Lumbar disc collapse
This is the lumbar MRI scan of a 70-year-old lady with a history of low back pain. She has multiple levels of disc collapse, worst at L2-3, with significant Modic changes at that level, i.e. edema of the adjacent vertebral endplates of L2 and L3. You’ll also note the lesser changes and lesser disc collapse of all the lumbar vertebral discs. These degenerative changes are fairly common in older people, and don’t seem to be correlated with the person’s lifetime physical demands.
Also noted are small disc herniations into the vertebral endplates.
Fortunately for this lady, her low back pain is not ever-present. She gets sufficient relief from her pain with non-surgical treatment, specifically spinal decompression treatment, which she does infrequently.
Also noted on the MRI scan is 
of the paraspinal muscles, specifically the multifidus muscles, which is often seen in people with chronic back pain and severe degeneration. As the spine collapses, due to the degenerating spinal discs, the joints become jammed and lose their range of motion. And joints that don’t move cannot use the muscles that attach to them. As a result, the muscle atrophy, i.e. get smaller in size, and in the case of the lumbar muscles, they also become infiltrated with fatty tissue. On the MRI scan this is visible as white-colored, fat where the tissues should be all dark muscle in color.
You’ll also see on the scan, that at certain levels of the spine, the spinal canal becomes narrow, i.e. stenotic. You see, as the discs degenerate, they lose water content, collapse, putting more pressure on the bones, including the joints, the joints and ligaments enlarge, and all of these structures then encroach upon the spinal canal where the nerve roots travel. This can result in pain down the buttocks and legs where the nerves are distributed.
If I can help you with your low back or neck pain, please call me at 404-558-4015.
