Sport Horse Spotlight

BushyGeneology copy

Real Estate Spotlight

100_7261

Sale Spotlight

COTH_without Subscribe
  • Welcome to the Chronicle Forums.
    Please complete your profile. The forums and the rest of www.chronofhorse.com has single sign-in, so your log in information for one will automatically work for the other. Disclaimer: The opinions expressed here are the views of the individual and do not necessarily reflect the views and opinions of The Chronicle of the Horse.

Announcement

Collapse

Forum rules and no-advertising policy

As a participant on this forum, it is your responsibility to know and follow our rules. Please read this message in its entirety.

Board Rules

1. You�re responsible for what you say.
As outlined in Section 230 of the Communications Decency Act, The Chronicle of the Horse and its affiliates, as well Jelsoft Enterprises Ltd., the developers of vBulletin, are not legally responsible for statements made in the Forums.

This is a public forum viewed by a wide spectrum of people, so please be mindful of what you say and who might be reading it�details of personal disputes may be better handled privately. While posters are legally responsible for their statements, the moderators may in their discretion remove or edit posts, though are not legally obligated to do so, regardless of content.

Users have the ability to modify or delete their own messages after posting. Moderators generally will not delete posts, threads or accounts unless they have been alerted and have determined that a post, thread or user has violated the Forums� policies. Moderators do not regularly independently monitor the Forums for such violations.

Profanity, outright vulgarity, blatant personal insults or otherwise inappropriate statements will not be tolerated and will be dealt with at the discretion of the moderators.

Users may provide their positive or negative experiences with or opinions of companies, products, individuals, etc.; however, accounts involving allegations of criminal behavior against named individuals or companies MUST be first-hand accounts and may NOT be made anonymously.

If a situation has been reported upon by a reputable news source or addressed by law enforcement or the legal system it is open for discussion, but if an individual wants to make their own claims of criminal behavior against a named party in the course of that discussion, they too must identify themselves by first and last name and the account must be first-person.

Criminal allegations that do not satisfy these requirements, when brought to our attention, may be removed pending satisfaction of these criteria, and we reserve the right to err on the side of caution when making these determinations.

Credible threats of suicide will be reported to the police along with identifying user information at our disposal, in addition to referring the user to suicide helpline resources such as 1-800-SUICIDE or 1-800-273-TALK.

2. Conversations in horse-related forums should be horse-related.
The forums are a wonderful source of information and support for members of the horse community. While it�s understandably tempting to share information or search for input on other topics upon which members might have a similar level of knowledge, members must maintain the focus on horses.

3. Keep conversations productive, on topic and civil.
Discussion and disagreement are inevitable and encouraged; personal insults, diatribes and sniping comments are unproductive and unacceptable. Whether a subject is light-hearted or serious, keep posts focused on the current topic and of general interest to other participants of that thread. Utilize the private message feature or personal email where appropriate to address side topics or personal issues not related to the topic at large.

4. No advertising in the discussion forums.
Posts in the discussion forums directly or indirectly advertising horses, jobs, items or services for sale or wanted will be removed at the discretion of the moderators. Use of the private messaging feature or email addresses obtained through users� profiles for unsolicited advertising is not permitted.

Company representatives may participate in discussions and answer questions about their products or services, or suggest their products on recent threads if they fulfill the criteria of a query. False "testimonials" provided by company affiliates posing as general consumers are not appropriate, and self-promotion of sales, ad campaigns, etc. through the discussion forums is not allowed.

Paid advertising is available on our classifieds site and through the purchase of banner ads. The tightly monitored Giveaways forum permits free listings of genuinely free horses and items available or wanted (on a limited basis). Items offered for trade are not allowed.

Advertising Policy Specifics
When in doubt of whether something you want to post constitutes advertising, please contact a moderator privately in advance for further clarification. Refer to the following points for general guidelines:

Horses � Only general discussion about the buying, leasing, selling and pricing of horses is permitted. If the post contains, or links to, the type of specific information typically found in a sales or wanted ad, and it�s related to a horse for sale, regardless of who�s selling it, it doesn�t belong in the discussion forums.

Stallions � Board members may ask for suggestions on breeding stallion recommendations. Stallion owners may reply to such queries by suggesting their own stallions, only if their horse fits the specific criteria of the original poster. Excessive promotion of a stallion by its owner or related parties is not permitted and will be addressed at the discretion of the moderators.

Services � Members may use the forums to ask for general recommendations of trainers, barns, shippers, farriers, etc., and other members may answer those requests by suggesting themselves or their company, if their services fulfill the specific criteria of the original post. Members may not solicit other members for business if it is not in response to a direct, genuine query.

Products � While members may ask for general opinions and suggestions on equipment, trailers, trucks, etc., they may not list the specific attributes for which they are in the market, as such posts serve as wanted ads.

Event Announcements � Members may post one notification of an upcoming event that may be of interest to fellow members, if the original poster does not benefit financially from the event. Such threads may not be �bumped� excessively. Premium members may post their own notices in the Event Announcements forum.

Charities/Rescues � Announcements for charitable or fundraising events can only be made for 501(c)(3) tax-exempt organizations. Special exceptions may be made, at the moderators� discretion and direction, for board-related events or fundraising activities in extraordinary circumstances.

Occasional posts regarding horses available for adoption through IRS-registered horse rescue or placement programs are permitted in the appropriate forums, but these threads may be limited at the discretion of the moderators. Individuals may not advertise or make announcements for horses in need of rescue, placement or adoption unless the horse is available through a recognized rescue or placement agency or government-run entity or the thread fits the criteria for and is located in the Giveaways forum.

5. Do not post copyrighted photographs unless you have purchased that photo and have permission to do so.

6. Respect other members.
As members are often passionate about their beliefs and intentions can easily be misinterpreted in this type of environment, try to explore or resolve the inevitable disagreements that arise in the course of threads calmly and rationally.

If you see a post that you feel violates the rules of the board, please click the �alert� button (exclamation point inside of a triangle) in the bottom left corner of the post, which will alert ONLY the moderators to the post in question. They will then take whatever action, or no action, as deemed appropriate for the situation at their discretion. Do not air grievances regarding other posters or the moderators in the discussion forums.

Please be advised that adding another user to your �Ignore� list via your User Control Panel can be a useful tactic, which blocks posts and private messages by members whose commentary you�d rather avoid reading.

7. We have the right to reproduce statements made in the forums.
The Chronicle of the Horse may copy, quote, link to or otherwise reproduce posts, or portions of posts, in print or online for advertising or editorial purposes, if attributed to their original authors, and by posting in this forum, you hereby grant to The Chronicle of the Horse a perpetual, non-exclusive license under copyright and other rights, to do so.

8. We reserve the right to enforce and amend the rules.
The moderators may delete, edit, move or close any post or thread at any time, or refrain from doing any of the foregoing, in their discretion, and may suspend or revoke a user�s membership privileges at any time to maintain adherence to the rules and the general spirit of the forum. These rules may be amended at any time to address the current needs of the board.

Please see our full Terms of Service and Privacy Policy for more information.

Thanks for being a part of the COTH forums!

(Revised 5/9/18)
See more
See less

Reading this MRI of the lumbar spine: anyone here good at deciphering results?

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Reading this MRI of the lumbar spine: anyone here good at deciphering results?

    My 25 year old daughter has had back pain on and off for several years related to an injury. When she was an undergrad, she was lifting weights in her room when she did it: she was bending down and forward to drop a 15 lb. dumbbell and heard something "pop".

    Her pain hasn't been bad until recently, and she finally went in for an MRI. Here are the results:

    (The Dr. suspected a ruptured disk, gave her some meds and some gentle adjustments, but it looks a bit more complicated than that, she goes in next week to have the Dr. read it and discuss the findings with her.)

    EXAM: MR LUMBAR SPINE WITHOUT CONTRAST



    HISTORY: Back pain.



    PRIORS: None



    TECHNIQUE: 1.2 Tesla open MRI imaging performed. Nonenhanced Multiple pulse sequences, MRI of the lumbar spine, were obtained in the axial, coronal, and sagittal planes.



    FINDINGS: There is normal lumbar lordosis. The vertebral bodies are normal in height and configuration. There are no acute fractures.



    L1-L2: There is no evidence of disc herniation or bulge. There is no central spinal canal stenosis. There is no significant neural foraminal narrowing.



    L2-L3: There is no evidence of disc herniation or bulge. There is no central spinal canal stenosis. There is no significant neural foraminal narrowing.



    L3-L4: Degenerative facet changes with synovial effusions. Degenerated disc with central disc protrusion. Moderate central stenosis



    L4-L5: Facet degenerative changes with synovial effusions noted. Degenerated disc containing a moderately large central and left paracentral disc extrusion. This results in central stenosis and left subarticular recess stenosis.



    L5-S1: Mild degenerative facet changes. There is no evidence of disc herniation or bulge. There is no central spinal canal stenosis. There is no significant neural foraminal narrowing.



    The conus is normal in configuration and signal intensity ending at L1.



    IMPRESSION:

    1. L4/L5 degenerated disc with a large central/left paracentral disc extrusion. Disc causes central stenosis and left subarticular recess stenosis.

    2. L3/L4 degenerated disc with central disc protrusion and moderate central stenosis.

    TIA for any insights!!
    "Hope is a good thing, maybe the best of things, and no good thing ever dies."

    "It's supposed to be hard...the hard is what makes it great!" (Jimmy Dugan, "A League of Their Own")

  • #2
    Disclaimer - I am not a neurologist or other expert in this area. My problems have been cervical spine. This is what I remember from medical school....

    The spinal cord ends around T12-L1, where all of the nerves become discrete and form the cauda equina (really does look like a horse's tail). Discs can press on these nerves, and narrowing of the foramen where the nerves leave the spine also can cause pressure. Pressure can cause pain. However, this kind of pain is often perceived as originating in the area where the nerve ends, not just in the back. Back pain could be from the degenerative changes - she has effusions (abnormal production of fluid) in the joints in the back.

    I'll be interested in hearing what the doctor says. But back surgery is a LAST resort, PT is first, PT is second, and PT is third.

    Comment


    • #3
      I used to work in radiology, and we saw DDD (degenerative disc disease) all the time, especially in older patients or people in high impact sports. I attached some pictures that explains it pretty well. In basic language, her bulging discs are pressing on nerves, causing her to feel pain. I second and highly vouch for Physical Therapy as well, and sometimes steroid injections in the back can do wonders.

      (Also as a general rule, anything they find abnormal in exams are always included in that last "Impressions" list, so that's really the only thing you need to worry about.)

      Comment


      • #4
        Like the other posters said, the pain is likely coming from some compression of the nerves.

        However, some of it could be coming from her lumbar lordosis. Even in "normal" cases, if you're tired, or have been standing or sitting for prolonged periods it can aggravate the lower back. She likely has tight hips/hip flexors and weak glutes. PT will also help with this.

        Comment


        • #5
          1.2 tesla? I'd be curious to hear what the experts say, but what a weak MRI. You have some actionable findings here, which hopefully provide direction and relief, but if not, I'd personally pursue another exam in a 3 tesla machine.

          Comment


          • #6
            Agree with Simkie and a follow on with a surgeon, rather than a GP or Chiro.
            _\\]
            -- * > hoopoe
            Procrastinate NOW
            Introverted Since 1957

            Comment

            • Original Poster

              #7
              Thanks, everyone - she is going in to the Dr. this week to discuss the results, and I'm sure PT will be the first step.

              I have my own back issues and have been through a HUGE variety of treatments myself, including (but not limited to) facet injections and radiofrequency ablation, but despite my x-rays: two bulging disks and significant arthritis at L5/S1 (decades of riding), stenosis, etc. - the majority of my pain is muscular so I now get trigger point injections (and dry needling) for the tight, spasming muscles. I am also on Robaxin, use heat, a TENS unit, use a Theracane, etc.

              I did 9 months of PT and it was a game changer; the biggest revelation was that strengthening my core would be the most beneficial "treatment", so I have devoted my life to this (along with stretching, and an inversion table), and I do this every single day, several times a day. As a result, I am in pain but pretty functional (and very active, riding, competing, teaching), but it is a LOT of work and I am very diligent - at the gym 7 days a week.

              My daughter does work out regularly and is in pretty good shape, but stretching? Dedicated core work? Not so much.

              I'm sure the PT will bring that home with her

              What concerns me is that she just turned 25; I'm 62 and my back issues are degenerative and consistent with an active lifestyle, lots of riding and horse related wear and tear - and age.

              My poor daughter will have to live with this for a long, long time. Lucky for her she has a mom who can commiserate and help motivate her! (And I turned her onto the TENS unit, along with a supportive back brace for when she is doing something that will stress her back; and yes - I know that back braces should NOT be worn all the time because the back muscles will weaken and rely on the brace )

              I appreciate the input!!

              As for the MRI, it might have been weaker? because it was an open MRI - my daughter has a lot of anxiety and is claustrophobic - she would have freaked in the regular machine...
              Last edited by Dr. Doolittle; Aug. 18, 2019, 12:33 PM.
              "Hope is a good thing, maybe the best of things, and no good thing ever dies."

              "It's supposed to be hard...the hard is what makes it great!" (Jimmy Dugan, "A League of Their Own")

              Comment


              • #8
                Originally posted by Dr. Doolittle View Post
                As for the MRI, it might have been weaker? because it was an open MRI - my daughter has a lot of anxiety and is claustrophobic - she would have freaked in the regular machine...
                The report indicates 1.2 T, which is considered a “high-field” MRI. The open magnets have come a long way in terms of field strength and image quality from when they first came out (and honestly they were pretty good for some applications, like human spine and knees, “out of the box”). While I am not a radiologist for human patients, I do keep tabs on that field as there are a lot of crossover points with veterinary radiology, and as far as I know there are no major image-quality advantages for a closed MRI vs. an open for routine lumbar spine imaging in adult humans. I speculate that it might not have the resolution OOOMPH to get good images on, say, a parrot brain, but do not know that for a fact. We had a 3.0 T at UMN when I was there and we could literally see the semicircular canals in the ears of raptors.

                Comment


                • #9
                  That's interesting, Toblersmom. I'm not in medicine but have had a lot of imaging and haven't seen anything but 3T MRI equipment in the last...ten years? I don't do open machines, and am nearly always imaged in the hospital. For hips, 1.5T just doesn't cut it, so I always confirm my test is in a 3T machine.

                  Comment

                  Working...
                  X