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Old 11-22-2012, 10:01 AM   #4
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Re: Degenerative Disc Disease with Cervical Radiculapathy

OK, back again....

If I didn't stress it enough before, this is the operative sentence in your report:

>>> Note is made of congenital narrowing of the cervical spine. <<<

Let me explain one level, and you can extrapolate to the others, OK?

<< C6-C7 Diffuse intervertebral disc bulge with right lateral disc protrusion. >>

The disk between the C6 and C7 vertebrae is bulging backward, more so on the right side. He doesn't say HOW BIG the bulge is, though, which is a CRITICAL piece of information.

<< Complete effacement of the ventral subarachnoid space >>

"Ventral" means "front" in this context. The "subarachnoid space" is the part of the spinal canal between the outer membrane (theca) and the spinal cord. This is filled with spinal fluid and should surround the cord. In your case, the bulging disk has "effaced" (pushed away) that space, so that the MRI shows no space for spinal fluid between the outer membrane and the cord. Not in front, that is.

<< and contact of the central cord >>

Kind of goes without saying that if the space in front of the cord is gone, then the cord has been "contacted".

<< The central canal is narrowed to 6 mm >>

That's pretty darn narrow. OK, I was down to 5mm (and I'm a big male type, in spite of the profile that HB has fit me with), but still, 6mm is cause for concern. I've read that cord compression that occurs over many years may have fewer symptoms than if it occurs quickly, so your 6mm may not be as bad as someone else's 7-8, but I don't think you'd be entirely non-symptomatic, and these symptoms could be a wide range of sensory, motor and functional effects anywhere downstream of the C6-7 level.

<< Severe right and mild left neural foraminal narrowing. >>

To be expected, given the above. This disk bulge is lopsided on the right and is pushing into the right foramen, which is the opening in the spinal cage through which passes the C6 nerve after it leaves the cord and eventually ends up in your thumb. Since the "root" of the nerve is being pinched, it's called "radiculopathy" ("problem with the root").

OK, so where does the congenital stenosis fit in? Because the radiologist does not say HOW BIG THE DISK BULGES ARE, we are left with the possibility - if not probability - that these bulges would not be large enough to be a problem in someone with a normal-sized canal. Because your canal is too small, relatively small bulges can have relatively large impacts.

This is important when determining treatment, or surgery. Surgically, the two main approaches to bulging disks are to either remove the disks, or INCREASE THE SIZE OF THE CANAL, through a decompression surgery such as a laminoplasty. The laminoplasty has the advantage of addressing multiple levels in one surgery without loss of rotational range-of-motion, but the disadvantage that the bulging disks are still bulging.

Last edited by WebDozer; 11-22-2012 at 10:14 AM.

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