Understanding Lumbar Spine MRI Report: Key Insights and What to Expect
Have you received an MRI report for your lower back and found yourself overwhelmed by terms like bulging disc, herniation, or Modic changes? You’re not alone. MRI reports are often written for doctors—not patients—leaving many people confused and anxious.
MRI of the lumbar spine is commonly used to evaluate chronic or sudden back pain, leg numbness, or suspected nerve impingement. This guide will help you understand the key terms in your report so you can make more informed decisions about your health.
About the Author
I’m Dr. Vahid Alizadeh. In this article from the “What Does My Report Say?” series, I’ll help you understand the common terms in your lumbar spine MRI report and what they actually mean for your health.
Real-Life Scenario: A Patient’s Journey
Sara, a 45-year-old office worker, had been suffering from lower back pain and tingling in her left leg for months. Her doctor ordered an MRI scan, which revealed findings like disc extrusion, foraminal narrowing, and Modic Type 2 changes. Unsure what this meant—or whether she needed surgery—she contacted us for a clear explanation.
What Do These Medical Terms Mean?
Intervertebral Disc
A cushion-like structure between vertebrae, made of a rigid outer ring (annulus fibrosus) and a soft gel-like center (nucleus pulposus).
Why It Matters: Discs absorb pressure and allow the spine to bend and move.
Disc Bulging
The disc extends outward beyond its normal space, but the outer ring remains intact.
Why It Matters: Common with aging, it may cause no symptoms unless it compresses nerves.
Treatment Needed? Usually not, unless symptoms are significant.
Disc Herniation
The inner gel leaks through a tear in the outer ring. Two main types:
Disc Protrusion
- The disc material bulges but remains partially contained.
- It may cause mild to moderate nerve symptoms.
Disc Extrusion
- The disc material entirely escapes the outer ring.
- Higher risk of severe symptoms; sometimes requires surgery.
Contained vs Uncontained Herniation
- Contained: The herniated material is still partially enclosed.
- Uncontained: The material has entered the spinal canal (often pressing the thecal sac or nerve roots).
Why It Matters: Uncontained extrusions are often more painful and less likely to improve without treatment.
Location of Herniation
- Central: Midline in the spinal canal.
- Paracentral: Just off center—most common.
- Foraminal: In the exit hole for spinal nerves.
- Lateral Recess: At the sides of the spinal canal near nerve roots.
Why It Matters: The location determines which nerve may be compressed.
Annular Fissure
A small tear in the disc’s outer ring without extrusion.
Symptoms: May cause localized pain or inflammation.
Treatment Needed? Often conservative, such as physical therapy.
Modic Changes
Degenerative changes in the vertebral endplates (bones adjacent to discs). Three stages:
- Type 1: Inflammatory (active pain).
- Type 2: Fatty replacement.
- Type 3: Bone hardening (sclerosis).
Why It Matters: Reflects chronic disc degeneration.
Facet Joints and Facet Arthropathy
Small joints in the back of the spine that control motion. Degeneration leads to arthritis (facet arthropathy).
Symptoms: Localized low back pain, especially with movement.
What Does This Report Say About My Condition?
MRI reports usually list findings as mild, moderate, or severe. Many people have abnormalities with no symptoms at all. Here’s how to interpret severity:
- Mild changes: Often age-related and not concerning.
- Moderate changes: These may cause symptoms but can often be treated conservatively.
- Severe changes may cause nerve compression and require further evaluation.
Important: The MRI must always be interpreted along with your symptoms. Not every disc problem means surgery.
Why You Should Get an Expert to Review Your Report
Interpreting your own report is risky. Here’s why:
- Some findings may sound serious but are not.
- Others may be subtle yet important.
- Without expert input, you may misunderstand the urgency—or overlook necessary care.
At AI-PACS, our team provides expert second opinions to help you understand your report clearly and guide your next steps.
Next Steps: Let’s Help You Understand Your Report
If you’ve received an MRI or CT scan report and aren’t sure what the findings mean, upload your report to our team of medical imaging experts.
📁 Submit your file here on AI-PACS online radiology report services