What is causing my consistent back pain?

Question

I read your query and can understand your concern. It is possible that you are having a lot of pain and discomfort in the lower back region, and this is also radiating to your legs. I am sorry to hear about it and hope that your pain management doctors are giving you the right medications. Concerning the MRI scan images, please find my observations below:

1. The MRI scan was done eleven years back, with the help of a 1.5T machine, and the one done recently is on a 0.2T machine; therefore, the recent images are not as clear as the earlier one. The noise element is higher in a smaller machine, and this causes images with less clarity to appear grainy. This is the reason you are seeing the L5-S1 less clearly on T1 in the MRI scan done nine years back.

2. Please note that it is unlikely for you to have osteomyelitis in this region as the visualized T2 image appears clear. However, the L5-S1 disc space appears somewhat reduced when compared to earlier MRI scans, indicating the possibility of progressive degeneration.

3. A point of note in the present MRI (magnetic resonance imaging) scan is that there is an area at the L4-L5 disc posteriorly that might indicate a small annular tear and is seen as a small white dot in the disc on the T2 image. The annular portion of the disc is at the periphery, and there is a white spot that is seen and is possibly the tear. This needs to be confirmed by viewing adjacent images and also in the axial plane.

4. As seen earlier, the L4-L5 disc is showing desiccation or loss of water content. The L5-S1 disc also shows mild desiccation changes.

5. Even a slight pressure on a nerve or its existing nerve root at the disc level or anywhere along its course can cause severe pain not responding to earlier treatment. However, as I am unable to see all the images in sagittal and axial planes, I am unable to comment on the exact cause, and I am sure your radiologist has seen all the images, and these findings might have been made available to you in the report.

The Anterior Cervical Discectomy and Fusion (ACDF) at C5-C6 has been a successful procedure and therefore is not a concern at present. I hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Do write back if you have any doubts.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

It is possible that you are having a lot of pain and discomfort in the lower back region and this is also radiating to your legs. I am sorry to hear about it and hope that your pain management doctors are giving you the right medications.

Concerning the MRI scan images please find my observations below:

The MRI scan was done eleven years back, with the help of a 1.5T machine and the one done recently is on a 0.2T machine, therefore the recent images are not as clear as the earlier one. The noise element is higher is a smaller machine and this causes images with less clarity and to appear grainy. This is the reason you are seeing the L5-S1 less clearly on T1 in the MRI scan done nine years back.
Please note that it is unlikely for you to have osteomyelitis in this region as the visualized T2 image appears clear. However the L5-S1 disc space appears somewhat reduced when compared to earlier MRI scans indicating possibility of progressive degeneration.
A point of note in the present MRI (magnetic resonance imaging) scan is that there is an area at the L4-L5 disc posteriorly that might indicate a small annular tear and is seen as a small white dot in the disc on T2 image. The annular portion of the disc is at the periphery and there is a white spot which is seen and is possibly the tear. This needs to be confirmed by viewing adjacent images and also in the axial plane.
As seen earlier, the L4-L5 disc is showing desiccation or loss of water content. The L5-S1 disc also shows mild desiccation changes.
Even a slight pressure on a nerve or its existing nerve root at the disc level or anywhere along its course can cause severe pain not responding to earlier treatment. However as I am unable to see all the images in sagittal and axial planes, I am unable to comment on the exact cause and I am sure your radiologist has seen all the images and these findings might have been made available to you in the report.

The Anterior Cervical Discectomy and Fusion (ACDF) at C5-C6 has been a successful procedure and therefore not a concern at present.

I hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Do write back if you have any doubts.

Thank you.