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Old 12-02-2008, 11:05 AM
Maddie Maddie is offline
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Wink New MRI...Annular Fissure & What it means?

I just got my latest MRI report back, a year from my first one. At the L4/5, it says there is an annular fissure. That means there is a tear in the disc membrane and it is leaking?

What are the repercussions of this, if any?

Have many of you found that reports vary a great deal from one radiologist to another? Last year's report said there was significant spinal stenosis at C5/6, while this new report, with a different doctor, says that the stenosis is moderate. That is a big change, when it comes to diagnosing for surgery, isn't it? Granted, the newest MRI looks pretty dark to me, and I can't understand how he can see much of anything in some spots. But things don't generally get better, do they?

There also seems to be a lot more changes in different levels, even if they are 'mild'. C6/7 now has a mild disc bulge, where there was none before, and a mild disc bulge at T3/4, minimal bulge at T4/5, and a small protrusion at T5/6. Mild, minimal, and small protrusion all mean the same thing, with the doctor trying to be poetic, correct?

(And please ignore the winkie face in the title...I didn't put it there and can't get rid of it for some reason....)
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C3/4-5/6- Mod. ant., severe posterior bulging w. nerve root compression. Sev. narrowing of spinal canal with cord compression.

L4/5/S1- Mod. narrowing, bulging disc, significant hypertrophy of flava lig.

Highly allergic to all metals.

NEW: 3/16/2010: Successful surgery in Brazil w. Dr. Pimenta; Nuvasive NeoDisc at C5/6, and XLIF & ALIF at L4/5/S1 w. PEEK cages. No rods, screws, plates. Non-metal lumbar ADR not available at present time, so went with fusion.
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  #2  
Old 12-02-2008, 03:26 PM
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Cirobi Cirobi is offline
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Default

I don't have much to comment on the annular fissure bit but I have noticed that there is definitely a big difference in how each physician/radiologist reads those images. For instance, my MRI report didn't say anything about how my L5/S1 was actually ruptured. The disk height was still ok, but there was definitely more material pushing against the nerves than the report let on. The whole report was mild this mild that. Those descriptions actually had me turned down by the surgeon who did my coworker's cervical fusions because it made me not look like a surgical candidate. So, I went to a different surgeon who was accepting non-surgical patients so I could ask about injections and he took one look at the MRI, shook his head and told me injections were in no way going to help because my L5/S1 was toast.

I recently got to look at all my medical records from my old primary care physicians office because I switched physicians and picked up copies of the documentation. I got so angry reading through that documentation. My old primary care made everything sound like nothing was wrong. The reports from my old physical therapist made it sound like I'd made tons of progress in PT when I specifically said that in general I felt a little better but was still regularly in a lot of pain, and then that MRI report. I wanted to scream. Of course, at the time I was already post-op and also laughing inside because I felt like I had the last laugh in a way by firing that physician and finally having the relief I was looking for when I first went to the doc.

I think too that a year can make a huge difference. When I first started going through this stuff and really trying to find a solution, I read and was told how even if we herniate a disk, usually rest and anti-inflammatories can help it heal, so maybe that specific level has been able to heal somewhat and start returning to a more normalized level? It could also his interpretation has adjusted slightly after seeing more or something like that. *shrug*

~Sara
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*************************
31 yrs old
Lumbar herniation L5/S1

- Did mild PT, some chiropractics and self regulated pain management since initial sports injury in Spring 1997.
- XRay and Bone Scan Jan/Feb 2007
- PT March to May 2007
- MRI Jan 2008
- Disco positive at L5/S1 Feb 2008
- ADR surgery at L5/S1 on June 23rd 2008 - Prodisc
- Recovery - so far so good!

*************************
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  #3  
Old 12-02-2008, 11:27 PM
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Harrison Harrison is offline
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Default Statement from the Master of the Obvious...

Look for the similar topics on the bottom of this topic. Actually, there are more on this site on this tricky issue, but you see my point. Call me for more context or references.
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
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  #4  
Old 12-03-2008, 12:23 AM
Maddie Maddie is offline
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Talking

"Statement from the Master of the Obvious..."

Those links showed up after I posted....LOL It's like magic! Thanks, Harrison, I will give you a call tomorrow to get more information. I have already looked into those other threads and found out a lot more than before I posted.

These two MRIs, a year apart, were read by two different docs. I couldn't believe the difference in them...several areas were said to be a lot milder now than before. Cirobi, what you said is so true. If the second one is what I had been going on all year, I would think I was crazy; it made my condition seem very mild in several levels, despite the pain. I don't think the second MRI was done very well though. It is very dark and fuzzy in most views.

Ask a dozen doctors, get a dozen different opinions.

My pain has been increasing, and I was glad to read that the fissure could cause that....nice to know I'm not making this stuff up.
__________________
C3/4-5/6- Mod. ant., severe posterior bulging w. nerve root compression. Sev. narrowing of spinal canal with cord compression.

L4/5/S1- Mod. narrowing, bulging disc, significant hypertrophy of flava lig.

Highly allergic to all metals.

NEW: 3/16/2010: Successful surgery in Brazil w. Dr. Pimenta; Nuvasive NeoDisc at C5/6, and XLIF & ALIF at L4/5/S1 w. PEEK cages. No rods, screws, plates. Non-metal lumbar ADR not available at present time, so went with fusion.
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  #5  
Old 12-03-2008, 12:58 AM
builder5840 builder5840 is offline
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Default Confusing

Like probably most of you I too have found this to be very confusing. I have had several xrays a couple of mri,s and a couple ct's. Like you it's confusing when one radiologist states that one level is severe and the other states it's mild or makes no notation at all. One report will coment on bone spurs and the others don't mention it. I think that my insurance company likes to down play everything hoping that you'll give up and go away. Or maybe they just don't know what they are doing or like they say they are just practicing medicine. I've had to keep fighting for help and have finally found my path. Good luck getting it all figured out and finding a solution to your pain.


Fall from ladder 05 lots of pain, lots of test
opted for two level ADR in Malaysia
surgery scheduled 03/09 using Discover disc
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