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qianlao 写了： 2023年 10月 15日 12:59 好不容易做了MRI，又要等3个月，才有下一个appointment。请感兴趣的大侠看看提提建议。多谢了。
MRI:
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MR LUMBAR SPINE WITHOUT CONTRAST: 10/12/2023 9:44 AM

INDICATION (as provided by referring clinician): Low back and leg pain, 6 weeks or more

TECHNIQUE: 3T MR imaging of the lumbar spine without intravenous contrast

FINDINGS:

Anatomy: Five lumbar-type vertebral bodies are present. The most inferior well-formed disc space will be referred to as L5-S1 for purposes of numbering in this report.

Prior surgical findings/hardware: None.

Vertebral bodies: Normal in height. Retrolisthesis at L2-3 and grade 1 anterolisthesis at L4-5. Mild left convex curvature of the lumbar spine.

Bone marrow: Normal for age. Small hemangiomas in L4 and L5. Mild fibrovascular and fibrofatty end plate changes at L2-3 and L4-5.

Intervertebral discs: Multilevel disc desiccation worse at L1-2, L2-3 and L4-5..

Conus medullaris: Normal. Positioned at: L1. Mild redundancy of the cord of fibrous at the lumbosacral region

Paraspinal muscles: No evidence of denervation or inflammation.

The following axial levels are detailed below:

T12-L1: Unremarkable.

L1-L2: Mild broad-based disc bulge with mild narrowing of the spinal canal. There is also mild bilateral neuroforaminal narrowing.

Exam(s):

MR LUMBAR SPINE WITHOUT CONTRAST

Exam Status:

Final

L2-L3: Small annular tear. Small disc extrusion. Moderate spinal canal and bilateral neural foraminal narrowing.

L3-L4: Mild broad-based disc bulge, no significant spinal canal and mild bilateral neuroforaminal narrowing. Mild facet arthropathy.

L4-L5: Annular tear and moderate extrusion. Severe spinal canal and moderate bilateral neuroforaminal narrowing left more than right. Severe facet arthropathy.

L5-S1: Broad-based disc bulge. Moderate left neuroforaminal narrowing. Mild spinal canal narrowing. Severe left facet arthropathy right.

Visualized sacrum and bony pelvis: Mild degenerative changes of the SI joints.

IMPRESSION:

Multilevel moderate to severe degenerative changes of the lumbar spine, most pronounced at L4-5 where there is severe canal stenosis and moderate neural foraminal narrowing.

cng 写了： 2023年 10月 16日 02:57 醫生是建議physical therapy 還是surgery?

littlek 写了： 2023年 10月 16日 03:54 MRI的结论简单点说就是L4-L5有cord compression, L4-L5是骨盆上的那2段。至于为啥有cord compression,可能是年轻是受过伤（比如干重体力活，比如生小孩），也可能是肿瘤造成的。进一步预约的目的是发现原因和确定治疗方案。

美国现在这个MRI和PET-CT实在太离谱了，我们这里MRI预约都要半年以上，PET-CT 3个月。还有 surgeon, initial consultation 都要等半年，除非是做隆胸的，那是随到随做。。。当然，MRI快的也有，比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之，帝国余辉啊。

qianlao 写了： 2023年 10月 16日 22:54 我经过了理疗，才好不容易争取到MRI。三个月后看能不能得到评估，即手术否。

littlek 写了： 2023年 10月 16日 03:54 MRI的结论简单点说就是L4-L5有cord compression, L4-L5是骨盆上的那2段。至于为啥有cord compression,可能是年轻是受过伤（比如干重体力活，比如生小孩），也可能是肿瘤造成的。进一步预约的目的是发现原因和确定治疗方案。

美国现在这个MRI和PET-CT实在太离谱了，我们这里MRI预约都要半年以上，PET-CT 3个月。还有 surgeon, initial consultation 都要等半年，除非是做隆胸的，那是随到随做。。。当然，MRI快的也有，比如你是in patient,当天就能做。如果你大喊医生我cash,连waiting room都不用坐。总之，帝国余辉啊。

qianlao 写了： 2023年 10月 16日 22:54 我经过了理疗，才好不容易争取到MRI。三个月后看能不能得到评估，即手术否。

qianlao 写了： 2023年 10月 18日 22:18 谢谢大虾们的指教。我的理疗其实就是网上常见的一些动作，没有什么效果。
针灸也做了4次了，据说要几个月。