Question
I recently had surgery fro heniated disks and am still experiencing significant pain. My doctor requested another MRI and was hoping you could help me with the report findings. Here they are.
Comparison: Prior preoperative MRI study dated December 6.
There are five types of lumbar vertebras in satisfactory position and alignment. Preservation of the vertebral height and signal arising from the marrow of the vertebral bodies. Conus medullaris ends at the level of the first lumbar vertebra. There is preservation of the signal arising from the marrow of the lumbar vertebras and visible porrtions of the sacrum. Postoperative changes are noted posterior to the fifth lumbar vertebra. There is narrowing of the L5-S1 disc space. Interval resolution of the large herniated disc projecting posterior to the L5-S1 level as compared to the prior MRI study dating back december 6.
Mild circumferential bulge of the anulus fibrosus posteriorly to the L4-L5 level similar to the prior study. No abnormal areas of enhancement. Enhancement of the tissues posterior to the fifth lumbar vertebra consistent with scar tissue from prior surgery. Mild hypertrophic changes of the posterior facets more noticeable at the lower lumbar spine and lumbosacral junction.
Imppression:
Interval resolution of the priorly described large herniated disc projecting posterior to the L5-S1 disc spaace as compared to the prior MRI study of December 6. Persistent circumferential bulge of the anulus fibrosus posteriorly at the L4-L5 level. No abnormal enhancement except for the scar tissue posterior to the L5-S1 level related to the prior surgery. No new herniated disc.

So does this mean the persistant pain is in my head?

Answer
Hi Richelle,
No it doesn't mean that it is in your head :).   The original disc herniation may NOT have been the entire cause of your lower back pain.  I am assuming that you did not have a "fusion" type surgery of L5-S1.  So regarding straight interpretation of the MRI. The comparative findings show a change, the herniation is now gone and being that you had surgery, that change is a good thing.  There unfortunately is probably more to your lower back pain than the disc herniation.  This is VERY common.  Please let me know if you have anymore questions.   I'm sorry that you are still having discomfort.  

Sincerely,

Dr. Kaldy
[email protected]
www.lasvegaschiro.com