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MRI findings in layman's terms?

MamapleaseMMamaplease Posts: 7
edited 06/11/2012 - 8:55 AM in Degenerative Disc Disease
I am hoping that somebody can explain my MRI report findings in layman's terms. My neurosurgeon did a good job thoroughly covering everything, but to be honest with you, I was so shocked by the news that I don't seem to have retained much. Also, internet searches lead to more words I don't understand. :) If you don't mind, I could use a little help.

A little background in case it's needed: Have had a herniated disc at L5/S1 for over 14 years. Previous MRI exactly 2 years ago showed a 5mm bulge at L4/L5 and a 2mm bulge at L5/S1. Went to ER in March 2011 because I woke up and could not move due to excruciating pain in my right sciatic nerve and had debilitating right leg weakness and numbness. I have been on 100mg Morphine 2x per day for 3 years. ER docs told me to file for SSDI because they couldn't believe I was still working a 40 hour week and still able to walk, even with my cane. They did a CAT scan which showed a 17mm herniation with a 3" bone spur extending into the spinal canal and causing complete compression of the spinal cord. Follow up visit 14 days later with regular doctor and he ordered a repeat MRI to see the progression from 2 years ago.

At work I cut back to 3 hours per day, 4 days per week and it has helped some, but I am on a 20 on- 20 off regimen of steroids along with muscle relaxers 3x per day just to keep on the job. I think it's time to give up and file, but I would like to understand my condition a little better before I do.

The new report in March 2011 showed normal findings for lumber L1/L2, L2/L3, L3/L4, and I will write verbatim the findings for L4/L5 and L5/S1:

L4/L5: There is disc space narrowing, disc dessication, and a 2mm broad based disc bulge not creating significant central or lateral foraminal stenosis.

L5/S1: There is disc space narrowing, disc dessication and an 18mm disc herniation evident. This is extending cephalad to the mid-portion of the L5 vertebral body. It is exerting significant mass effect on the thecal sac as well as the exiting bilateral nerve roots.

I think I understand about L4/L5: not a problem and not causing any problems yet.

L5/S1, though, I don't know which direction cephalad is nor what a thecal sac or mass effect is.

Can anyone help explain this to me a little clearer?

Thank you so much and God Bless!


  • We cannot interpret MRIs here as we're not doctors. But its fairly obvious that your L5/S1 herniation is pressing on some nerves, and that can be extremely painful. You also have a bone spur that intenting the sac around your spinal cord and it seems to me that these things need to be dealt with.

    You mention the ER doc, but what has your neurosurgeon said about it? Is this surgeon a fellowship-trained spine surgeon, one that only works on spines? Did he mention a plan of action?

    I know it's difficult to take in everything the surgeon says, most of us tend to not be able to absorb all the information that the doc tells us. Too bad you didn't have another set of ears with you to help you remember what he said.

    I believe that your surgeon needs to let you know what you're dealng with exactly and what needs to be done to take care of it. Any time something is indenting the thecal sac, it's time to take some action.

    Take care and please keep us posted.
  • None of us here are are doctor and able to read a mri. With that said I can tell you the thecal sac is what covers the spinal cord. In your case that is not really the spinal cord at that level it is as they say the tail of the cord. It is very hard and can with stand a lot of pressure although the shape can be deformed and the supply of fluid cut off. If you google thecal sac you will get a better idea of what it is and how it works to protect the cord. What type of treatment did the doctor recommend for you? Don't get hung up on the finding of the MRI, but focus on what treatment plan they have for you, as that is more important. I would google lumbar thecal sac. Or you can use the search feature at the top of the page and be sure to check the box for articles.

    AS far as filing for SSDI, one thing to note is you can make up to $980 per month and still file a case. Understand it is a long wait, and many will get turned down the first time. When I say a long wait expect no less than a year and anywhere up to two years for your case to move through, depending on the state you live in. If you check in the insurance section you will see many more post with people filing for SSDI, and what they have been through.
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  • Just to follow-up on what tamtam said, mass effect means it is causing shifting out of it's proper place. So the disc is compressing the thecal sac and has caused it to shift out of alignment, basically.
  • I took everyone's advice and did some googling and I think I understand better what is going on in my back.

    The neurosurgeon said that only Microdiscectomy surgery can correct the problem, but that since it's gone on for so long that the nerve damage is permanent, so even with the surgery I won't get much relief from the pain and symptoms. Since I don't have insurance, it doesn't seem work spending $20K and draining my savings if there won't be any relief.

    I filed for SSDI and am awaiting the determination. They did not send me to any of their doctors but they did send me a packet to fill out stating, in my own words, how my disability impacts my life and work. Oddly enough, 8 days after I received the packet in the mail, I got a phone call from the Disability Determination office asking me to send in my packet ASAP so they could make their determination. I figure that since they did not send me to any doctors or ask for any other doctor's opinions that I will probably be turned down - it's ok though because I know that most people do.

    Thanks again to everybody for helping me to understand what this MRI means. I admit to being pretty freaked out by the overload of information from the neurosurgeon, but it really eased my mind to see so many people willing to help!
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