Q. I am suffering from severe back pain. Please explain my MRI findings.

Hi doctor,

I am suffering from severe back pain, so I got an MRI of the lumbar spine. I do not understand the findings. Please explain the MRI findings to me.

The report read, five non-rib-bearing lumbar vertebral bodies are identified. For purposes of numbering, the L5/S1 level corresponds to axial image 36 series 7. The overall vertebral body height and alignment remains anatomic. The bone marrow signal intensity is preserved without evidence for bone bruise or fracture. No suspicious focal osseous lesion is identified. The conus is normal in overall size, morphology, and signal intensity terminating at the L1 level. The cauda equina is unremarkable in appearance without nerve root clumping or mass effect. No intradural mass lesion or extra-axial fluid collection is identified.

There is a tiny low-grade strain of the paraspinal musculature approximately at the L2 level. Tiny scattered vertebral body hemangiomas are visualized. There is no suspicious osseous lesion at T12-L1, there is no significant disc pathology. The central spinal canal and neural foramina are widely patent. At L1-L2, there is no significant disc pathology. The central spinal canal and neural foramina are widely patent.

There is mild bilateral facet arthrosis, with a small posterior projecting right facet joint cyst and tiny left posterior projecting facet joint cyst. At L2-L3, there is no significant disc pathology. The central spinal canal and neural foramina are widely patent. At L3-L4, there is a minimal disc height loss, mild bilateral facet arthrosis and a minimal diffuse disc bulge with only minimal effacement of the ventral thecal sac, but no significant central spinal canal or neural foramina narrowing.

At L4-L5, there is a small diffuse disc bulge with mild disc height loss, disc desiccation, and mild bilateral facet arthrosis. This results in mild effacement of the ventral thecal sac, where it abuts the traversing L5 nerve roots in the lateral recess without significant displacement or compression. Mild bilateral neural foraminal narrowing is present. At L5-S1, there is there is mild disc height loss, disc desiccation, and mild bilateral facet arthrosis. A small diffuse disc bulge is identified with a superimposed posterior central broad-based disc protrusion measuring approximately 1.2 x 0.4 cm in greatest dimension. This results in only mild effacement of the central ventral thecal sac without nerve root displacement or compression. Minimal right greater than left neural foraminal narrowing is also noted.There is mild nonspecific posterior soft tissue swelling in the subcutaneous fat superficial to the muscular fascia.The visualized upper sacral levels are unremarkable.

Impression: 1)Minimal to mild multilevel degenerative disc disease as detailed above is most prominent from L3 through S1. 2) A low-grade strain of the right paraspinal musculature 3) Mild nonspecific soft tissue swelling in the subcutaneous fat of the lower lumbar region, without fluid collection or subfascial extension.