MRI Results

[Dave]

I had my MRI on 10.12.2009. Here are the findings:

The lumbar vertebra appear normal in height. The alignment of the vertebral bodies and posterior elements is preserved. There are spondylotic changes within the lumbar spine with marginal osteophytes seen rising from the vertebral body end plates to varying degrees at all levels. There is mild DDD at multiple levels, most pronounced however at the L5-S1 level. The marrow signal of bone is normal. The alignment of the posterior elements is preserved.

There is a loss of the normal T2-weighted signal, as well as height of the intravertebral disk at the L2-3 and the L5-S1 levels. The L1-2, L3-4 and L4-5 interverbal disk's appear normal in signal intensity as well as height. Mild DDD is also present within the lower thoracic spine. No definite disk herniation or disk bulge is seen within the lower thoracic spine. There is mild bulging of the intervertebral disks at the L2-3 level. No focal disk herniation is noted at this level. The disk bulge flattens the anterior aspect of the thecal sac. No focal disk herniation or disk buldge is noted at the L3-4 level. There is mild budging of the intervertebral disc at the L4-5 level. There is a broad based disk herniation which is central and left para central in location at the L5-S1 level. There is a central annular tear of the intervertebral disk at this level. The disk protrusion appears to cause some posterior displacement of the descending S1 nerve root on the left.

There are facet joint degenerative changes with associated hypertrophy of the ligamentum flavum at the L3-4 and L4-5 levels. Facet joint arthropathy is also present at the L5-S1 level bilaterally. There is hypertrophy of the ligamentum flavum at the L3 and L4-5 levels.

There is an acquired spinal canal stenosis predominantly in the lateral dimension at the L3-4 level. This is mild in degree. There is moderate to severe spinal canal stenosis at the L4-5 level No significant spinal canal stenosis is noted at the L5-S1 level.

There is acquired neural forminal encroachment on the left at the L4-5 and more significantly at the L5-S1 level. There is acquired neural foraminal on the right, most pronounced at the L4-5 level.

Incidental note is made of a simple appearing cortical cyst originating from the right Kidney. This measures approximately 1.5 cm in size.



Impression:

1. Central and left paracentral broad-based disk herniation at the L5-S1 level.
2. Bulging intervertebral disks at the L2-3 and L4-5 levels.
3. Acquired spinal canal stenosis at the L3-4 and the L4-5 levels.
4. Multilevel spondylosis and DDD
5. Multilevel facet joint arthritis with associated neural foraminal encroachment as discussed above.
6. No intradural abnormalities are seen.
7. Small simple appearing cortical cyst originating from the right kidney.

Well there it is in a nutshell. I see my surgeon next Tuesday and at that time we will formulate a plan on how to fix these issues, if possible.

[Terry Newton]

WoW! I don't know what to say Dave. I am so sorry that you have such challenges with your spine. I am hopeful that they can put you back together again in one piece and that you have the same results like you did with your previous surgery. Please let us know what the surgeon has to say and hang in there. Any time you need to speak to someone for support I am available.

Hang in there Dave.

[daveinaustin]

Dave,

I'm certain you have a good level of anxiety right now. Just remember that 80% of the battle is determining what's wrong. Now that they know, your doctor(s) can put together the strategy to fix it.

Also, although all of the impressions sound scary, some of them will probably be considered minor. The MRI picks up a lot of things that are slightly "imperfect," but might not be a pain generator.

I don't recall if you've had it yet, but your doctor will probably want you to have a discogram next. If you have any concerns or questions, feel free to PM me at anytime.


-Dave

[Dave]

Thanks guys. I have a hard shell on the outside, but mentally I am having a hard time with this. We have all experienced some butt head saying, "What's wrong with you. You look healthy enough". I deal with these people everyday. Ya just want to smack them in the back with a 2x4 and say "that's how I feel".

I see Hamati on the 20th, so the beginning of a new journey will start soon. I have the utmost trust in this man. Until then, I will just stay as mellow as I can.

Peace be with all of you.

[Terry Newton]

Dave:

Please take some good drugs and call me in the morning.

[Justin]

Hi Dave,

Thanks for posting your MRI findings. Even though you have a lot going on in your lumbar spine, being in Dr. Hamati's gifted hands will most definitely get you back to feeling good again. I wish you the very best with your appointment on the 20th.

We'll be thinking of you, and I'm here if you need me.

[Dave]

I had my appointment with Hamati yesterday at 8:30 AM. Cyndie went along to help ask questions we both had, and to lend support to me.

We went over the MRI films and the report in detail and discussed potential fixes and timing. Being that the facets seem to be an issue, he ruled out ADR at this time. So that leaves either fusion or some other form of repair. We decided to start with PT 3 times a week for 6-8 weeks. He also set up a schedule to wean me off Norco and start using Darvacet.

He was also pretty frank about the long term degeneration of my spine. Since the Thoracic region is seeing mild DDD, he said I will most likely never be completely pain free. That was a gut punch.

So, here we go.................

[daveinaustin]

With your facet condition, it is good that Hamati discounted ADR. There have been too many people left in worse condition from having an ADR when they should have been treated with other options.

Right now, you have enough going on that you shouldn't worry about long term thoracic DDD. Remember that many people can have mild/moderate DDD without pain.

If you haven't already, you might consider some type of walking and/or swimming regimen besides your PT. This may help your thoracic to stay pain free throughout your later years.

For now, good luck with the PT! Hopefully, it will provide relief.

-Dave

[Justin]

Hey Dave,

It's great to hear that Cyndie was at your appointment with Dr. Hamati.

We went over the MRI films and the report in detail and discussed potential fixes and timing. Being that the facets seem to be an issue, he ruled out ADR at this time. So that leaves either fusion or some other form of repair. We decided to start with PT 3 times a week for 6-8 weeks. He also set up a schedule to wean me off Norco and start using Darvacet.

He was also pretty frank about the long term degeneration of my spine. Since the Thoracic region is seeing mild DDD, he said I will most likely never be completely pain free. That was a gut punch.

So, here we go.................

Although a surgery is necessary in your situation, it is good to see that you are first going through physical therapy to help strengthen your core and provide you with some relief before crossing that bridge.

Like Dave mentioned, focus on what you have to and stay positive (easier said then done) about the rest of your spinal health.

I'm thinking about you and Cyndie.

[Cindylou]

Oh, brother, I wrote you out a long response Dave, but lost it with all the changes going on these last few days. When I tried to send it, it disappeared. Anyway, all in all, I was just also agreeing that it was so nice that Cyndie went with you to help advocate for you. Sometimes they can even help remember to ask questions we might forget to ask, or get flustered over, in the moment. Sorry about the gut punch too. His timing wasn't exactly good. Hang in there and let us know how things are progressing for you. We're here for you.