How to Read a Lumbar MRI
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- Опубліковано 11 тра 2019
- This video discusses basic lumbar anatomy and what your physician might show you during an MRI appointment to review your mri
#thespineguy #lumbarspinemri #lumbaranatomy #spinesurgeon
Dr. Brian W. Su, MD
Spine Surgeon
Chief Development and Strategy Officer | California Orthopedics and Spine
Medical Director of Spine Surgery | Marin General Hospital
Director | Marin Healthcare District Board
Chairman | Marin Specialty Surgery Center
Yelp:
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Contact two locations:
www.caorthospine.com/
415-927-5300
2 Bon Air Road, Suite 120
Larkspur, CA 94939
7100 Redwood Blvd, Suite 200
Novato, CA 94945
Curriculum Vitae:
www.caorthospine.com/brian-su...
FTC: This video is not sponsored.
Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Information obtained from this video should not be taken in lieu of your own medical provider's advice and treatment plan. Please consult directly with a physician or other healthcare professional regarding any diagnosis or treatment plan options. Content provided on this UA-cam channel is for informational purposes only and should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose , treat, cure or prevent disease.
I can't tell you how grateful and reassured I am by your explanatory (and cautionary - "take the MRI reports with a grain of salt") videos. I had been to an orthopedic surgeon at one of our very distinguished medical centers/schools who gave me little information other than "there is no cure spinal stenosis" and the sense of don't waste my time unless you're ready for surgery. Even before my appointment with you, I am quite confident that you'll be able to help me. What a world of difference it makes to include a patient in a process of informed decision-making. Many Thanks.
Feel free to watch the series on lumbar spinal stenosis
Excellent presentation. Impressive Dr. (Brian Su) with exceptional teaching clarity. Empathic young man, too. Thank you!
Best video ever..Not sure why they this video doesn't have millions view..👍🏽👍🏽💙
I've learned more from your videos than I have from every doctor I've seen for my back issues. Thank you!
Thank you so much for this video! I have been in excruciating pain for the last 5 weeks and finally had an MRI last week, it showed L3-4 disk bulging with compression on my thecal sac and degenerative disk stenosis on disk L4-5 with nerve compression. My regular doctor never got in touch with me about my results so I have just been so worried not understanding exactly what my results meant, then I received a referral to an orthopedic surgeon again with no explanation of anything. Seeing this video has really explained a lot and also calmed my worries! Thank you!!!
Thank you thank you. First, for your clear and precise explanation to possible problems, the cause & affect, and full explanation to possible treatments. Only wish my physician initially would have made the effort to give me basic diagnosis and possible treatments... So after experiencing for the last 3 + months with excruciating, debilitating pain, leaving me bedridden during that time...with the doctor w/o seeing me prescribed a cocktail of medications leaving me at the very least sick in every possible manner...altho, I guess I received minor reprieve from pain...at least what I can remember, that is! So, now I have received referral and authorization to see a Surgeon, at the end of week.
What your videos have given me is calming my anxiety! Thru your videos I feel comfortable with a good educational foundation as to proceed to the surgeon and able to feel confident in what is suggested for my situation..again thank you.
I really hope you are a teacher as well as surgeon. ❤❤
Dr. Su, as a patient with spine issues at both cervical and recently discovered lumbar spondylosis, w/pars fracture, spondylosthesis slippage and rotated coccyx. I have found your videos a gold mine in understanding my condition and in mapping out treatment options . Thank you for taking the time to create these videos.
Thanks for the super clear description of how to basically read an MRI, in particular.
I always was confused why the Lft and Rt sides were switched upon viewing. Now I get it! 😃
Great series , after watching a lot of videos this is the series that most effectivly clearly explains the subject . Thank you .
Really enjoyed your video so easy to understand. I recently was dx with herniated disc L3-L4 and was really afraid about my prognosis. But after watching a few of your videos I have a greater understanding and I feel empowered.
I would like to see a video on scoliosis
You did a great job explaining how to read my MRI.
Agreed! I recommend he include this link in all of his videos because finally looking at an mri or xray is somewhat understandable. Such valuable information! 🙂
Dr., Best Video I have seen showing the Lumbar Spine in an MRI. I'm 71 yo, and have Spinal Spondyliosis and Facet Joint Arthritis. Misery Index is very high with terrible stiffness from head to toe (literally). I posted before on your Videos. This is best of any doctor descriptions of these conditions that I have received. An Old Neurologist, 52 years in practice told me that the disc Bulges that i have at L2-L3 , bulging Fore and aft could be causing some of my stomach isues. I have stenosis at many levels of the entire spine and Dextroscoliosis of 25 Degrees due to a 1 inch shorter right leg which was a result of a fractured femur in 1966 at age 15.
Please do more teaching and more videos
Thank you!
Thanks for all the information you tell us every day!
Great video. Thanks
Thank you for the wonderful explanation dear Dr. Su. God bless you.
Thank you, Dr Su! I love your videos, they’re educational and reassuring.
very god teaching . easy to understand.clear and infrmative
very well explained! thank you, Dr Su
I love the way you explain everything! I've had DDD, scoliosis and spondy for about 45 years. My neck was fused at C3,4,5 and 6.
My surgeon did a fine job but when I showed him my MRI, he said he wouldn't know where to begin because I have virtually no disc spaces. I am getting weak in the legs, constant back pain and having some elimination problems lately.
I'm 69, weigh 150 and was pretty active. I'm at a loss as to what to do.
It sounds like you need to be evaluated by a surgeon. You can call California orthopedics and spine for a virtual consult
Thanks for taking the time to make us smarter about the lumbar spine. Your explanation and technique are exceptional. Best
You are the best 👍
Thank you 😊 you are the best
These are fascinating. I am working with an excellent surgeon at Northwestern now and am going through the initial stages of having gotten the MRI and EMG and I will find out next steps next week hopefully. thanks to you, I knew how to read the MRI, at least some of it as well as any layperson could.
Very informative
Thank you so much for this video, I have been in excruciating pain for 4 years, taken all sorts of pain killers, done all manner of massages, physiotherapy and chiropractic care..pls I need your help. Just recently did another MRI..how can I send you my images. Can you send your wats app number or e-mail
The link to this incredibly informative video should always be included in your description box on your other videos.... or as a tag to click on the screen when an mri is shown so this basic information is readily available with each video. Just a thought... thank you Dr. Su! 🙂🙂🙂👍👍👍
Great video, very informative and easy to follow. Looking forward to future videos.
Hi Doctor SU. I'd like to have a virtual meeting. I was diagnosed to have a sciatique. I ve suffering for back radiation my legs and also the joint between leg and sacruum since August 2022 to now. I couldn't walk an d run even now. On january I went to South Africa for MRI test and it shows L3/L4, L4/L5, L5/S1 protusion as said professor Modi. I ve MRI result and I d like to show to you to have your advice because I'm no longer motivated for the treatment proposed to me after watching yours great videos. He proposed chorticotherapy (what the prof want) or surgery (He don't want because he said I'm still young). I'm 45 years old but athletic. My pain has decreased but I have some when I walk long and I can't run.
Excellent video. I have been trying to get this explained clearly to me for a yr now, and 15 min. of your video gave me all the information I had been asking for. I love the "treat the back, not the MRI" as that is how I was feeling. I have much more positive prognosis in my mind now after watching this and can ask my doctor better questions. How the nerves relate to each vertebra now is a question I have because my butt leg pain comes and goes, not consistent but my back of thigh, calf and half of my foot on outside stays numb all the time now. I would like to go back to my walking/hiking but not sure if that will happen so pretty discouraging at times. Wish you were closer for a consult but maybe I should push UC Davis a little more for answers next visit. Thank you for such a great video.
Thank you Dr Su! This makes me feel a lot better about understanding my MRI. Additionally, I am awaiting consult with an orthopedic surgeon. I saw in the comments that you offer virtual appointments and may contact your office about getting one.
You can certainly call California orthopedics and spine and make an appointment with me. I do zoom appointments for patients who live far away.
You explained everything with such clarity! You should consider teaching.
I had the L5-S1 cleaned out 3 times over the past 12 years. I just had an Open MRI and it shows All the lumbar discs above the L5-4 are bulging/herniated.
L1-2. Shows a superimposed left posterior para central disc extrusion extending cranially, measuring 15x9x4 mm. It appears to compress and impinge the exiting nerve L1 and transiting left L2 nerve root.
L2-3 Bulge (3mm)
L3-4 Bulge (4mm)
L4-5 Bulge (4mm)
L5-S1 Bulge (5mm) Grade I Retrolisthesis
Question: Since it was an open MRI, could The imagines be missing more severe injuries or exagerarte? I regret getting the open MRI and should had requested a closed one since I had heard that the open does not give you as clear picture as the closed in one. I am in a lot of pain even with good pain management. My pain. Management doctor recommends against surgery and wants me to get an epidural injection (I had those in the past and they did not do a thing in the long term, probably did more damage than good).
I am scheduled to see a Neuro surgeon in August. Is my only option a fusion? I am 51 year old. Thank you Dr. Su!
Definitely get a closed MRI. Open ones are not good quality.
I’m a 70 year old fit male 1.68 m tall and 86kg
I first had lumbar spine problems in 1998 and was lucky to visit a very experienced neurosurgeon. Gave me great advice which I followed.
Now I have compressed nerves, stenosis, specifically in L4/5 and after 2 years of non invasive procedures, physio and exercise ( strength and stretching daily) I am now really struggling with buttock and leg pain.
My current specialist gave me my first steroidal injections into L3 to S1 facet joints and nerve block to L4/5 both sides.
He said this should get me through Christmas and says I should consider surgery, which he recommends I should now have, in January or at a time that suits me. Basically the sooner the better.
There is some instability and he recommends removing the stenosis and a fusion with cage.
I was still playing golf 2/3 per week up until about 2.5 mths ago but now struggle with 18 holes.
I would like to continue to play as long as I’m possible as I feel I’m still fit and active for my age. Reasonable h/c of 10.
My question is ( as difficult as it may be for you to answer with my limited info) is, do you think this is still my best option.
Dr I think your videos are wonderful and just so informative.
Kind regards
Paul.
My email is empo@mweb. Co.Za.
Unfortunately it seems that open surgery is the only type available currently in SA.
I would have to do a virtual visit with you. You can call California orthopedics and spine for a zoom appointment with me
I need a member ID thank you for trying to help me I really appreciate it
Happy to have found your channel-appreciate all the information cogently explained. After several years of PT and other non surgical treatment, my wife's doctor has recommended two level fusion for her spondy and spinal stenosis (doctor said it was uncommon but she has spondy at L4L5 and stenosis L3L4. She also might need cervical fusion for stenosis (she had a symptom of "electrical" pain down her back from her neck, but no other symptoms, thankfully). Question: would it be better to have fusion for the spondy and decompression for the stenosis?
Watch the video on stenosis series. Also watch the series on spondylolisthesis. In general you do not need to fuse the levels that are stable. She may not require l34 fused. You will have to defer to your surgeon on that.
Before my L3-L4 spinal fusion and my ACDF i had 13 herniated discs. The dr said i have the spine of someone in their 70's but im only 48 and this has been an issue for many years.
Which rehab method do you believe is most beneficial; The McKenzie Method or Dr. Stewart McGills Big 3?
This is quite informative.
I have S1 radiculopathy and have been in agony for more than a year.
Do you think I should consider having surgery now or should I just keep getting therapy treatment?
Thanks.
I would have to look at the imaging you can make a virtual appointment at California orthopedics and spine
Surgery was needed on L4-L5 to fix my issues. Did L1-L2 and L2-L3 and fixed nothing. No other surgeon in two bearest counties (Kootenai ID or Spokane WA) will give me a consult. I scarcely walk now and no help. Better to get more surgery?
Thanks I got a piece of paper & no proper explanation, just a referral to a specialist ❤
Excellent video!!! If I were to send you my MRI results, would you be able to tell me what you would recommend?? Thanks you so much for all the information you provide.
You can make an appointment with me virtually by calling California orthopedics and spine
Will a hemangioma just come on suddenly in adulthood, and should it be able to be seen on previous MRI(s) too?
OMG this is great! I was able to open my MRI and I looked at while you explained everything! I feel so lucky to be local to your practice!
I watched all the lumbar videos so I'm ready for my appointment tomorrow. The inside the OR one was a little intimidation, particularly when the patient got flipped, but I wanted to understand it in case that's what I need. Which, I hope, I will not.
Hi Dr Hu Was wondering if a lumbar ESI at L3 could at least help pain at the Iliac capsule to a degree ? I was in a car accident October 6th 2023
Dr Brian I woman 83 having spondiololsthesis too much pain bone density very poor Dr recommends prolia injection do I have to go for it pl recomend
I have severe low back pain that was aggravated by a work injury last year, causing progressively worsening sciatic pain and numbness down both legs, which has now reached both feet. My MRI shows moderate L4/L5 disc degeneration and severe L5/S1 disc degeneration, involving L5 nerve. The L5/S1 joint is bone on bone and both are severely inflamed. I've been doing PT for a couple weeks, but it's not helping at all. I have another 2 weeks of PT scheduled, but I'm not expecting any significant improvement. I think injections are next, but who knows if that will work. I am in severe pain everyday and I don't know how much more of this I can take. I'm not sleeping and I can barely work. This is pure hell.
Not even age 50 and mine is loss of intervertebral disc height C5-C7 where degenerative disease is greatest C5-C7, despite degenerative end plate changes, invertebral bodies unremarkable though. Lumbar - mild posterior disc protrusion w/mild bilateral neural foraminal narrowing. Mild degenerative disc disease L3-L5. Arthritis is devastating. My knee's are bone on bone from a work injury years ago. Had spine CT almost two months ago and still no real plan for treatment so far. This herniated disc makes standing and sitting almost impossible after about 15 minutes of it.
Dr i have a severe left neoro floraminal stenosis on mri which clearly is in line with my pain..when i took my mri to a surgeon the only pic he went off was the canal and cross section..he never showed me the advaced pic of the foramin where the root would be pinched..told me im fine when obviously im not..do all mri have that advanced imaging to see the foramin..thx
Hi doctor who is it no spine surgeon uses disograms anymore? I'm getting a new mri technology called nuciscan mri says it grades degeneration
Got laminec
3/23 laminectomy on L1-2, L2-L3. Fixed none of m
Laminectomy 3/23 on L1
What protects a nerve coming out of spine to lower body, like out of L2 ?
Once it exits the spine it's only the soft tissue
Can you explain what "large eccentric left posterior disc protrusion with severe effacement of the left lateral recess" means. L4-5
Watch the playlist on lumbar disc herniation. Also watch the playlist on lumbar spinal stenosis.
Hi Dr. Is it possible to have MRI result that show small pinchment of l5s1 nerve root without spinal cord trapment but a progressive leg weakness?
Yes that's possible
What does Modic type I endplate degenerative changes are seen at L4-5 mean?
Please watch the degenerative disc disease playlist
Can I ride bicycle if I have stenosis, can help me to reduce my leg pain ?
Patients often feel better riding a bicycle because it allows them to be in a flexed forward position which opens up the spinal canal. Riding a bicycle is fine.
Really when I first got an MRI, it was a 3T one and I didn't know, looked at the pictures, and then I got another one done at a 1.5T and when I looked at the pictures for a at the follow up and in-between was doing an injections and I asked to seen the imaging, I was blown away how actually bad the 1.5T resolution was.
Clarification; I know the teslas values and thought it was a 1.5T bc on the door of the room it says 1.5T but I think these stickers just never been updated as they go by the room number. i.e.room 1-2 is 1.5T and Room 3 is 3T with a totla of 3 rooms. Also it was on different brand, they didn't really tell me directly, but from what I can gather Siemens have better imaging and clearer contrast then GE which along with the tesla the difference is significant. Though I think the main difference is still int he teslas.
Sometimes a three Tesla scan can interfere with the flow of the spinal fluid leading to a slightly poor image. However there's plenty of software that can correct that. 1.5 Tesla is plenty for the lumbar spine
Do you take ambetter insurance?
I do not know but you can always call California orthopedics and spine to check
I have severe spinal stenosis from about 8 years ago. I have getting worse I am scared to go the operation. They say if I do it I would not be able to turn my head. And it's a Two day surgery. This is in Sacramento at Mercy Hospital. Help me
It is hard to say without evaluating your imaging studies and a physical exam. You can always contact my office for a virtual appointment at California orthopedics and spine
How to prevent osteophytes
Osteophytes are byproduct of arthritis. They are essentially bone spurs that occur when there is cartilage loss in the joint because the human body is trying to increase surface area of the joint in order to spread out the forces placed on it. These bone spurs called osteophytes can sometimes cause problems and pinch nerves. As a disclaimer please consult your surgeon.
Can a pinched nerve recover
Yes
@Dr. Brian Su - The Spine Guy Hi Dr. Su my mother sustained a spinal cord injury high on the neck (c3) . She is suffering the effects of that injury now. Even though the fusion was put in, the deterioration of the cord continues. Is there any way to slow that process?
Can I send you my MRI and pay you for your analysis? 🙂 please
sorry I just now read the comments and saw how many people have asked you to look at an MRI, Nevermind. Thanks for your videos! I'm learning a lot from them
Please call California orthopedics and spine and schedule a zoom appointment with me
i find it surprising that most radiologists look at the Axial MRI wrong. They determine the level of neuroforaminal narrowing wrong. they see it at the facet joint level. most of the time the nerves are already outside when youre looking at the facet joint intersection in an axial view. you should see it when the nerves leave the cord, just slightly after the Lateral recess.
secoondly, they should not know the patients age to avoid age bias. because when they acknowledge the age, they automatically assume the ligament is folded for old patients and not young. but that is not true. young patients also have ligament issues. which are not commonly reported on MRI's. i believe we are still behind some aspects in medicine in 2023.
So for you doctor having all those bad things you name is normal sounds to me like you work more for the company or the insurance then for the people I bet you write on your report his mri looks normal he can go back to work besides all those issue you name
Wow ....The first dozen or so comments are...how shall I say....completely ridiculous!! People shouldnt YT while on drugs.
How are you Dr.Su.
Could you please send me your email I want to send my MRI for further interpretation.
You can make an appointment at California orthopedics and spine