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Old 05-02-2011, 10:15 AM   #1
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Cervical pain

MRI shows moderate disc protusion at C5-C6 producing spinal stenois of 8mm moderate disc protusion at C6-C7 producing spinal stenosis of 8mm posterior hypertrophic changes at the C7 level producing spinal stenosis of 8mm. There is mild posterior cord compression at this level with no acute osseous findings.

 
Old 05-02-2011, 03:34 PM   #2
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Re: Cervical pain

Your MRI shows the spinal canal problems but does it say anything about "foraminal" stenosis or narrowing? That causes more pain than the spinal canal stenosis.

If you want to post more of it, level by level, I can help to interpret what it says in plain language.

What has been suggested as treatment?

Jenny(fused C3 to T1)

 
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Old 05-03-2011, 10:23 AM   #3
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Re: Cervical pain

Thanks for replying. This is exactly what the report says: MRI was taken without contrast.

Hypertrophic lipping is visualized from the intervertebral margins, more prominent in the lower cervical segments. No focal osseous signal abnormaility is defined to suggest acute traumatic change of bony destructive lesion.
A focus of relatively prominent posterior hypertrophic change is visualized posterior to the C7 vertebra. This hypertrophic change reduces the AP diameter of the thermal sac to 8mm at this level representing a mild stenosis at this level. There is mild posterior compression of the spinal cord at this level.
A moderate disc protusion is present at C6-C7 which combines with posterior hypertrophic changes to produce a spinal stenosis of 8mm at the C6-C7 levle. The neural foramina are satisfactorily preserved.
A moderate disc protusion is present at C5-C6 levle reducing the AP diameter of the thermal sac to 8mm at this level. The neural foramina remain patent.
There is minor posterior compression of the spinal cord at the C7 level. Otherwise, the spinal cord remains normal caliber and contour. Spinal cord intensity is normal with no evidence of edema, mass or myelomalacia.

Impression:
Moderate disc protusion at C5-C6 producing spinal stenosis of 8mm Moderate disc protusion at C6-C7 producing spinal stenosis of 8mm Posterior hypertrophic changes at the C7 level producing spinal stenosis of 8mm. There is mild posterior cord compression at this level. No acute osseous findings.

 
Old 05-03-2011, 10:26 AM   #4
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Re: Cervical pain

I forgot to mention that I will see the doctor on Monday, May 7th. I have pain in my back and neck. This pain radiates down my arms. I have had three lower spinal surgies to include a fusion. About one year ago I was told that the screw of the top of my hardware was loose. I am not sure if this is trying to travel upwards or not. Thanks for anything you can tell me.

 
Old 05-03-2011, 05:53 PM   #5
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Re: Cervical pain

Thanks....now I get a better idea of what is going on.

Most of the pain in neck problems comes form the spinal nerves getting pressed on by bone spurs or a herniated disc. But yours seem to be fairly good and no problems are reported so your pain is from the stenosis.

Stenosis is the closing up of the spinal canal around the spinal cord. Some people get pain and some don't(I didn't). The normal spinal canal is about 10-11mms and you are down to 8mms. through the lower part of the cervical spine. Some of it is from herniated discs that herniated backwards toward your spinal cord but at C7, you have bone thickening from the back of the canal.....true spinal stenosis. For some reason, the bone starts to get thicker and no one knows why. Can do the same in the lumbar area too.

There is a brand new surgery for stenosis called a laminoplasty but only a few docs do it(only neurosurgeons, not ortho spine docs). If you go to the board called Spinal Cord Disorders, I am doing a thread on it right now for another person. There are 2 people there right now with the same problem you have. Check it out if you want.

Removing the discs from the front in a traditional ACDF surgery will not fix the stenosis and an even more traditional laminectomy removes the back of the spine and leaves it open to damage but the very new laminoplasty, removes the bone over the back of the cord, reshapes it and then re-attaches it, doubling the size of the spinal canal. I had it done 4 years ago.

Let me know what the doc thinks you need as you may not need surgery just yet. Epidural injections can reduce the pain quite well for many people at your stage.

Let me know what the doc says, okay?

hugs............Jenny

 
Old 05-04-2011, 07:01 AM   #6
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Re: Cervical pain

Thanks for your help.

 
Old 05-04-2011, 08:05 AM   #7
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Re: Cervical pain

Jenny,

You have been through so much already to only be 60 y/o. God Bless You! I also had a MRI of my lower spine which stated that there are postoperative changes present at L4 and L5 with a bilateral rod and pedicle appliance in the lower lumbar spine. The pedicle screws are found in L4 and L5. Posterior postoperative changes are visualized at these levels. A cone shaped metallic appliance is present in the L4-L5 disc space.

A focus of decreased ignal intensity is visualized in the posterior margin of the L5-S1 disc showing contrast enhancement. This appears to represent postoperative alteration at this level. There is no visualized neural compromise.

Hypertrophic changes produce relative narrowing of the central bony canal at the level of the superior endplate of L4 and the L3-L4 disc and the L3-L4 disc but an AP diameter of 11mm persists at this level. This is not considered a significant spinal stenosis. The remaining discs maintain normal contour.

Impression: Mild residual disc protusion at L5-S1 without visualized no compromise. Postoperative changes at L4-L5. No significant foraminal or spinal stenosis is defined.

The last X-Ray done which led to MRI of lumbar and cervical states:

Impression: Apparent disc degenerative change L4-5 with treatment with screws and rods. The right rod is conected to the lower portion of the apparatus but not to the upper. Appearance suggests motin around the upper half of the device on the right.

 
Old 05-04-2011, 04:20 PM   #8
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Re: Cervical pain

So in your lower back, you've had a fusion at L4-5 and it looks stable except one end of the rod appears to not be connected properly. I also have rods in my neck and all that means is the rod didn't fit into the head of the screw, probably because of the way the surgeon had to put it in. It isn't a big problem and probably gives you more movement than if he had gotten it in place.

At L5-S1, it looks as of they didn't remove the entire disc(not abnormal) and the edge that is left shows up as being on the edge of the spinal canal but it is not causing any problems like touching the canal or the thecal sac around the spinal cord.

From L3 to S1 they can see arthritic(hypertrophic) changes in the bones(probably bone spurs) along the ends of the vertebrae and even inside the spinal canal but they aren't touching anything and the spinal canal itself is still well open with a diameter of 11mms.

The openings for the spinal nerves are all open.

So it's not bad but you have arthritis and that won't go away. Removing bone spurs can make new bone spurs grow back even bigger.

Sorry you are in so much pain.

hugs...........Jenny

 
Old 05-11-2011, 07:26 AM   #9
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Re: Cervical pain

Hey Jenny,

Good morning. I wanted you to know that I went to the doctor. The doctor took some additional X-Rays. He stated that the hardware needed to be removed as it has shifted into the joint area. It is completely loose. He said they will not put in anymore hardware. They will pack it with bone graft to stabilize that area. He stated that the surgery is only about 30-45 minutes. He also said the recovery time is only abut a week. I am not sure of this, but the doctor is a qualified physician. My friend checked him out and his reviews are 4.5 out of 5. He has had no malpractice suits against him.

The cervical discs are C2-C7, but he wants to do epidural injections to see if this helps. If it does not then we will discuss options at that time.

Let me know if you know anything about this type of surgery.

 
Old 05-11-2011, 05:48 PM   #10
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Re: Cervical pain

Sorry....no hardware removal for me...yet. I do know that they used to routinely remove hardware put in for fusions to strengthen the bone. Hardware actually makes the bone soften. But now, they have newer hardware that helps that.

This may help you.

Let me know how it goes, okay? And watch that neck. My epidurals made me worse and that is a sign that you need surgery so let me know how that goes too.

hugs...........Jenny

 
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