How to Read a MRI of the Normal Lumbar Spine | Lower-Back | Vail Spine Specialist

How to Read a MRI of the Normal Lumbar Spine | Lower-Back | Vail Spine Specialist

the MRI essentially shows two
separate views of the spine a side view or a sagittal view and a bottom up view called the axial view on the side view we literally take a samurai sword and we
slice the spine like a loaf of bread into different
sections and that is represented by this side view here on the MRI the bottom-up view is essentially axial slices and you can see here the disc which would be located right
here the center of the canal here where you see the nerves and then the two facets on either side
in the back which she is represented on the MRI
here and here now we’re going to examine a normal lumbar spine we have two views of the spine we have this side view here and we have the bottom-up view here on the side view you can see that this side view
corresponds to this line in the cut of where we are cutting the spine in half literally so if this arrow or this line is right
in the center of the spine this is the center cut of the side of the spine move this line anywhere and we can see cuts for example to the
side of the spine here we can move these lines to get to the other side of the
spine there so this line that we’re looking at on the right side indicates where the
cut is on the side of the lumbar spine here to get to the anatomy this is the spinal cord the spinal cord ends about right here and then the spinal cord exits into the
cauda equina which are the peripheral nerves which sit in the center of the canal we don’t see the nerves coming all the
way down because they start to exit if i move this cut over to the side you can
actually see the individual nerve roots on one side we go back to the center and then cut on the other side and again
you can see the individual nerve roots on the opposite side the white material in the center here is cerebral spinal fluid which is
essentially water on this particular scan called a T 2 scan water is white you can also see the fat in the back
here the fat is also white mimicking the water these are the vertebral bodies that i’m circling here an in-between
the vertebral bodies are the discs the vertebral bodies are named for the
five lumbar segments so this is an L one L two L three L four and L five the lumbar spine as we talked about
before sits on the sacrum and this is the sacrum the sacrum has some of the
discs but they’re not relevant and this is
really one bone we name the discs for the vertebra they are sandwiched in
between so for example this is the L five
vertebra and this is the sacrum we call S one
so this is the L five s one disc as we go up this is the L four five disc the L three four disc the L two three disc the L one two disc and the T 12 L 1 disc
as we are now in the thoraic spine the vertebra themselves have a normal grayish hue which is a little indeterminate that’s what bone looks like which is filled with osseous structures and with fat the edges of the bone on the side you’ll
see these little black and white areas these are where the veins of the bone
exit called the basi- vertebral veins and they’re normal if we follow back here we can see this spinal processes of the vertebra in the very back an in-between we see both muscle and ligament that hold these vertebral processes
together we can take the side and come to the outside where the nerve holes are and now we can visualize the boney tunnel called the foramen where the nerve
exits in this case this is the L two nerve sitting in its white fat which is
nature’s packing in the L two three foramen here is the three four foramen and this is the L three nerve right here in it’s fat packing here is the four five foramen with the L four sitting in it’s fat
packing and the l five s one foramen with the l five nerve there we can conversely go to the opposite
side and see the exact same thing with the nerve roots exiting out the
foramen if we then go to the top down view here we can look at the angulation and cut of the spine and visualize the spine is what it
would look like if you took a samurai sword and looked up at the spine from there we’re going to start at the L five S
one disc at this view this is the dural sac the sac of nerves all these black dots within this white
sea of water are the nerve roots and these are the nerves that hae already exited out of this sac these nerves exit like branches on a tree so this is the five one level and as we march up we can get to the four five level before five level here you can see the
normal disc which has the jelly on the inside the
outer plies of the tire on the outside the back of the disc being either flat or
little concave all of the nerve roots sitting in the area here of the dural sac and then these are the two facets and back some people say that facets looks somewhat like hamburgers with the
buns where you have the meat a little
mustard on the inside and the two buns on the outside these
are normal facets we can march up then and go to the next level and three four and again see the same
thing the jelly filled donut the outer plies of the tire the sack of nerves we get a little higher we can see the
actual forcet joints and this is a normal level we can continue to go up and see more
here is the basi vertebral veins and some of the veins within the
vertebral body itself so when you look at these images these are normal

89 comments on “How to Read a MRI of the Normal Lumbar Spine | Lower-Back | Vail Spine Specialist

  1. lonewizzard Post author

    It will also demonstrate a coronal (front to back) view if scanned in that particular plane. MRI rocks!!!!

  2. Mahfuz Munir Khan PT Post author

    wouldnt mind a BJ after some massage therapy, nice username u have there love. cowgirl is my fave position for not aggrevating my back! missionary is ok on morphine x

  3. Sherry B Post author

    I would love if you could review my mri's that I had done yesterday of my L spine and T spine, your video was so clear and helpful you explained it very well

  4. Maritza Zamora Post author

    Hi doctor,
    could you please tell me what are the symptoms of lumbar spine L5- S1 also I would like to know what is a retrolistesis of L5 on S1 and how can this affect my future live!

  5. Linnea Hooker Post author

    Sorry, I can't help that being my last name. I assumed it would show my email as my username. Thanks for pointing it out, I'll definitely figure out how to change it.

  6. marya Post author

    sweet doc i have low back pain for 9 months i am 30 year old
    our surgen give me the mecobalmin,and more medicen but my problem not solve
    plzz suggest me .tel what i do my low back pain .
    my doc siad me my mri is clear .but the pain is not removed .

  7. maheshwaram nagendhar Post author

    Gud Evening Doc.My self Padma Age 27 Years F as that MRI Report Investigation performed LUMBOSACRAL SpINEMulti Planer Images of LBSpine were obtained T1,T2,Medic and Stir Sequences Screening sagittal T2 TIM sequence of whole spine was obtained .Sacralisation of L5 verterbra is noted.Mild multilevel osteophytosis is seen in lumbar spine .Multilevel gradeIIdisc degeneration is seen with grade III at L4-L5 level.minimal multilevel modic type II end plate changes are seen.
    Contine in 2nd Mail

  8. maheshwaram nagendhar Post author

    mild diffuse discbulge is seen at L3-L4level.there is evidenceof posterocentral disc herniation eccentric2wards Rt side at L4-L5 levell with mild inferior migration causing moderate thecalsacindentation and significant compression on Rt L5 and mild compression onLt L5 traversing nerve roots .Mild hypertrophy of liagamantum flavum is noted at L4-L5 level Normal vertebral height and alingment are maintened Visualized cord and conus appear normal inMR signal intensity and morphology
    Continued in M

  9. Donald Corenman, MD, DC Post author

    Dr. Corenman personally replies to all questions posted anonymously in his forum at askspinedoc (dot) com. Please post your question there for his quickest response.

  10. Hunter W Post author

    This was a wonderful tutorial. It explained the spine images very well. I have had occasion to see Body Works twice, and so this added to what I'd seen. The sagittal remarks were perfect. Thank you for posting!

  11. harsh mondal Post author

    You're right. even i was very sad since i workout well for abs but nothing was coming. And I heard that most of the celebrities used to follow to kill their belly using this 7 food items. have a look here

  12. Nazanin Keshavarz Post author

    Thank you for your step by step explanation. I really enjoyed that. Please keep posting information about neck pain and shoulder pain related to Lumbar problems. Wish you all the best.

  13. Ellen B Post author

    Thanks, Dr. Corenman.  Helpful as, once again, I look at my own images.

    But you don't "literally" cut the spine with a Samurai sword. 😉


  14. kurt mccarthy Post author

    Dr Corenman, this is great! Thank you very much, I have had major back pain for 2 years constantly EVERYDAY! I am in the middle of being medically retired from the Army. Nobody can tell me what is causing my pain, an abnormalitiy was found. A neoplasm to be either ependymoma or schwannoma. However, the doctors here keep telling me at 4mm located in the caudal nerves it is too small to cause issues. My is most likely arthritis. Maybe this can help me understand my MRI a little better, I am sick of feeling disabled every day of my life.

  15. Sofiene Chaouch Post author

    Good morning and thank you for this tutorial!
    But i want to rectify that in L3 L4 foramen passes the L3 nerve, L4 L5 formen passes the L4 nerve (unlike the cervical spine) because of the descanding trajectory of nerves…
    Have nice day

  16. jludtxs Post author

    thanks for making the video. I am just starting to learn so I will be studying hard. In the R- picture, are the 2 black areas at the bottom the gluteal muscles? They kind of look like steak.

  17. joe campbell Post author

    thanks for the information Doctor, & time. I wonder are these scans always a 100% in giving information as regards to prolapsed discs etc, ? thanks Joe U.K. ☺🇬🇧🇺🇸

  18. Insight Curiosity. Post author

    i would like to know that when surgeon says that he has to carry out surgery on the back due to the pain( lower back pain) what type of surgery the surgeon carry?

  19. Charles Tan Post author

    Can you do a video showing a human twisted neck and how it could of got to that stage? I've looked around on the internet and there is no video or image at all of a twisted human neck and how it got that stage.

  20. Tom G Post author

    If you had a samurai sword you would be cutting, and looking at the same time. Cool video. MRI creates pictures in 3d, in something called voxels, essentially 3d pixels.

  21. VJ Post author

    I run a support group for people with spine conditions click on link if you want to learn more

  22. Jody Hakala Post author

    Good video to see what the MRI scans can show.
    Also I like the explanation of the body and what your looking for and how.
    I don't think you using that word correct. Litterly is actually doing it. Your not really cutting the spine with a samurai sword. Ha ha

  23. عمار الكريم Post author

    انا من العراق مصاب بمرض التهاب الفقار الاصق ارجو المساعده ممكن اتواصل مع الدكتور وهذا رقمي الواتساب ٠٠٩٦٧٨١٦١٩٥٢٠٣

  24. heyabbottdog Post author

    I'm so glad he isn't my radiologist as he "literally takes a samurai sword to our spines"!… pretty sure I'd rather have an MRI.

  25. Michael Dimitriadis Post author

    I had L5 S1 decompression on 19 June 2017 by Dr Ralph Mobbs in Sydney Australia . The day before I could not walk ,one hour after surgery they couldn't get me to sit down … God bless you guys !!

  26. Tom Bee Post author

    I just had my MRI done for my lower back pain. After watching this video, Now I feel like can teach my Orthopedic Surgeon ! 🙂

  27. Barbara Pocius Post author

    Ya but its accuracy is not true on a horizontal. Also a horizontal mri done with a pillow under cervical and pillow under knees modifies the image. Therefore the disc reading is modified and mis-guides the surgeon. A vertical view must be done for accuracy

  28. Moheen Mahmood Post author

    Have you got a email address I can send you my MRI and X-ray images to tell me what exactly is wrong???

  29. dharam raj Choudhary Post author

    My MRI report findings
    Straightening of lumber lordosis seen
    Mild diffuse bulging at L3-4 & L4-5 level mildly narrowing the external foramina. Facet joint arthropathy and ligamentum flavum hypertrophy noted.
    I started my gym just two month earlier. From last one and half month I stoped my gym training.
    What should I do.
    Currently I feeling better, my leg pain is gone but I still have pain in my back.
    Which type of exercises I do. Please…. please help me. Thank you for useful videos
    Currently I need atleast 10 hours sitting due to my professional exams. So please help me.

  30. Escaping from New York Post author

    if you "literally" took a samurai sword to patients, nobody would be living after an MR study

  31. abd lkabir Post author

    Please can you help me ? I play basketball. I have a spine problem. Medical report of my injuries: The protrusion of the L5-S1 disk
    Spon dylolisthesis Phase 1 of Meyerdinge from L5 with respect to S1 of histochemical bonds spondylolated from L5
    Abnormality of the abnormal signal of the treminal cone.
    The scale of the channel is normal. I am 23 years old and still want to play basketball to achieve my basketball goal. Please help me.

  32. Janet Barry Post author

    Thank you Dr. Corenman. I have learned a great deal from your fine explanation. Yesterday I had an RFA to L3, L4, L5 nerves. So far my pain has been diminished to a simple ache which I was told would probably be expected. I must say I was able to move around in bed without waking every 20 minutes, which resulted in the bed sleep I've had in months. Would ever consider completing a video explanation of some of effects of nerve and facet problems. I have been search for a good diagram of the lumbar spine that shows the nerves and labels. I have one provided by a PT person but I am having a tough time really exploring it. I am going to trying viewing my MRI again to try to find where exactly the dr. applied the radiofrequency. Thanks again and please keep those fine concise and easily understood videos and explanations.

  33. aditya aayurved Post author

    48 PM] Aditya Aayurved: हैलो दोस्‍तो aditya aayurved chenal को लाईक करो सब्‍सक्राईब करोे ओर बैल आईकन पर क्‍लिक करना ना भूले कमेन्‍ट कर 👏👏👏👏👏👏👏 दोस्‍तो आप सभी भाईयो से हाथ जोड. कर विनती है कि अगर किसी को L1L2L3L4L5S1S2 कमर दर्द nas block back pain है सर्वाईकल घूटनो का दर्द सैक्‍स से सम्‍बनधित समस्‍या है तो हमै बताये ꫰आप का गारन्‍टि सै ईलाज किया जायेगा꫰ अगर फायदा नही तो पैसै डबल वापिस गारान्‍टि से 🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏जिन को डा, ने ओपरेशन का बोला है वो एक बार जरूर सम्‍पर्क करे धन्‍यवाद꫰6376773854. 9660383671

  34. Shamiran Younan Post author

    hi, I worked hard at work with a lot of lifting and twisting and bending
    now I have bulging discs all over my discs, do you thing my bulging is caused of my work or what


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