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    What does an MRI scan of the lumbar spine (low back) show?

    Posted by John Holden on Sun, Mar 08, 2009
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    MRI lumbar spineMRI scans are frequently used to evaluate the internal structures of the lumbar spine, also known as the low back. A variety of trends have increased the use of MRI in evaluating the spine - more sports activity, increase in obesity rates, and we've remained much more active into our later years than previous generations.

    If you've injured your back or have chronic back pain, your doctor will probably first order an x-ray. After an x-ray, an MRI may be needed to evaluate the internal structures of the lumbar spine. On your doctor's order for the MRI you might see:

    "r/o disc disease" -  this refers to the discs that act as shock absorbers between the vertebral bodies of the spine. They can be injured or "flatten" over time and bulge and press on nerve roots.

    "r/o herniation"- this refers to a disc herniation. If the outer part of the disc tears, a jelly like substance can escape out (aka herniate) and cause radiating pain or weakness in the leg and foot.

    "r/o stenosis" - this refers to narrowing of the spinal canal and openings for the nerve roots. Bulging discs and other degenerative changes of the spine can narrow the spinal canal, causing back pain.

    (FYI - "r/o" is short for "rule out")

    An MRI of the lumbar spine will evaluate:

    Bones

    A lumbar spine MRI will include the lumbar vertebral bodies, lamina, facets, spinous process and parts of the lower thoracic spine and the upper sacral spine. The lumbar spine MRI can detect bone fractures, tumors, infection and evaluate post-surgical changes. An MRI can also determine the extent of degenerative changes (arthritis) and be used for pre-operative planning for spinal fusion.

    Discs

    Lumbar spine MRIs are very good at looking at the discs between your vertebral bodies. A lumbar spine MRI can detect disc flattening, bulges, herniations, and infection (aka discitis).

    Spinal Canal and Neural Foramina

    Spinal nerves travel down through the spinal canal and leave at each level of the lumbar spine. The nerves leave the canal through holes called the neural foramina. The canal and these exit points can be blocked and cause pain or leg and foot weakness.

    Conus and Nerve Roots

    The conus is the end of the spinal cord - it looks like a cone with many nerve roots extending from it. A lumbar spine MRI is very good at detecting tumors, inflammation or impingement on these structures.

    Soft Tissues

    This refers to the muscles and tissues around your lumbar spine. The lumbar spine MRI can detect infections, fluid collections and tumors of these structures.

    Your Lumbar Spine MRI Scan

    A lumbar spine MRI generally takes about 20-30 minutes or so to complete. If you are going for one, wear loose comfortable clothing and remember to remove all metal (jewelry, phones, rings, etc) before going into the MRI scan room. If you've had surgery or have a history of cancer, you'll probably have the test done with MRI contrast.

    If you're insured, you may need to have your test authorized (approved) by your insurance company first. If you're uninsured and need to look up prices and buy an MRI scan of the lumbar spine, you can use our website to look up MRI scan costs.

    Have you had a Lumbar Spine MRI scan? What was it like? Please leave your comments below.

    Tags: ,

    COMMENTS

    I've had several lumbar mri's and one thing to think about is...if you are having lower back pain then laying flat is often uncomfortable. Ahead of time ask for a pillow to put under your knees. This makes the test much more comfortable for you. Don't be afraid to ask. Most techs are very nice.

    posted @ Monday, March 23, 2009 9:27 PM by Angie


    What would be the frequency in which one would get another MRI done (for spinal eval)...ex: no change in s/y, just no relief of pain from any treatment measures anymore. last MRI was 9 months ago. Is it appropriate for another MRI to be done again???

    posted @ Thursday, May 07, 2009 11:51 AM by lisa


    Lisa, 
     
    Probably not the answer you're looking for but it depends on your symptoms, what therapy you've undergone, your doctor's recommendations, etc. Patients do get their MRIs repeated after a short period of time if there has been recent injury, surgery or a sudden change in their symptoms.

    posted @ Thursday, May 07, 2009 12:06 PM by Ravi Sohal


    I had a lumbar spine MRI in 2003 which resulted in a dx of spinal stenosis, requiring a lumbar laminectomy and fusion of L4/5. I now have pain on the opposite side which is barely lessened by Vicodin. I go for an MRI today. The procedure is nothing; it's the results I'm concerned about!

    posted @ Saturday, June 06, 2009 8:14 AM by Shelley M. Saunders


    I had a lumbar spine MRI in May this year, which took about 30 minutes. Although there wasn't much space, I closed my eyes and tried to relax. My breathing was very heavy at first, but as I relaxed it slowed down, which was good as I though I must be moving too much. I agree with Angie about getting a cushion to put under your knees. I was told that the MRI scan is only current for 3 months, after which I would need a new one, if I decided to go for the suggested decompression (laminectomy)and fusion surgery. How did you get on Shelley?

    posted @ Saturday, September 19, 2009 10:57 AM by Lindsey


    I’m one of those who always suffer for back pain and I’m doing some treatment to ease the pain. Can you give me some tips to totally relieve my back pain?

    posted @ Friday, December 11, 2009 1:51 AM by lower back support


    I'm having a "MRI Lumbosacral Spine w/o contrast" report as following : 
     
    Decreased lumbar lordosis is seen. 
     
    Vertebral bodies are normal in shape, signal and alignment. 
     
    A small T1 and T2 high signal intensity focus suggestive of small hemangioma is seen in L2 vertebral body. 
     
    Decrease of T2 signal intensity in L4/L5 and L5/S1 intervertebral disks indicates dehydration. 
     
    Small focal central protrusion are seen at L4/L5 and L5/S1 levels. 
     
    Bone marrow signal changes in L5/S1 vertebral bodies is due to degenerative disk desease. 
     
    Conus medullaris as well as cauda equina apprea normal. 
     
    Cold you please explain what my disease is, and let me know what the report means 
     
    Regards, 
     
    Reza 
     

    posted @ Sunday, January 24, 2010 12:21 PM by Reza


    Lindsay asked how I got along after my laminectomy with fusion. 
     
    I got along fine with that. It was the push I needed to quit smoking as well. I did and I am so glad. Now, unfortunately, I have Lung cancer which has metastasized to bone and liver so I have spinal tumors which had to be radiated. Prognosis is not good.

    posted @ Tuesday, January 26, 2010 5:16 PM by Shelley


    I'm am having a MRI an MRA of the Lumbar which my back isn't hurting and I have osteopenia. I don't know what they are looking for. My insurance denied my PET scan of the same region

    posted @ Tuesday, February 23, 2010 1:02 PM by Connie


    Shelley, 
    I just read your post. I wish you well, and hope that they manage to keep you comfortable and feeling well. 
    Take care

    posted @ Thursday, February 25, 2010 7:52 AM by Lindsey


    my pain is in my left glut area. will a lower lumbar MRI cover this area?

    posted @ Tuesday, March 09, 2010 6:17 PM by lynn


    Lynn, 
     
    A lumbar spine MRI doesn't cover the gluteal area. But gluteal pain can be caused by disc bulges and narrowing in the lumbar spine.

    posted @ Tuesday, March 09, 2010 7:00 PM by Ravi Sohal


    my left glut pain in worse when i lay down, which is only at bed time. no possition to find relief. i have degentive disk dias. and ostoarthitis, but this is sharp stabing pain.

    posted @ Tuesday, March 09, 2010 7:19 PM by lynn


    Does a lower lumber MRI still show if there is a problem if I am not having pain at the time of the MRI?

    posted @ Saturday, March 13, 2010 4:06 PM by Marla


    I have killed my back. I can't get up or out of bed without help. 
     
     
     
    I have an MRI approval from my insurance but the hospital is telling me that I need to wait 8 weeks, as I had surgery on my eye on 2/8. I can't wait and I don't understand why I would have to wait. 
     
    I know I have herniations at L4-L5 and S1. Anyone know why you must wait? I work at the hospital, and I have to do a lot of bending and reaching and I can't see where I can do that tomorrow. 
     
     
     
    Thanks in advance for your help. 
     
     
     
    Karen  
     

    posted @ Sunday, March 21, 2010 6:25 PM by Karen


    I had an MRI of the lumbar spine. The radiology department said that with the order being lumbar spine area, they do not go to other areas such as to look for tumors elsewhere in the body. Do they automatically scan the whole body before doing the area that was ordered by the doctor?

    posted @ Monday, March 22, 2010 7:46 PM by Ellen Stevens


    Spine Surgeon sending me to pain management, says I’m not a canidate for surgery at this time. Not sure what he meant? 
     
     
     
    MRI OF THE LUMBAR WITHOUT AND WITH CONTRAST 12/22/2008 
     
     
     
    There is desiccation and narrowing of intervertebral discs from level of L3 through S1. 
     
    At the level of L1-2, there is no evidence of focal disc protrusion or significant canal or neural foramina stenosis. 
     
    At the level of L2-3, the intervertebral disc is mildly circumferentially bulging with an element of early vertebral osteopthytic ridging circumferentially. Disc changes are very slightly asymmetric to the left and cause fattening and mild indentation of the anterior margin of the thecal sac without canal stenosis. There is bilateral facet hypertrophy which is slightly more prominent on the right. The disc/osteophyte complex does mildly contact the exiting right L2 root within the foremen. 
     
    At the level of L3-4, there is moderate bilateral facet hypertrophy. The intervertebral disc is desiccated and circumferentially bulging, slightly asymmetric to the left. There is a tiny fluid-filled annular tear in the central disc margin. The disc material mildly indents the anterior margin of the thecal sac, slightly asymmetric to the left. The combination of disc bulging and facet hypertrophy causes minimal narrowing of the inferior aspect of bilateral neural foramina without direct nerve root compromise. 
     
    At the level of L4-5, there is postsurgical change related to previous laminectomies. The intervertebral disc is narrowed and mildly circumferentially bulging with an element of early circumferentially vertebral osteophytic ridging. There is no significant mass effect on the thecel sac or evidence of overall canal stenosis. Disc/osteophyte complex formation extends into both neural foramina causing a mild degree of narrowing, slightly greater on the right with direct contact with the exiting right L4 root at the foramina exit.  
     
    At the level L5-S1, the inervertebral disc is mildly bulging without evidence of focal protrusion of significant canal or neural foramina stenosis.  
     
    The post contrast images demonstrate subtle enhancing surgical scar in the laminectomy defects at L4, slightly greater on the left without evidence of significant mass effect on the thecal sac or arising nerve roots. 
     
    A fatty fllum is present, best seen in the sagittal plane (series 3 image 6) measuring approx. 3.9 cm in length x 0.4 cm in max. width. The conus terminates in normal position, however.  
     
    There is no gross abnormality seen in the parespinal soft tissues. 
     
     
     
     
     
     
     
     
     
    MRI CERVICAL SPINE WITHOUT CONTRAST: 9/26/09 
     
     
     
    Alignment of the cervical vertebrae is normal. The vertebral bodies are normal in height. No areas of significant marrow signal alteration are identified in the vertebrae. 
     
    At the level of C2-C3, there is no disc protrusion or canal or neural foraminal narrowing. 
     
    At the level of C3-C4, there is no focal disc protrusion. There is moderate right and mild left neural foraminal narrowing due to uncinate and facet hypertrophy.  
     
    At the level of C4-C5, there is bilateral uncinate and facet hypertrophy causing minimal narrowing of the right neural foramen. The left neural foramen is patent. There is mild disc bulging flattening the anterior margin of the thecal sac. 
     
    At the level of C5-C6, there is minimal disc bulging flattening the anterior margin of the thecal sac without focal protrusion or cord impingement. There is early uncinate and facet hypertrophy bilaterally causing subtle narrowing of the caliber of the bilateral neural foramina without direct compromise of the exiting roots. 
     
    At the level of C6-C7, there is no evidence of focal disc protrusion or canal or neural foraminal stenosis. 
     
    At the level of C7-T1, there is no disc protrusion or canal or neural foraminal stenosis. 
     
    No areas of signal alteration are seen within the spinal cord. The visualized portions of the posterior fossa and craniocervical junction are grossly normal. 
     
    No abnormality is seen within the visualized paraspinal soft tissues. 
     

    posted @ Friday, April 09, 2010 9:31 PM by James


    How far up does a lumbar MRI go? In addition to the pain by the lower part of my spine, I also have pain/aches/tightness in the side muscles almost half way up my back (above the bottom of my rib cage). My insurance is scheduling the appointment, so it most likely won't be at the same clinic I have been going to so there will be no communication between the doctor and the technician before hand. I'm just wondering if they are going to be able to see that part.

    posted @ Thursday, April 15, 2010 3:03 PM by Joe


    Hi 
     
    I have been suffering from chronic lower back pains since Dec 2008 when I slipped and landed awkwardly with both feet in the air. I had physio treatment which I did not respond to therefore my physiotherapist reffered me back to my GP who sent me for an X-ray which came back saying no abnormility found.  
     
    Beacuse pain kept on persisting I was reffered to a orthopeadic specialist who sent me for an MRI scan. The company which carried out my MRI was an independant company. Because I got an appointment date for follow up with specialist 2 months after my scan had been done my GP requested my MRI scan results because my health condition had gone so bad I could not sit stand or sleep.  
     
     
     
     
     
    The findings from the scan were as follows: Loss of central hyperintensity withing the lumbar intervertebral disc of L3-4 to L5-S1 suggestive of disc dehydration. Dorsobilateral disc bulging at L 2-3, L 3-4, L 4-5 and L 5-S1 level without severe involvement of both nerual foramina. Degenerative changes at the facet joints noted and mild thickening of the ligamentum flavurn at the lower lumbar levels which are age related. No signal pattern change within the lumbar vertebrae despite schmorl nodules at the upper lumbar spine. The conus medullaris is of normal size. Shape and location and has no signal alterations. 
     
     
     
    Conclusion:  
     
     
     
    Dorsobilateral disc bulging at L 2-3, L 3-4, L 4-5 and L 5-S1 level without severe involvement of both nerual foramina 
     
     
     
    Recommendation:  
     
     
     
    Depending on accute pain. Pain clinic referral matbe helpful. 
     
    My GP managed to bring forward my appointment date with specialist. When I went to see specialist he askd what do I reckon is wrong with me? I replied saying based on MRI scan report I have a disk bulge. He said the above report findings are incorrect. the quality of the scans are not clear and also that the report is made up and he has written to the company to stop writing false reports. 
     
     
     
    Due to my symptoms stabbing pain in lower back and numbness in toes he said that he will send me for another MRI scan. 
     
     
     
    The findings from second MRI scan were: 
     
     
     
    MRI Spine lumbar and sarcal: poor quality scan due to patient movement. No abnormility seen. 
     
     
     
    I visited the pain clinc and the Dr was confused due to two diff MRI reports, however she said the Orthopeadics consultant has the final say as he specialises in that field. 
     
     
     
    The pain I am experiencing makes me feel as though I have a trapped nerve. 
     
     
     
    The Dr at the pain clinic after thorough examination said my lower back is very tender and I have bad muscle spasm. she is refering me for physio and accupunture and told me to use a Tens machine. 
     
     
     
    I have been or very strong pain killers for 1 year. starting from diclofence to co drydamol leading to tramadol and amititrypline and eventually onto diazapam. I have now been presecribed baclofenec. 
     
     
     
    I feel so dopey and like a zombie. I find it difficult to remember things and feel so down stressed and depressed. 
     
     
     
    Can you offer me any advice? 
     
     
     
    Can all this pain i am experiencing be just down to muscle spasm? 
     
     
     
    I look forward to hearing from you soon. 
     
     
     
    Kind Regards 
     
     
     
    Sayed

    posted @ Tuesday, May 04, 2010 6:03 PM by Sayed


    MY SISTER JUST GOT OUT OF HOSPITAL. 
     
    HAD LOTS OF TESTS,HEART PROBLEMS,LOTS OF BACK AND NECK PAIN.ALSO TAILBONE PAIN FOR LONG TIME. TEST SHOWED HOLES IN HER SPINE. DRS DIDN'T KNOW WHAT THAT WAS!!!!HER HEART TESTS WERE SENT TO CLEVELAND CLINIC CARDIO. BUT SHE 
     
    IS VERY CONCERNED ABOUT "HOLES" IN 
     
    SPINE?? 
     
    ANYONE HEARD OF THIS. I AM AFRAID THIS IS VERY BAD. 
     
    THANKS FOR ANY COMMENTS.

    posted @ Friday, May 21, 2010 2:24 PM by BRENDA


    Brenda, 
     
    Can you elaborate? What did the report say. The word "holes" in lumbar spine report would be unusual...are they referring to "lytic bone lesions"?

    posted @ Friday, May 21, 2010 9:34 PM by Ravi Sohal


    At L4-L5 there is a left foraminal annular tear seen as an area od the linear hyperintensity in the T2-weighted images at the posterior annular margin at the level of the foramen. There is mild dic dehydration at L4-L5 suggesting mild degenerative change. Can someone tell me what this means? I have been in alot of pain from this.

    posted @ Friday, May 28, 2010 4:16 PM by Suann O


    Suann, 
     
    Annular tears are early "breaks" in the tough fibrous part of the disc. Think of it as the shell around a jelly donut. Once this completely breaks it can result in a disc herniation - that is the jelly part leaks out.  
     
    Annular tears can cause pain and sometimes the disc itself bugles and presses on a nearby nerve root. It sounds like that might be the case in your MRI.

    posted @ Friday, May 28, 2010 4:49 PM by Ravi Sohal


    Thank you Ravi Sohal. Your help 
     
    is appreciated. Suann O

    posted @ Saturday, May 29, 2010 3:15 PM by Suann Okun


    What does the comment W/O mean on a lumbar MRI.

    posted @ Saturday, June 05, 2010 2:19 AM by Gary Johnston


    Gary, 
     
    The "w/o" stands for "without". So your doctor has ordered your Lumbar Spine MRI without contrast.

    posted @ Monday, June 07, 2010 5:38 PM by Ravi Sohal


    ive had lower back pain for over 12wks now im being sent for a mri scan next week but when i walk sometimes it sounds like bones banging together my doctors thinks i might have disloged dics im not sure what to make of the bones banging ant ideas

    posted @ Wednesday, June 09, 2010 7:18 AM by sharon


    Sharon, 
     
    It could be that your lumbar spine discs are very dehydrated and you have abnormal motion in the spine. The grinding feeling could be related to that and muscle spasm or tightening of ligaments.

    posted @ Thursday, June 10, 2010 1:54 PM by Ravi Sohal


    If you lay in more comfortable position with pillows under knees will it show the painful position's causes as easily. Seems that position would effect bone posture and there fore causes of pain???

    posted @ Tuesday, July 06, 2010 1:21 PM by Teresa


    Teresa, 
     
    That is a very good observation. The position of the spine lying down could potentially mask a large disc bulge. There are some facilities that have standing MRIs to look for this.

    posted @ Tuesday, July 06, 2010 11:46 PM by Ravi Sohal


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