Question
I am a female, 54 years old.  I am 5'6" and weigh 121 pads.  I started having neck pain and lower back problems in 1992 at the age of 38. The spasms in low back became severe at times, gradually getting worse over the years.  In Jan. 2006, I was diagnosed with congenial spinal stenosis and degenerative joint and disc disease.  I had a laminectomy and lumbar fusion of L2,3 & 4.  In July 2007, I had 3 discs removed from my neck and fusion of C4, C5, C6 & C7 with titanium plate and screws.
    I continue to have problems and had another MRI of my mid back and lumbar spine.  I have heard nothing from the neurosurgeon who performed both surgeries since the MRI over 5 weeks ago.  I am very anxious to hear about the results of my MRI.  I just want to know what is going on since my last two surgeries so I am sending a copy of my MRI's to see if you can shed some light on what is taking place in my back.  

Sincerely,
Marilyn Ferguson


MRI of my mid "THORACIC SPINE"  -----  OCT. 08th, 2008

History: Mid to low back pain

Large field-of-view localization sagittal series was obtained along with routine axial and sagittal images.  There is some motion artifact on the sagittal T2 series.  This one is the most useful for assessing disc pathology.  Level localization is difficult due to artifact from cervical spine postoperative changes.   When comparing conus medullaris postion with the accompanying lumbar exam, tip of the conus is at the inferior margin of T12 and the T12-L1 intervebral disc level.  

A1 T5-T6, there is small left paracentral disc herniation present.  No spinal stenosis.

T7-T8  Small left paracentral disc herniation.  No spinal stenosis

At levels T9-T10, T10-T11 and T11-T12 ---- Minimal disc bulges

Impression:

Two small thoracic spine disc herniations at T5-T6 and T7-T8

Also minimal disc bulges.   T9, T10, T11, & T12 No spinal stenosis     

MRI of my LUMBAR SPINE

The axial images begin at L2-L3

At this level, small posterior osteophytes (bone spurs) are present

Moderate disc bulge along with mild facet hypertrophy.   

Within the right kidney, there is a rounded structure measuring about 8mm.  This is T2 hyperintense and does not enhance.  This most like represents a small cyst.  

L3-L4:  Posterior osteophytes (bone spurs) and Moderate disc bulge.  There is additionally a superimposed right central to paracentral disc herniation of moderate size.  This mildly indents the thecal sac.  No spinal stenosis.  Postoperative changes posteriorly.  Some minimal enchancement in the right paramidline deep soft tissues.

L4-L5:  Postoperative changes posteriorly.  Small posterior ostophytes (bone spurs) and moderate disc bulge.  Superimposed moderate central disc herniation and Facet hypertrophy.  Borderline changes for spinal stenosis.   Deep right parmidline soft tissue enhancement.  

L5-S1:  Postoperative changes.  Facet hypertrophy.  Small disc bulge.  Moderate spinal stenosis.  The neural foramina appear open.  Some minimal deep soft tissue enhancement.  

IMPRESSION OF LUMBAR SPINE

Multilevel postoperative changes.  Multilevel disc abnormalities.   There are some areas of soft tissue enhancement in the posterior soft tissues, but no findings for any epidural fibrosis to contribute to spinal stenosis and focal peripherally enhancing hypointense areas to suggest abscess formation.  

Answer
Marilyn,
I will break the report down for you section by section, my comments in caps:
A1 T5-T6, there is small left paracentral disc herniation present.  No spinal stenosis.  SMALL DISC HERNIATION AT T5/T6

T7-T8  Small left paracentral disc herniation.  No spinal stenosis SMALL HERNIATION AT THIS LEVEL

At levels T9-T10, T10-T11 and T11-T12 ---- Minimal disc bulges MINOR BULGES AT THESE LEVELS

Impression:

Two small thoracic spine disc herniations at T5-T6 and T7-T8 SMALL BULGES AT THESE LEVELS

Also minimal disc bulges.   T9, T10, T11, & T12 No spinal stenosis     SMALL HERNIATIONS AT THESE LEVELS

MRI of my LUMBAR SPINE

The axial images begin at L2-L3

At this level, small posterior osteophytes (bone spurs) are present  BONE SPURS ALONG THE LUMBAR SPIN, TOWARD THE BACK OF THE VERTEBRAE

Moderate disc bulge along with mild facet hypertrophy.   BIGGER DISC BULGE AT THIS LEVEL

Within the right kidney, there is a rounded structure measuring about 8mm.  This is T2 hyperintense and does not enhance.  This most like represents a small cyst.  SMALL CYST IN THE KIDNEY

L3-L4:  Posterior osteophytes (bone spurs) and Moderate disc bulge.  There is additionally a superimposed right central to paracentral disc herniation of moderate size.  This mildly indents the thecal sac.  No spinal stenosis.  Postoperative changes posteriorly.  Some minimal enchancement in the right paramidline deep soft tissues. BULGE AT THIS LEVEL WITH BONE SPURS.  ENOUGH OF A BULGE TO PUSH INTO THE SAC THAT CONTAINS THE SPINAL CORD.  MAY OR MAY NOT CAUSE SYMPTOMS

L4-L5:  Postoperative changes posteriorly.  Small posterior ostophytes (bone spurs) and moderate disc bulge.  Superimposed moderate central disc herniation and Facet hypertrophy.  Borderline changes for spinal stenosis.   Deep right parmidline soft tissue enhancement.  BONE SPURS AND DISC BULGE.  VERY START OF SPINAL STENOSIS AND THE START OF INFLAMMATION IN THE FACET JOINTS

L5-S1:  Postoperative changes.  Facet hypertrophy.  Small disc bulge.  Moderate spinal stenosis.  The neural foramina appear open.  Some minimal deep soft tissue enhancement.  BULGE AT THIS LEVEL AND SOME SPINAL STENOSIS

IMPRESSION OF LUMBAR SPINE

Multilevel postoperative changes.  Multilevel disc abnormalities.   There are some areas of soft tissue enhancement in the posterior soft tissues, but no findings for any epidural fibrosis to contribute to spinal stenosis and focal peripherally enhancing hypointense areas to suggest abscess formation.    NO BAD THINGS HAPPENING OVERALL, BESIDES WHAT HAPPENS AFTER SURGERY, AND HAVING THE BULGES AND SPURS.

Hope that this helps