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Old 08-11-2009, 07:54 PM   #1
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A lot of words, what does it all mean?

Below is what I just pulled from MRI report. Have no clue as to what it really means. I went to dr with neck ache & weakness in my right arm. Sent for MRI. Below is result:

CLINICAL HISTORY: Radiculopathy.


Noncontrast multiplanar MRI imaging of the cervical spine was performed.
There is degenerative disc space narrowing at C5-C6 and C6-C7 levels as
well as at C3-C4 with associated degenerative anterior osteophyte
formation and straightening of the normal cervical lordosis. Diminished
T2-weighted signal intensity due to disc degeneration is seen diffusely.
Hypertrophic facet changes are present diffusely.


At C2-C3 there is minimal central disc protrusion which is unchanged
from previous cervical MRI scan of 07/03/2006. There is small focus of
increased T2-weighted signal intensity in the posterolateral aspect of
the annulus to the right consistent with annular tear which was not
present on the old scan.


At C3-C4 there is moderate broad-based disc protrusion in the midline
and to both sides of the midline. There may be concomitant small ventral
osteophyte formation contributing to this extradural signal change. This
results in moderate to severe central spinal stenosis with mild
flattening of the AP diameter of the spinal cord which has slightly
increased in extent when compared with the old scan. No abnormal
increased T2-weighted signal intensity within the cervical spinal cord
is identified.


There is mild annular bulging at C4-C5 which is increased from the prior
scan. Minimal disc protrusion had been suggested at this level on the
old scan however this does not reproduce the current study.


At both the C5-C6 and C6-C7 levels there are disc osteophyte complexes
to both sides of the midline somewhat greater to the left resulting in
mild to moderate central spinal stenosis at these levels with slight
flattening of the contour the ventral aspect of the spinal cord,
unchanged in the previous study.


There is degenerative foraminal narrowing bilaterally at the C3-C4,
C5-C6, and C6-C7 levels the greater on the right.


IMPRESSION: There is broad-based disc protrusion with moderate to severe
central spinal stenosis at C3-C4 which is slightly increased in extent
when compared with prior study of 07/03/2006. Disc osteophyte complexes
resulting in mild to moderate central spinal stenosis greater to the
left at C5-C6 and C6-C7 levels. Degenerative foraminal narrowing is
noted above.
______________________________________________________________________________
________

 
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Old 08-12-2009, 07:31 AM   #2
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Re: A lot of words, what does it all mean?

the one big thing here that REALLY needs to be fully identified is just what IS causing that "increased signal intensity" within that c cord area? this could be a few different things but it does need an opinion/eval by at least a good neurosurgeon who can just eval your MRI at that area to at least give you an idea of what could be causing it. its just NOT a 'normal' type of finding to actually have anywhere within that cord area. it just could be a nothing and having to do with the way the area was scanned or it could be a 'something' like a lesion of some kind? most common in that cord would be a vascular type like a hemangima?

a new tear at c 2-3(along with what you already had there too), c 3-4 needs some further eval just based upon several findings there. you just also have an 'extradural" signal change there too. this means there appears to be some level of real compression on at the very least that dural/thecal sac that surrounds the actual cord. in some cases these can create what are called "flow voids if that compression is strong enough? the stenosis at the c 6-7 appears to be big enough and impacting enough to actually flattening that ventral area of the cord, it has to be within that actual spinal canal and not just outside of it at least to some degree.

are there any other symptoms you are experiencing other than what you mentioned above? what was that first MRI needed for, the same thing? you do appear to also have DDD? degenerative disc disease? i have this too along with millions of other people. it seems to be much more common within that c spine for some reason as opposed to the other levels of the spine.

have you ahd any consults yet with a good neurosurgeon to discuss any options here to help with some of what could be the mosr significant or painful findings? i would most definetly get to one soon if you have not yet already done so. they also really need to find out about that signal change within your cord there too. its too bad they did not actually use a contrasting agent with this on since it would have shown certain findings much more clearly. but seeing a good neurosurgeon is what i would do with this type of MRI findings. you just have certain findings that need some level of decompression there too.

i do wish you luck with this and please keep me posted on things, espescially what that signal is within your cord area. Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 08-12-2009, 08:36 PM   #3
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Re: A lot of words, what does it all mean?

Thank you for the insight. My previous MRI was due to pain ... that was in 2006. One thing that is different this time is I am having difficulty with using my right arm. While the prednisone pack has helped, I still have difficulty with some motion, particullary raising my arm.

Dr office called to day to ask if the prednisone has helped, but with the continued symptoms, have referred me to a dr for possible steroid injection. Nurse said the dr would also do his own evaluation.

As far as other symptoms, not sure ... back/neck pain, touble using my right arm. I tend to be clutzy, loose my balance, but dont think that is related. I am having other issues outside the back realm ... struggling for words in communication ... memory loss.

I will call dr tomorrow to ensure my HMO approved my specialst visit.

Again thanks ... I knew that most everyone has degeneration as they age, but did not know what was "normal" vs "abnorma" .. will keep you posted.

 
Old 08-13-2009, 10:12 AM   #4
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Re: A lot of words, what does it all mean?

honestly? you just really never know just what could or could not be a real related symptom til you just find out what really IS being impacted within the spine or other possible areas that do contribute to the area of involment too, and within that cord area as well.

what you are actually describing with that arm actually could be spinal OR actually shoulder/rotator cuff related. since all innervation down that arm simply runs thru that area too(with some actually running and stopping at that shoulder), the specific loss of ROM you mentioned just could also be stemming from your actual shoulder too. this does not diminish your other findings at all, its just another possible area that can create the very same types of possible symptoms that does just need some ruling out or in.

trust me. i have a ton of spinal issues and went thru my own rotator cuff tear nightmares a couple of years ago? i actually thought my c spine problems were what was causing like all the shoulder stuff i was feeling off and on. it wasn't til my top tendon that just runs from the very base of where your neck meets the upper shoulder area and then runs to the very top of that shoulder itself(humerous bone)just snapped in half on me that i found out where THAT crap was actually stemming from all this time.

just where is the doc planning on doing that injection on you, in the c spine area or that shoulder itself? this is just something that you need to ask your NS about, how much overall impact could a shoulder issue be playing with what you are experiencing with that loss of arm ROM? if there are just certain shoulder problems alone it could create very specific types of symptoms that at times can mimic c spine crap. i really had no idea just how much of both of those areas truely play off each other til i had both the rotator and the c spine crap, just seperately not together like you could be?

while you most definitely DO have some strong findings going on up in that c spine area that cannot be discounted, you just really need to find out what IS the major contributor here with the arm problem. medrol would have helped alot if this was either thing really being involved. but the shoulder i do think would have been helped alot more if this is even tendonitis, which is bascially inflammation of the tendons for some particular reason. i would just make CERTAIN that your treating NS really checks out the possible rotator cuff here too. you just really DO need to know if this is part of at least the arm thing. are you having ANY numbness or tingling or pain running down to particular fingers? marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 08-13-2009, 07:37 PM   #5
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Re: A lot of words, what does it all mean?

I have my appointment with the doctor. I was referred to a Physical Therapy & Rehab dr. When I made the appointment, the receptionist said he will do an assesment. He will review the MRI, examine me and make a determination if physical therapy or the Injection would help, or if I should see a neurosurgeon.

As far as arm, actually seems a bit better today, although constant (annoying) pain in upper back/neck. Sometime no issues, just mobilty & strength issue. At times just a numbess down teh arm, not specific to a finger. Thinking back, over the last few months, I have had an occasional bout where it felt like electric current running down my right neck & into my arm.

One other thing, don't think it could be related, a few months ago, went to dr with fatigue. Blood work showed a little low on iron, but my vitamin d level was the "lowest he has ever seen". I was put on prescription vitamin d, which has recovered. Vitamin affects bones, I do wonder if there could have been some impact.

How did you finally get the rotor cuff diagnosed? How was it treated. What type of symptoms did you experience?

 
Old 08-14-2009, 10:04 AM   #6
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Re: A lot of words, what does it all mean?

all it took was my primary running thru ALL of the shoulder ROMS and me having some big pain issues with certain posisitons and loss of my lifting ability when like lifting upwards with my hand upwards? in that posistion? i just could not actually lift anything even remotely heavy. that shows a tendon problen in most cases. since i did have what would be considered an "abnormal" eval of the ROMS /shoulder area,he just sent me for a simple MRI that showed ALOT of wear and tear type damage that just occurs over the years or from playing certain sports,or just "doing' things during the course of any given day type stuff? but i had very clearly totally snapped that top tendon and then partially tore the one that sits directly under it too.

honestly,the best test for possible rotaot problems is just an MRI. but having that phys doc simply run your ROMS within that shoulder would show him,and just his level of real working knowledge,as to whether or not this could even be playing a part.

with most rotator issues,you DO NOT have what you are describing just so you know. that describes more of what is termed radiculopathic symptoms. this would be related much more closely to actual spinal than rotator issues in most cases. unless there is real trauma present along with this that triggered it, which yours is not immediate trauma, the electrical and possible numbenss would be more spinal related.

my real rotator symptoms were some burning pain within like the bicep area at the top of the humerous level with a real soreness in specific areas within the rotator area and just a 'feeling' of something actually 'injured"? don;t know if you get what i mean there or not. but it just felt, within that shoulder that there was an injury there and not at all what i had felt and continue to feel with my c spine stuff. it was just very different. but i did not have the electrical crap i felt when my c spine issues were active at all. no numbness either. but alot of what we actually will have with anything as far asd real symptoms actually depends much more upon just what is actually injured/torn and what other components may also be involeved too.

this area itself just really needs a much more in depth look and the full ROMS tried to be run by someone who actually just KNOWS how they should run and what impairment feels like when they are doing it too. but like i mentioned above, getting that MRI really would show alot of what could be going on within that very complcated shoulder area. i would just make certan that someone takes note of this and really checks it out for you. there just really can be soo much real crossover/mimicing types of symptoms within those areas it may take that MRI just to really see what could at least be a contributor here. this just really HAS to be done before ANY real surgical intervention is considered. i would really have an in depth chat and eval with that physio right now. he would really be able to tell by ROMs. good luck with this and do please continue to keep me posted. if i had not actually had my own c spine hell first, then also the rotator stuff occur too, i seriously would have believed that EVERYTHING i was feeling just WAS all c spine related. now i know much more/differently, ya know? Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 08-14-2009, 05:41 PM   #7
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Re: A lot of words, what does it all mean?

Thank you for the information, you have given a lot of good info and issues to raise with the dr. That rotator issue sounds painful; actuall excutiating; and fortunately, I have not had that. Hope you are doing ok now ... will keep you posted when I go to doctor.

 
Old 08-22-2009, 08:45 AM   #8
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Re: A lot of words, what does it all mean?

Went to rehab dr this morning. I have significant weakness in my right arm. He wants to rule out rotator cuff. Having MRI of shoulder tomorrow. The intersting thing he said is that where my cervical issues are are not necessarily where it would "normally" cause my right arm weakness, but it can happen. He believes it is nerve damage, not just compression, but as mentioned, needs to rule out rotor cuff. If the MRI does not show a tear, then he will send me to a neurosurgeon for evaluation. As far as the pain associated with the degeneration, he said he can do an epidural and therapy. Need to resolve potential nerve damage first.

 
Old 08-23-2009, 10:10 AM   #9
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Re: A lot of words, what does it all mean?

i am sooo glad he took the possible rotator involvment seriously and just did the right thing for you by getting that crucial MRI done on it. it will at least help define just what may be stemming from either the c spine and or the rotator itself, and that IS very important for you right now too. please let me know just what you find out. good luck,Marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 08-24-2009, 07:41 PM   #10
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Re: A lot of words, what does it all mean?

Ok .. got a call from my doctor (he actually called, not a nurse). My rotor cuff is fine ... maybe a little tendonitis, but he said it would not be causing the weakness in my right arm. He said the "best way to handle" it is to be evaluated by a neurosurgeon. He keeps repeating ... not to have surgery, but for an evaluation. He did say that for the pain, when I am ready, call his office & they will do the epidural.

My right arm seems stronger, I am using it more. Most trouble when trying to reach. The newest development ... the last few days, I have been having occassional tingling in my left arm ... although no weakness. The tingling is very occasional.

Now I am waiting for a call back from the neurosurgeon office to make an appt.

 
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