Question
I got the results of my MRI and my dr explained it to me but due to my bad memory as a result of a stroke I suffered in 2012, I cant remember what she told me in plain English and cant understand what this report is telling me. Can you help me understand what its telling me?

RADIOLOGIC EXAMINATION:
MR LUMBAR SPINE WO CONTRAST

CLINICAL HISTORY:
Chronic low back pain radiating to the left hip and leg worsening over the past 3 years.

COMPARISON:
None available

Technique:
Multiplanar multi-sequence MRI of the lumbar spine was performed without the administration of intravenous contrast.

FINDINGS:
Vertebral body heights and alignment are maintained. Osseous marrow signal is mildly heterogeneous, within normal limits. Partial disk desiccation throughout with preserved intervertebral disk heights. Prominent epidural fat deposition beginning at L5-S1 level collapses the distal thecal sac. Conus medullaris is normal in location and caliber. Paraspinal soft tissues are normal in appearance. Visualized portions of the sacroiliac joints demonstrate mild degenerative changes. Posterior subcutaneous dependent edema present.

On axial images,

T12-L1 through L2-L3: Mild facet arthropathy and ligamentum flavum thickening without spinal canal or foraminal stenosis.

L3-L4: Minimal concentric disk bulge. Facet arthropathy and mild ligamentum flavum thickening without foraminal or spinal canal stenosis.

L4-L5: Mild broad based left foraminal disk protrusion, facet arthropathy and ligamentum flavum thickening causing mild to moderate left foraminal stenosis. No spinal canal or right foraminal stenosis.

L5-S1: Mild concentric disk bulging and facet arthropathy with no foraminal stenosis. Increased epidural fat deposition begins collapsing the thecal sac at this level.


IMPRESSION:

Mild broad-based disk protrusion causing mild to moderate left neuroforamenal stenosis at L4-L5.

No significant central canal stenosis present.

Answer
Hi Dezarie,

OK, lets go over the findings that are related to your symptoms of chronic low back pain radiating to the left hip. We look for a correlation between the findings on imaging studies and the symptoms that you have. This should also be correlated with physical examination findings.

In this case, there are related findings to the pain that you are experiencing.

"L4-L5: Mild broad based left foraminal disk protrusion, facet arthropathy and ligamentum flavum thickening causing mild to moderate left foraminal stenosis."

The L4-L5 is the level where this is going on. It is the fourth and fifth lumbar vertebrae or spinal bones in your lower back. You have a disc between these 2 bones that is protruding. The language can sometime be confusing between bulging, protruding and herniating, but you have a herniated disc that is causing nerve pressure on the left side.

Facet arthropathy is arthritis in the joints in the back of the spinal bones called the facet joints. This can cause outgrowths of bone on the joints and restricted motion or stiffness.

The ligamentum flavum is a ligament that runs along the inside of the back part of the spinal bone. The thickening is part of arthritis and can be irritating from inflammation.

What all this does is narrow the space where the nerve comes from the spinal cord and outside to the hip. Foraminal stenosis is the medical term for this. It is a pinched nerve more or less from a herniated disc and arthritic changes. The herniated disc and arthritis can cause back pain as well pain that radiates into the left hip. It is pinching the L5 nerve root, which goes into the hip and down into the side of the leg and can even effect the first few toes.

I hope this helps and wish you all the best in alleviating this problem.

Regards,

Dr. Steve