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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does My MRI Scan Report Indicate?

I am a 40 year old male. I recently had mild numbness in my left foot, S1 area. My dr ordered an MRI and he called me to tell me I had a bulging disc in L5-S1. He recommended physical therapy. I obtained a copy of the MRI results, and some of the results concerned me, and weren t mentioned to me. I assume they are common findings and sound scarier to me than what they are. Can you lend some insight on the following findings, and let me know if they are significant? Specifically concerned about the epidural lipomatosis and atypical hemangioma mentioned. Findings: Mild disc space narrowing and dessication seen at L5-S1. A focal marrow signal abnormailty measuring 12mm by 6mm in the axial plane is seen in the posterior aspect of the L2 vertebral body. This lesion demonstrates homogeneously increased T2 signal, heteregoneous T1 signal, an increase STIR signal. No aditional marrow abnormalities are identified. The conus terminates at L1-L2. Spinal cord caliber and signal are within normal limits. The cauda equina images normally. Mild epidural lipomatosis is noted beginning at the superior endplate of L5. Impression:L1-L5: No significant spinal or neuroforaminal stenosis. L5-S1: Concentric disc bulge with mild spinal stenosis predominately secondary to epidural lipomatosis. No significant neuroforaminal narrowing evident. Focal bone marrow signal abnormality in the L2 vertebral body as described above most likely represents atypical hemangioma. In the absence of worsening back pain, this can be followed with MRI in one yea to confirm stability.
Fri, 27 Mar 2015
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Pain Medicine & Palliative Care Specialist,  's  Response
Hello sir, I understand your concern regarding your MRI. Thankfully many of the findings are fairly common. First off let me tell you that the finding of a single vertebral body hemangioma is nothing to be concerned about and this can be found incidentally on many patients MRI scans without them even having back pain. Typically these represent benign vascular findings. In regards to the disc bulge and and epidural lipomatosis, this is also very common. Approximately 50% of MRIs performed on individuals over the age of 40 will find some disc bulge. As long as this bulge does not encroach upon a nerve root ot the neural foramen, the best treatment truly is physical therapy. Finally epidural lipomatosis simply means that the out covering of your epidural space, the ligamentum flavum, has simply hypertrophied or enlarged. While there is no specific remedy to cure this, as long as your stenosis is not severe, and as long as you don't have red flag symptoms ( loss of bowel or bladder function, sudden leg weakness), its also nothing to worry about. Recently there is even a outpatient procedure which a well trained interventional pain physician can perform to alleviate this problem, its called a MILD procedure ( minimally invasive lumbar decompression). Good luck in therapy and i hope this answer was helpful.
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What Does My MRI Scan Report Indicate?

Hello sir, I understand your concern regarding your MRI. Thankfully many of the findings are fairly common. First off let me tell you that the finding of a single vertebral body hemangioma is nothing to be concerned about and this can be found incidentally on many patients MRI scans without them even having back pain. Typically these represent benign vascular findings. In regards to the disc bulge and and epidural lipomatosis, this is also very common. Approximately 50% of MRIs performed on individuals over the age of 40 will find some disc bulge. As long as this bulge does not encroach upon a nerve root ot the neural foramen, the best treatment truly is physical therapy. Finally epidural lipomatosis simply means that the out covering of your epidural space, the ligamentum flavum, has simply hypertrophied or enlarged. While there is no specific remedy to cure this, as long as your stenosis is not severe, and as long as you don t have red flag symptoms ( loss of bowel or bladder function, sudden leg weakness), its also nothing to worry about. Recently there is even a outpatient procedure which a well trained interventional pain physician can perform to alleviate this problem, its called a MILD procedure ( minimally invasive lumbar decompression). Good luck in therapy and i hope this answer was helpful.