Degenerative Changes of the Lumbar Spine on MRI
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- čas přidán 7. 07. 2024
- As we age, our spines undergo two major processes that can lead to back pain and in some cases, neurologic symptoms such as weakness and numbness. These processes are degenerative disc disease and facet arthropathy. But what are those and how do you know if you need treatment?
Almost everyone with back pain will get an imaging study, including an x-ray, CT, or MRI with an MRI being the most valuable. If you have had an MRI or even if you haven’t but you have back pain, this video will help you better understand what happens to our backs as we age using MRI as a guide.
Dr. Evan, a highly trained neuroradiologist who specializes in spinal imaging, will start by explaining in detail the structure of the spine. Then, he will compare normal spine MRI results with MRI images of the degenerative disc disease and facet arthropathy. Dr. Evan will demonstrate the process of how degenerative changes in the lumbar spine progress over time.
Watching this video will help you better understand your radiology imaging results, as well as the causes of possible lumbar spine pain.
All of Dr. Evan explanations will be supported by high-quality 3D models of the lumbar spine and real-life degenerative disc disease and facet arthropathy MRI images provided by Mediphany.
Looking for more radiology imaging breakdowns like this one? For more Mediphany radiology report samples, visit: mediphany.com/product-tour/
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Time Stamps:
00:00 Degenerative Disc Disease Introduction
00:43 Spine Structure 101
02:44 Degenerative Changes in Lumbar Spine
04:24 Severe Degenerative Disc Disease
05:43 Axial View Annular Fissure
06:50 Outro - Věda a technologie
When I was 21 I was pinned against an immovable object by a large diameter rope under high tension. The result was fractures of L1 and L3 with a crushed disc and a slight rotation. I refused to have a spinal fusion operation and ended up wearing a brace for 9 months followed by a warm & form for a long time. I was able to have a mostly normal life and played sports and enjoyed hiking in the mountains. I’m 73 now and the cost has come due. I don’t take NSAIDS or anything stronger, I’m just bearing it. I expect it to worsen over time. I sympathize with the other responders and basically I’m just venting. The video was really informative. Thanks for listening.
Very well done . I have had chronic pain from serious facet and bulging disks for 35 years . This is by far the most informative explanation I ever received . Thank you.
Very well explained and illustrated!
Very helpful
When I was 30 I was told by orthosurg that I had the spine of an 80 year old. The only thing they did was send me to rehab...a waste of time. Now I am 76 and can only walk about 4 ft, bent over at nearly 45°, and can only stand still about 1 min. I can't go anywhere or do anything...my life is over, as I can't do much of anything for myself.
I have severe DDD, bonu overgrowths that have fused my lumbar spine, sciatica, hyperlordosis, and lateral scoliosis.
I have lost over 6" in height, and my breathing is compromised due to organs being compressed into smaller cavity.
I am the oldest of 5 kids and no one else on either side of the family has anything like this.
Why do I?
Awesome. This helps me understand my diagnosis of “DDD” more clearly. It seems to me that one may have different types of arthritis at the same time.
I have polyarthritis..there are actually 52 different types of arthritis at least according to my arthritis Dr..
Hi, nice video. What is the medical treatment?
Which medication are used?
Welcome to the Golden Age. Ain't getting older fun?
I have had several MRIs due to lumbar pain. I was diagnosed with DDD. I'm 71 and over the last several years I experience more low back pain when I'm walking which causes me to lean forward to reduce the pain. I have had episodes of sciatic pain several years ago but not recently. I don't have pain while sitting until I need to get up. At least 15 years ago I had 2 ESI's which helped for several years. Later I had 2 more but these didn't help. I'm not sure what I can do in the form of exercise if that would help. Thank you.
What can be done to ease the pain of degenerative disc disease?
What surgeries come after laminectomy? How long?
I've had a mega-fusion (L2 dn to S1 with 12 bolts and connecting rods) but though I'm a gym and pool rat, I can't get pain relief permitting me to stand/walk more than 5-8min. Diannosed w DDD and ADD (Adjacent Disc Disorder) in an effort to reduce pain I've had SI joint shots, Intracept vertebral abalations, facet injections ....where from here?
Hemihypertrophy?
Can you explain the differences between Disc “Protrusion” vs Disc “Extrusion”? Thank you!
Of course! A disk is essentially a circle with 360 degrees. If a disk is pushed out more than 90 degrees of the circle, it is called a "bulge." If it is pushed out less than 90 degrees, it is a "herniation." All "herniations" are then subdivided into disk protrusions, extrusions, and sequestrations. A protrusion means that the "neck" of the herniated fragment is wider than the end or "dome" of the disk. An extrusion means that the "neck" of the herniated fragment is more narrow. Extrusions are much more common and they are the ones that can move up or down within the canal and/or neural foramen as well. A "sequestration" is very rare and means that a piece of disk actually tore off and is separated from the main disk.
What can we do to help it get better ?
And please do a video about COMBINED SUBACUTE COMBINED DEGENERATION OF THE SPINAL CORD,
SEE this exact video : DIAGNOSING AND TREATING VITAMIN B-12 DEFICIENCY.
❤️❤️❤️
It depends but it's always best to discuss a treatment plan with your own physician. Treatments for back pain can range from simple OTC pain relievers like ibuprofen or aleve, corticosteroid injections, physical therapy, or even surgery. Usually, physical therapy is the best long term treatment unless there are neurologic symptoms such as weakness or numbness in your legs. Those symptoms should be evaluated by a physician/surgeon. Nothing can reverse the aging process unfortunately.
Combined subacute degeneration of the cord is a rare condition in patients with low vitamin B12 in which the back part of the spinal cord is affected. These are called the corticospinal tracts and are the parts of the cord on each side that control fine motor movements of the hands and feet. On an MRI scan, we can sometimes see bright signal (color) within that back part of the cord. With treatment, most patients will recover. We will attempt to find a good case of this and make a video sometime.
Which is a more severe condition, stenosis or Spondylolesthesis, anterlothesesis & retrolothesis?
Stenosis is a general term for narrowing and can be caused by many different things. Both the neural foramina and the spinal canal can be narrowed and can be graded as mild, moderate, or severe. If severe, neurologic symptoms and/or pain may occur.
Spondylolisthesis is the generic term for slippage of a vertebral body relative to the one below it. Anterolisthesis and retrolisthesis are more specific terms that describe whether there is anterior or posterior slippage. These are graded 1-4 with 4 being the most severe. The higher the grade, the more likely the slippage can lead to narrowing of the spinal canal and/or neural foramina which can cause symptoms.
Can cervical spine problems cause severe headaches?
Is there some kind of surgery that would relive pain?
In general, pain is not commonly relieved by surgery unless there has been a fracture or similar injury. Surgery is usually performed when there are symptoms related to nerve impingement such as weakness, numbness, and tingling. Most studies show that back pain itself is better treated with NSAIDS and physcial therapy. That being said, each patient and spine is different and evaluation is best done by your physician guided by your imaging findings.
@@mediphany4852 Thank You.
I have DDD and It started when I was 20 years and I had a lumbar fusion because of how bad it was. Mine were rubbing together.
I still have a lot of pain but with my pain meds I can do the everyday things everyone else takes for granted. But I had the best Doctor/surgeon L4 L5 S1
Have you had patient's that have a rare condition of he might per trophy or memimitosis, an overgrowth in the right side of the body, beginning under the chest and ending at the enlarged foot?
Yes, we have seen this as part of syndromes such as Beckwith-Weidemann and usually resulting in scoliosis.
Can you please answer or explain the amount of disc degeneration appropriate for each age group?
Could you please show an MRI for each age group, eg, 30s, 40s, 50s 60s etc and indicate how much degeneration is generally applicable for each age group.
I'm 55 and have some degeneration, but so far, I can't find out if it is more severe than would be expected for someone my age (a potential issue) or merely age appropriate wear and tear. Thanks.
While age is important, the overall changes of degenerative disk disease are variable depending upon the activity level and genetics of each person. That being said, approximately 30% of people will have some level of disk disease by age 35 and 90% by age 60. Whether the disk disease is serious or not is usually guided individually based upon a patient's symptoms. Underlying conditions such as scoliosis will also lead to more rapid advancement of disk disease.
A paper that shows some data on lumbar spine disease by age: www.nature.com/articles/s41598-021-84724-6
@@mediphany4852 Thank-you, appreciate your response, I'll have a read of the above paper.
@@mediphany4852 Doctor should we be doing some type of back strengthening exercises to slow progression of DDD or other kind of movements?
In general, muscle strengthening can help decrease the load and stress on the bony parts of the spine. Strong and healthy muscles can help support our necks and backs and those can be obtained by exercises which are best prescribed by a physical therapist and/or physician specialist.
Ur video nice ,but speedy speech and dark pictures make hard to understand what u say !!?? pl rectify !!!
I have cervical myelomalacia, severe cervical spinal stenosis of C5-6, eccentric disc bulge lumbar spine. I have MS and no spinal surgeon will do surgery because they blame my right leg , hip, ankle paralysis and foot drop on MS. I know my symptoms are not due to MS because my legs are better in the evening. I assume my symptoms at due to lack of blood flow in the spinal canal. I think the doctors do not want to waste their $ doing the surgery and have no back pain so refuse to operate. Should I get a third opinion? My MS Neurologist never told me about the myelomalacia and spinal stenosis since 2014. I only found out by getting copies of all Radiology MRI Reports date back to 2014. My partial paralysis and foot drop started after I was rear ended, I had no back pain so thought it is just MS.
Thank you for your comment. We actually have a video about degenerative changes of the cervical spine as well if you'd like to watch it. Myelomalacia is typically caused by compression of the spinal cord, most commonly from degenerative changes. Once myelomalacia occurs, it usually cannot be completely reversed, but further damage can be prevented with treatment options such as therapy and/or surgery. The issue in your case may be that MS lesions and myelomalacia can appear similar on MRI and your physicians may not be certain which is the source of your symptoms. Discussion of your options with your physicians is the best path forward for both your MS and your degenerative changes.
Keep searching
But never gets investigated why that happens ? Or is it a money machine …
Then the VA decides to give a diabetic steroid shots or the wonderfully ineffective drug gabapentin. If you complain about ineffective treatment, they offer you an antidepressant but be damned if they're going to spend the money to replace the disc.
Be damned if they're gonna do much of anything for anyone, cause it's getting more an more, like it's about the $$$ .I totally agree with You. Thank You for all you've done to keep us as free as we are. Suffering is Not a Life!!!