Question
i was injured in auto accident ,mri states L-1/2 POSTERIOR DISC BULGES W/HYPERTROPHIC CHANGE ALSO L-2/3 AND L-3/4POSTERIOR DISC BULGE FLATTENING THE VENTRAL THECAL SAC AQLSO L-5/S1 GRADE 1 RETROLISTHESIS W/ FACET HYPERTROPIC CHANGE ,FORMINAL NARROWING W/ABUTMENT OF THE PERIPHERAL R/L5 ROOT ON ITS VENTRAL ASPECT.SCATTERED ANTERIOR DISC EXTENTION,ANTERIOR SPURRING.C2/3 POSTERIOR DISC BULGE C3/4 DISC BULGELEFT FACET HYPERTROPHIC CHANGEW/PROMINENT LEFT FORAMINAL NARROWING AND NEURAL OUTLET IMPINGEMENT RAISED FOR CONSIDERATION

Answer
Dear Mr. Smith,

You have multiple areas of degenerative changes in the spine which will likely make your recovery much harder.  Most of these issues were present before the crash (hypertrophic changes which means bony overgrowth like spurring).  However, some of the disc bulges are probably a result of the impact.  If you have previous MRI findings, it would be smart to compare the pre-crash images to the post-crash images to see where the differences lie.  I would also suspect that you have some significant ligament damage in the neck and this need to be quantified.  The best way to do this is with flexion/extension radiographs, A DMX study (dynamic motion x-ray), or with a FLAR study MRI looking for ligamentous damage.

For a better understand of what a disc bulge really is, I have a full discussion of this topic on my website along with illustrations for your appreciation.  You can also move from that page to others on the site which help to explain spinal anatomy along with a glossary of terms to help you understand the anatomy and physiology associated.

http://suncoasthealthcare.net/chiropracticinformation/discherniation.html

Now, some terms used:
Flattening of the ventral thecal sac means that the disc bulge has placed pressure on the front side of the tissue that surrounds the spine (the meninges also called the thecal sac)...this contains the spinal cord and the cerebrospinal fluid that protects, nourishes and cushions the spinal cord.

Retrolisthesis of L5 is the rearward movement of the lowest lumbar vertebra upon the sacrum.  This can reduce the area that the spinal cord has to move around as well as the area the spinal nerve roots have to move around.  This mat result in pain/inflammation/or compression of the nerve roots that supply information to the legs and feet.

Facet is the name for the joints in the spine...degenerative changes to the facet are often called hypertrophic changes, and this results in cartilage loss along the joint space, erosions, and bone deposition.

In your neck C3/4 DISC BULGE LEFT FACET HYPERTROPHIC CHANGE W/PROMINENT LEFT FORAMINAL NARROWING AND NEURAL OUTLET IMPINGEMENT RAISED FOR CONSIDERATION...means that the nerve roots that exit the spine on the left side of the neck are compromised with pressure from the disc bulging and/or the degenerative bony changes.  This can easily result in left sided neck pain as well as pain into the upper back and left shoulder.

Hope this helps your understanding Bob.  I know that some of the terms can be confusing...please check out the glossary on my website as it should be able to help.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net