| | MRI Analyses
I have had neck pain for over 20 years. I was in a car accident at age 18, suffered a skull fracture and concussion, received 18 stitches on my left side, 4" above my ear. I have had 2 MRI's on my neck, one in July, 2008 and one in August, 2012. My neck always hurts, always on the right side. I have had radiculopathy off and on, but have kept things more or less under control with PT, NSAIDS, home traction and such.
I had a lot of trouble with my right shoulder starting a year ago, was diagnosed with a partial rotator cuff tear, couldn't get in to see an ortho for 3 months. The PT said my right shoulder was noticeably smaller than my left and my biomechanics were completely out of whack. I started getting a specific headache, a shooting pain in the right eye socket a couple months ago. Two weeks ago I was holding a large, glass mug of hot tea in my right hand. The mug dropped in my lap, giving me a pretty good scalding, but fortunately not a serious burn. I have had the 'clumsy hand' going on for a while. I have a very good primary care doctor now, who ordered the MRI and is sending me off for electrical studies and to a neuro-surgeon. Previous electrical studies have been normal. My primary said I might need 'decompression'.
When I started having the shoulder trouble last year I described it as 'my right arm doesn't feel attached to my body'. Is this more likely from the further cervical degeneration, as opposed to an 8mm rotator cuff tear?
Straightening of the normal cervical lordosis. No evidence of compression deformity or listhesis. Brainstem and cervical cord demonstrate normal morphology and signal. However, there is mild indentation of the cord in the mid cervical spine from degenerative disc disease.
Brainstem-C3: Mild bilateral facet arthrosis. No protrusion or stenosis.
C3-C4: Mild bilateral arthrosis. No protrusion or stenosis.
C4-C5: Moderate posterior diffuse disc bulge-osteophyte complex with more focal protrusions in the right and left paracentral regions. Moderate bilateral uncovertabral hypertrophy. Moderate right foraminal stenosis. Canal diameter lower limits normal at 1 cm, but no definite central canal stenosis.
C5-C6 Moderate posterior disc bulge-osteophyte complex. Moderate bilateral uncovertebral hypertrophy, right greater than left. Moderate right and mild left foraminal stenosis.
C6-C7: Moderate disc space narrowing. Mild disc bulge-osteophyte complex. Mild bilateral uncovertebral hypertrophy. Mild to moderate bilateral foraminal stenoses. No central canal stenosis.
C7-T4: These levels appear normal
Findings: Further progression of reversal of normal cervical lordosis centered at C5. Vertebral body heights are normal. Type II bone marrow changes are present at C5 and C6. Normal relationships are seen of the structures at the craniocervical junction. There is no evidence for Chiari malformation.
C2-C3: no evidence for disc herniation, foraminal encroachment or canal stenosis.
C3-C4: no evidence for disc herniation, foraminal encroachment or canal stenosis.
C4-C5: there is a broad based posterior osteophytic ridge unchanged from prior examination. Moderate left facet arthropathy has progressed. There is moderate left formaminal encroachment, previously mild. There is a right-sided posterior lateral disc herniation that appears to impinge on the right C5 nerve root, this is slightly larger than observed on the prior study.
C5-C6: there is a broad based posterior osteophytic ridge impresses upon the thecal sac but does not compress the spinal cord. The AP dimension of the spinal canal is 8mm, previously 10mm. Bilateral uncovertabral joint which is also increased in size resulting in moderate to bilateral foraminal encroachment. A soft disc herniation is not identified.
C6-C7: there is a broad based posterior osteophyte which has increased in size from the prior study. The AP dimension of the spinal canal is 9mm, previously 11mm. Lateral uncovertabral changes result in severe bilateral foraminal encroachment, or 4 previously there was mild right and moderate left foraminal encroachment. A soft disc herniation is not identified.
C7-T1: there is no evidence for disc herniation, foraminal encroachment or canal stenosis.