A MRI report usually goes two pages long with a lot of details describing your spine. People often get scared reading the terms used in their report. Firstly, an explosive report does not mean that you are ill.
The two most common conditions that are reported are Disc bulges and Degeneration. Disc Bulges are seen in many people without any complaints of back pain or leg pain, so they aren’t necessarily the reason for your pain. Degeneration is nothing but aging. As you grow old your spine shows increasing signs of degeneration, which is completely normal. Disc degeneration is seen in 37% of individuals in their 20’s, 68% individuals in their 40’s, 88% individuals in their 60’s without the presence of back pain.
90% of people with back pain do not show any relevant findings on the MRI causing their pain. This in fact should make you relieved as this suggests that your back pain will be cured by only Conservative Treatment.
There are certain conditions that are dynamic in nature, which can be seen when you sit or stand. As your MRI is done in a comfortable lying down position, they may not be picked up. A clinical examination and other modalities like X-ray will confirm such conditions.
Your Doctor is the best person to understand your MRI from and know, how pertinent your MRI findings are to your condition. The following explanation of terms is just for guidance and a better understanding of your condition.
| Aging disc | Normal changes of the disc occurring with age. They are not considered a specific reason for back pain and are frequently found in asymptomatic people. |
|---|---|
| Annular tear or fissure | Tear in the outer part of the intervertebral disc. A degenerative change that can in some cases be a reason for a disc herniation but does not have to be associated with any symptoms. |
| Anulus fibrosus | Outer fibrous ring of the intervertebral disc. Tears in the fibrosus ring can be a reason for a disc herniation. |
| Arthritis | See Osteoarthritis |
| Bilateral | On both sides |
| Black disc | See dark disc |
| Bulge, bulging | Bulges are very common and rarely cause any pain or symptoms. Many people have them at multiple levels in their spine. |
| Cauda Equina | Latin for the ‘tail of the horse’, refers to the bundle of spinal nerves running in the spinal canal in the lumbar region. These nerves are responsible for the function of the lower extremities and genital area providing them with sensation and muscle power. |
| Cerebrospinal fluid (CSF) | Fluid surrounding the spinal nerves. In spinal stenosis CSF circulation can be impaired leading to a decrease of nutrient and oxygen supply for neural tissue, which can cause spinal claudication. |
| Claudication, Spinal claudication | Is a symptom that goes along with impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. Can be caused by Spinal Stenosis. |
| Compression | Compression refers to a narrowing of the space around the lumbar nerves. It can be caused by a disc herniation or spinal stenosis. Depending on the amount of narrowing or compression this can lead to symptoms such as radicular pain. If occurring slowly as in the aging spine it can be asymptomatic in many cases. |
| Dark disc | Normal change of the disc occurring with aging caused by dehydration of the nucleus pulposus. It is not associated with a higher rate of back pain and can be commonly found in asymptomatic people. |
| Degeneration, Degenerated disc | Is the natural ageing process of gradual dehydration and narrowing of the intervertebral discs. This is commonly visible on MRI scans and is not considered as a specific reason for back pain. |
| Disc | See Intervertebral disc |
| Disc height, disc space | Space between two vertebrae, were the intervertebral disc is found. Narrowing of the disc space or loss of disc height are part of the natural ageing process. |
| Dura mater | A membrane made of connective tissue that surrounds the spinal cord and nerve roots and forms the dural sac. |
| Dural sac | A tube formed by the dura that that surrounds the spinal cord and the cauda equina and contains the cerebrospinal fluid. |
| Epidural space | Space within the spinal canal surrounding the dural sac. |
| Extrusion, Extruded disc | See herniated disc. |
| Facet joint | Small joints at the back of the spinal column. Two facet joints, one on each side, are found in each spinal motion segment. Degeneration of these joints are commonly found in elder people and can be a reason for back pain in some cases. |
| Foramen, Foraminal zone | A channel between two vertebrae through which the nerve roots exit from the spinal canal on each side. The borders of the channel are made up of the vertebra, the intervertebral disc, and the facet joints. Alterations of these structures can lead to a narrowing of the foramen and consequently compression of the exiting nerve root, which can lead to radicular symptoms (e.g. pain). |
| Herniated disc, Herniation, Herniated nucleus pulposus | If the annulus fibrosus (outer part) of the intervertebral disc is torn, the nucleus (inner part of the disc) can herniate. If a herniation occurs in vicinity of the nerve roots it can lead to compression and inflammation of the nerve roots, leading to radicular symptoms (e.g. pain, numbness or weakness). However, many disc herniations do not lead to any symptoms and don’t have to be treated specifically. Commonly disc herniation will resolve with time. |
| High intensity zone | Describes the appearance of an annular tear in the MRI. see Annular tear. |
| Hypertrophy | Ligamentum hypertrophy or facet joint hypertrophy refer to an enlargement of the facet joints and surrounding soft tissue. Depending on the amount of enlargement it may lead to compression of the nerve roots or spinal canal stenosis and may potentially cause symptoms. |
| Instability | Excessive movement within a spinal segment. In some cases, this can lead to back pain or nerve root compression. |
| Intervertebral disc | A strong soft tissue connecting two vertebrae, which acts as a hinge, shock absorber and energy converter. It is made up of the annulus and the nucleus pulposus. |
| Intravertebral herniations | Disc material is displaced beyond the disc space through the vertebral end plate into the vertebral body. This is commonly found in the aging spine and not necessarily associated with any back pain. |
| Lateral Recess | Part of the spinal canal on both sides were the nerve root runs down and can be affected by disc herniation or compression. |
| Lordosis | The normal curvature of the lumbar spine when viewed from the side. Degeneration of the lumbar spine can lead to a decrease of the lordosis and consequently to malposition of the spine that, depending on the magnitude can be associated with back pain. |
| Modic | The Modic classification describes degenerative changes involving the vertebral end plates and adjacent vertebral bodies associated with disc inflammation or degenerative changes of the intervertebral discs. Different stages referred to as type 1 to 3 (or mixed) can be described. Depending on the stage these changes may be a reason for back pain. |
| Motion Segment | Functional unit of the spine consisting of two adjacent vertebrae and the intervertebral disc. |
| Nerve Root | At each level of the spine, a pair of nerves emerge between the vertebrae on each side. Depending on the level they are responsible for the function of the lower extremities, genital region, bladder, or anal sphincter. Compression of the nerve roots can lead to neurologic symptoms such as radicular pain, numbness, weakness, gait disturbance or bladder and bowel dysfunction. |
| Nucleus Pulposus | The soft inner core of the intervertebral disc is made up of a gel-like material that consists mainly of water. In the aging spine, the nucleus pulposus dehydrates. The nucleus pulposus can herniate through the annulus fibrosus and lead to compression and inflammation of the nerve roots. |
| Olisthesis | See Spondylolisthesis |
| Osteoarthritis | Wear and tear changes in a facet joint occurring with age. In advanced stages it may be a source of back pain. |
| Osteochondrosis | An unspecific term for any disc degeneration. It is part of normal aging and is not necessarily a pathologic finding leading to back pain. |
| Osteochondrosis | Osteophytes are also called “bone spurs”. They are bony changes that occur with natural aging. Commonly they are found with other findings such as disc degenerations. Osteophytes occur when the bony edges of the vertebra that attach to the discs enlarge as the disc degenerates. Depending on their location they may come in contact with nerve roots and lead to nerve compression. However, in most cases, they typically do not cause any symptoms. |
| Prolapsed disc, Prolapse | See Herniated disc |
| Protruded disc, Protrusion | Displacement of disc material beyond the normal margin of the intervertebral disc space. Depending on the location and amount of nerve root compression it may lead to stenosis or radicular symptoms. However, this is a very common finding in MRI and most cases is not associated with any symptoms. |
| Schmorl Node | See Intravertebral herniations |
| Sequestrated disc, sequestration | See Herniated disc |
| Spinal canal | The bony canal within the vertebral column that contains the dural sac, the spinal cord and the nerve roots. Severe narrowing or stenosis of the spinal canal may lead to compression of nerves. |
| Spondylolisthesis | Refers to the slipping of one vertebra over another. It can be caused by a degeneration of the intervertebral discs which links two vertebrae. In cases of a severe slip neurologic symptoms or pain can occur due to instability or nerve root compression. |
| Spondylolysis | Describes a bony defect in the vertebral arch. May in some cases lead to instability or spondylolisthesis. It may be a source of back pain but can also be found in asymptomatic people. |
| Spondylosis | A common nonspecific term used to describe any degenerative changes of the intervertebral discs. It is part of normal aging and is not necessarily a pathologic finding leading to any back pain. |
| Spondylosis deformans | A term used to describe any degenerative changes of the intervertebral discs and surrounding bone, such as osteophytes. It is part of normal aging and is not necessarily a pathologic finding leading to any back pain. |
| Stenosis, Spinal stenosis | Narrowing of the spinal canal caused by degeneration of the discs, ligaments or facet joint or by instability. It can result in compression of the nerve roots. Spinal canal stenosis can lead to gait disturbances or claudication. Stenosis of the foramen may lead to compression of one nerve root and radicular symptoms. |
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