior aspects of both neural foramina. Facet arthritis of moderate to severe severity is present bilaterally.

L5-S1: A large central disc extrusion is present with associated annular tear. There is marked deformity of the anterior aspect of the thecal sac. In addition, there is diffuse bulging of the disc, as well as hypertrophy of the ligamentum flavum with resultant central spinal stenosis of moderate to severe severity. the neural foramina are patent.

Impression: MULTILEVEL SPONDYLOSIS WITH L5-S1 BEING THE MOST SEVERLY AFFECTED.

I am a 24 yr old mother of 1(13 month old girl) who had a skiing accident in November, I have EXTREME pain (shooting sharp pain)down my left leg with numbness and tingling. It sometimes affects my right leg to my calf. I have INTENSE pressure in my low back. I have been in physio since December with no help.

Hoping I might be able to get some help and advice.

Thanks!!
Mary

[mary.mary]

OOPS!! I forgot to mention that I also have absent reflexes in my feet..I think that was what he said...I am SORRY if non of this makes sense......I am really new at all of this stuff!!

[mmglobal]

Mary, I'm so sorry that you are having such problems. I'll bet that much of your trouble predates the November injury because of the level of degeneration... that doesn't happen in just a few months.

Unfortunately, your options will be quite limited by the severity of the problems. Treatment options will vary greatly depending on where you go. Do your homework and make sure you discover all your options before you do something permanent, like a big multi-level fusion.

Good luck,

Mark

[mary.mary]

What are the different options out there? I am truly uneducated when it comes to all of this stuff. I am happy to have found this site, and I am hoping that I might be able to get some advice and direction.

Is surgery going to be my ONLY option? What is meant by a fusion? I don't even understand what ANY of the information on my report means etc etc. How could I have had all these problems before and not even realize it and not be in ANY pain, then I have my accident in November and BAM!! the pain starts and I have all these problems.

I am SORRY if I am asking too many questions or whatever, but I am REALLY confused, in pain & scared.

I HONESTLY don't know where to go or what to do, I am SO EMOTIONAL at this point, I am a TRAIN WRECK!!

[dshobbies]

Hi Mary,

Welcome to the forum. We're here to support, help educate, cry and laugh with you. We've been in your shoes. I know you're in pain and scared but calm down and take one step at a time. The first thing is definitely understanding your MRI.

Your discs, that cushy, crab-meat like material between your vertabrae are named for the vertabrae they lay (lie) between. The lowest, S1 is sacral 1, the only sacral, then lumbar, thorasic and cervical. Cranial is the top but I've never heard of anything going wrong with those??? You have a lumbarized S1 segment. Not sure but this might mean you have 6 lumbar levels instead of the normal 5. Not a big deal, so do I but also not sure????

So disc #S1/L5 is that cushy disc between sacral 1 and lumbar 5. A bulging disc (or herniated) means that the disc wall has weakened and the disc material is literally bulging out of it's usual space. A tear means that wall has a tear in it and the disc material can actually leak out. Picture this like a car's tire. If the side wall weakens, the rubber can bulge out like a small balloon. If it has a small hole, the air slowly leaks out.

Facets are those 2 bony structures sticking out from the round vertabrae. They may also limit the remedies available to you. Multi-level Spondylosis is degenerative disc disease (DDD) which simply means your discs are sick, weak and degenerating. It's also catching. If a disc is degenerated, the one on top and/or bottom of it has to carry an extra load and can also degenerate.

The terms moderate to severe are generally not good and require intervention. Your pain is also a pretty good indication that something needs to be done... but what.

When you go back to the doctor who ordered the MRI, make sure (s)he explains everything to your satisfaction. Remember, you are paying for his services and have a right to this information. Don't allow him to pull the 'there, there, trust me, I'll take care of everything' routine. This is your spine and you have the final say in what happens and when but before you can do that, you have to know what's what. Ask him what he recommends as a remedy. If he's not a surgeon, he'll probably recommend one.

Then you need other opinions. Different doctors, different opinions. If a surgeon doesn't perform a certain surgery, he is not likely to recommend it and his opinion might be biased in favor of those things he can do himself.

So your choice of doctors is of primary importance, both in the remedy selected and his level of expertise. Where do you live Mary? Perhaps someone on this forum knows of a great doctor in your area. Are you able to travel to consult with a doctor? What is your insurance which presents its own problems?

You also might want to consult a pain management specialist to help ease your pain while taking care of that baby. It can't be easy lugging her around.

So first, consult with your doctor about the results of your MRI. Ask as many questions as necessary. Consult with a pain management doctor. Get 2nd and 3rd opinions. Ask questions.

Please keep us posted as you manuever through this maze and we'll help as we can. And my advise to everyone is your situation, calm down and breathe!

Dale

[Kathy]

Mary,
Welcome and so sorry you have to be here. It is so scary to get thrown into this spine world, knowing nothing and feeling so overwhelmed (a good cry every now and then helps me... sometimes more now than then) I was 25 years old with a 2 and 1/2 year old and a 2 week old baby when we were hit by an 18 wheeler. I did all the usual therapy, shots, etc. It took me 3 years to finally find out what was wrong with me, so you are way ahead of the game since you already know what is wrong. Don't let a dr. push you around, I did and wasted time, money and in one case, made my situation worse. Ask questions, ask us, ask the surgeon, just ask and keep asking until you get it. We have all been there and are more than happy to help you out, just ask us. I am by no means an expert on MRI findings (I don't even understand all of mine); but it does sound like your problem is one that will not get better on it's own or with conservative treatment; which means you need surgery. Don't let that scare you, you will get through this. Where do you live? You need to first go meet with at least 3 different surgeons, different dr's and get lots of different opinions (which can make it more confusing; but you need to be educated going into this). Unfortunately, the dr's may seem all caring and all knowing; but they don't live with your pain and ultimately don't have to live with a bad outcome, so don't be overly trusting (I learned this the hard way). You are the only one looking at for you and you are your best advocate. You are probably freaking out right now; but you can do this, you are a mom, which means you have survived way worse than this (childbirth anyone?) Feel free to ask me any questions or to send me a private message and maybe we can chat by phone. Hang in there and be glad you found us, it's a great resource.
Best Wishes,
Kathy

[Terry Allen Blackburn]

I started rupturing discs in my 20's and continued spiraling downward with a total of four herniated discs in my early thirties. I had my first neck surgery in 1995. I had 4 discs replaced with artificial discs in 2006.

I hope that you don't have to go down some of the paths that others have had to travel down. If you do have to travel down some of the same paths, you won't have to do it alone.

We are here to help and support you in the process of your journey.

Terry Newton

[mary.mary]

PHEW!!

Thanks everyone for your honest answers!! If there is ONE thing I read that makes sense is to "calm down & breathe". I never realized how wishy washy my post sounded until I re-read it myself.

I have an appt on Tuesday with my doc to see where we are going to go from here. Is there ANYTHING that I should be asking him that I might not think of because I am new to this?

All I HOPE is that he will give me something that will work for this PAIN!! OMG!! I can't believe how bad it is!! I almost had this feeling that he didn't believe that I was in so much pain, I guess the numerous times I went in bawling my eyes out from the pain didn't give him any sort of a clue THAT THERE MIGHT BE SOMETHING WRONG!! UGH!! I find it REALLY hard to try and do the things I need to with my little girl and it breaks my heart because she really doesn't understand.

Anyways, thanks again for all the input and advice, I am SO THANKFUL that I have found this site and am surrounded by people who (unfortunately) have been or am in the same situation as I am.

I will keep you updated as I know more of what direction this is going in!!

Take care EVERYONE!!
Mary

[Kathy]

Mary,
Sometimes we just need a day or two to be mad, feel down and have a 'pitty party' for ourselves. But we all then must get up, dust ourselves off and decide to kick some spine rear! You are headed in the right direction by seeing your dr. Start making appts with surgeons now, don't trust just one surgeon. What happens is they treat you, if it fails, they may try something else; but eventually get to the end of their knowledge and guess what happens? They move on, sorry we couldn't help you (if you get even that) and you need to see someone else. At the end of the day, it is not their problem if you are better or not. They are taught to distance their emotions from the patients and some are REALLy good at it I can't think of many questions right now, probably will come to my mind as I lay in bed tonight I would have him show you your MRI films and point to and explain (in people terms) exactly what is going on. Why does he reccommend what he is reccommending? What would he do if this were his wife/family member? If he wants to do the procedure/surgery, what is his experience? How many of the ?treatment/procedure/surgery? has he done? What is the success vs. failure rate? How long will you be down? What will happen if you do nothing, will it make you worse? What if you get treatment, would he forsee future problems or does he think that it will be good for life (obviously they can't say for sure; but for instance my surgeon said that my spine should never need any more treatment; which I know is an opinion; but at least he gave his opinion and I took it as that). If he is referring you out, why the dr he chose? Does he personally know him/her? Buddies? Colleagues? Best of the best in your area? I was referred to a dr early on because my dr. was buddies with him, well, it was crappy treatment and I naively just went and trusted him. You can't get to many opinions.
Maybe see a few of different kinds of dr's, so it's not just surgery reccommendations (although that may be your only choice). I know this is asking a lot of your time; but trust me, you will not regret doing your homework. If you rush into somehting and it does not work, you will kick yourself in the rear forever (I say this from experience). All any of us can do is make the best choice for us, with the knowledge that we have. I wanted to know going into surgery, that I had done all my research (saw good, bad and ugly outcomes), researched my alternatives, and did what I felt was best for me. I wanted to have no regrets and I don't. I felt that I owed it to my husband and kids to get better, to keep fighting, to get better and get the old me back. I felt my best shot at the above mentioned was surgery. Others may choose to wait for better technology; but the way I saw it was that technology is always going to be getting better. So, I may wait for a new one to come, then there will be another on the horizon, so might as well wait for that one, and then so on. I figured if I can get 10-20 years out of this surgery, that the technology then will be good enough to fix me again (this is a gamble; but one I felt I had to take)
Discuss it with your family; but be prepared if you get the 'it can't be bad enough to need surgery' attitude, or 'I have pain all the time' or 'you seem to be fine, you still take care of the kid and house' etc. People not in this kind of pain, DO NOT GET IT. My family all thinks I am nuts for having surgery, with the exclusion of my husband, dad and step-mom. They think that I should just tough it out and that it could even be 'in my head'. That is why I LOVE this site. I have never ever been one to 'chat' online, no chat rooms, forums or whatever. Thought people who had online 'friends' were weird, didn't have a life, and lots of other hateful things. It was not until my pain and subsequently finding this site, that I got it. I am sure that these boards have saved lifes, just by having a listening ear that 'gets it'.

[mary.mary]

KATHY,

THANK YOU for taking the time to 'show me the way'. It is for sure the road I NEVER thought I would have to go down, it ALWAYS happens that way, just when you think life couldn't be any worse than BAM!!

I have had ALOT to deal with on my end other than the new spinal issues. When my daughter was 4months old her dad (my husband) was in a car accident and died, I STILL am not over it and to tell you the truth it is affecting me MORE now that I am having a hard time physically and constantly ask myself what it is that i had done to have all of this happen to me. I know that sounds selfish, but I can't help it!! I unfortunately have very little support, my mother died when I was 19 and my father I never really had a great relationship with. I do have my WONDERFUL sister-in-law, who God knows if she wasn't around it scares me to think where I would be at this point, even before the skiiing mishap!!

Anyways, I don't really want to bore people with my non-spinal issues, I just wanted to THANK YOU for being a shoulder to lean on since like you said, people who are not going through this HAVE NO IDEA how bad the pain is!!

Hope you are recovering well!! All the best to you and the family, your daughters are BEAUTIFUL!!

Talk to you SOON!!
Mary

[Kathy]

Originally Posted by mary.mary

KATHY,

THANK YOU for taking the time to 'show me the way'. It is for sure the road I NEVER thought I would have to go down, it ALWAYS happens that way, just when you think life couldn't be any worse than BAM!!

I have had ALOT to deal with on my end other than the new spinal issues. When my daughter was 4months old her dad (my husband) was in a car accident and died, I STILL am not over it and to tell you the truth it is affecting me MORE now that I am having a hard time physically and constantly ask myself what it is that i had done to have all of this happen to me. I know that sounds selfish, but I can't help it!! I unfortunately have very little support, my mother died when I was 19 and my father I never really had a great relationship with. I do have my WONDERFUL sister-in-law, who God knows if she wasn't around it scares me to think where I would be at this point, even before the skiiing mishap!!

Anyways, I don't really want to bore people with my non-spinal issues, I just wanted to THANK YOU for being a shoulder to lean on since like you said, people who are not going through this HAVE NO IDEA how bad the pain is!!

Hope you are recovering well!! All the best to you and the family, your daughters are BEAUTIFUL!!

Talk to you SOON!!
Mary

Mary,
I am so sorry to hear about your husband. I can not fathom going through that, you are obviously a very strong person. Sounds like you have been through more than most of us will ever have to deal with, and you are so young.
You won't bore us with non-spinal issues. It is nice to get our minds off of spines for a little bit. When I am in pain, all I can think about is my spine, so non-spine stuff is good. We are here to support you in ANY and EVERY area that you need. We all need a helping hand and an ear to listen. Please share whatever you need to, this is the best group of people... no judgement, just empathy and compassion.
I don't guess there is ever a 'good time' to have your spine fall apart. Just remember, that if you think you got it bad, just look over your shoulder. I had this re-enforced to me the other day at the airport (was having my post-surgery pitty party on how bad it was, how I hurt and all the other bs). I ran into the bionic man in the elevator (read my "I met the real bionic man post). He had 4 ADR's and both hips replaced, at the same time. He had a tumor and it destroyed his spine and hips. So, not only was this man fighting the fight of his life, cancer, he had major spine and hip problems. Made my 1 level ADR seem puny, put me back into perspective!
You can do this, you will do this and come out stronger. I know it is a hard fight and it is easy to get discouraged; but we are here for you. You are now part of our 'online family'. I'll have to say, that in my imagination, Terry is like the cool dad you always wanted, several women who are like the moms and lots of siblings, and cousins (and better than a real family, they are all claimable ) Well.... most of the time

[Justin]

Hey Mary,

I'm sorry about your spine issues. Good luck at your appt on Tuesday. You'll find the support system here is amazing and feel free to share whatever you need to with the forum. It can be very therapeutic. For private issues you don't feel like sharing with the world, you can also send private messages to forum members. I am sorry to hear about the loss of your husband.

Keep us posted on your situation!

[dshobbies]

Mary,

You are a whole person, not just a spine. Every aspect of your life affects who you are and how you tackle the world. The support system you have can make a huge difference. We, I Spine, as well as other forums you may have found are part of that support system. The non spine issues in your life, both good and bad, are important to those who support you.

Part of our job is to bring you back up when you get too low and laugh with you at your successes and even a good joke. Whether you need a easy and nutricious recipe to feed your daughter or a recipe for the perfect combo of meds, we're here for you.

You won't/don't bore us so please, just be who you are.

Dale

[treefrog]

Mary,
You have had a number of good suggestions. I'll add one. I don't know what sort of doctor you are going to, to discuss your MRI and medication. But for the medications, it may help for you to ask your doctor to refer you to a pain management (PM) specialist. They deal with chronic pain, and can be life-savers. General Practitioners sometimes get weird about prescribing heavy-duty medications (some by law, aren't even allowed to prescribe them), the kind that unfortunately, you may need. PM docs deal with people on meds for the long-term, as well as short-term, and should have no problem trying different meds until you find the one(s) that help control your pain. My PM doc is also the one who does epidural injections, recommended acupuncture, and also did my discogram.

I also lost my husband at a young age, when my son was 2.5 yrs old. But his was from diabetes, and was not totally unexpected, as he was ill for quite some time. I was lucky though, that I had my Mom and my sister close by to help me out. I'm glad that you have your sister, I'm sure she is a god-send to you.

Let us know how your visit goes tomorrow, and what plan of action they recommend. I highly recommend getting more than one opinion, but having that first one, gets you started. And we can help you understand what the pros and cons are of different options.