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Old 03-11-2012, 04:28 PM   #1
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Help, please? MRI interpretation on my neck & back

I just had an MRI done on my neck and my lower back. My doctor is referring me to a neurosurgeon and pain management for further followup. He has not read me the results but I was able to get a copy of the report from the MRI office. The appt. with the neurosurgeon is still another week away, but I am really confused about it all - could someone help me understand what my report says? Thank you so much in advance.

Here is what my C-spine MRI says:

There is mild reversal of the normal cervical lordosis, with minimal retrolisthesis of C6 on C7. Cervical vertebral body stature, height and alignment are otherwise unremarkable. Minimal T2 heterogeneity within the cervical spinal cord is most likely artifactual. A CSF signal fluid collection in the posterior fossa most likely represents an arachnoid cyst. There is no cerebellar tonsillar ectopia. Incidentally noted are inflammatory changes in the sphenoid sinus.
DISC LEVLS:
C1-2: Unremarkable
C2-3: A disc bulge contributes to minimal narrowing of the central canal
C3-4: A disc bulge and posterior osseous ridging combine with uncovertebral spurring to cause minimal left neural foraminal stenosis
C4-5: A disc bulge and posterior osseous ridging eccentric to the right contribute to mild central canal stenosis and mild bilateral neural foraminal stenosis
C5-6: A disc bulge and posterior osseous ridging contribute to mild central canal stenosis and combine with uncovertebral spurring to cause mild bilateral neural foraminal stenosis, left worse than right
C6-7: A disc bulge and posterior osseous ridging eccentric to the right contribute to mild central canal stenosis, moderate right and mild left neural foraminal stenosis
C7-T1: No focal disease
IMPRESSION:
1. Disc bulge and posterior osseous ridging eccentric to the right at C6-7 contribute to moderate right neural foraminal stenosis
2. Discogenic and spondylitic changes elsewhere the cervical spine contribute to mild degrees of central canal and neural foraminal narrowing as outlined in detal above.

Next post I will detail my back (L spine) MRI. I am 42 with about a 9 year history of back pain and about a year long ordeal with my neck. From the above neck MRI, is there anything I should be concerned about?

 
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Old 03-12-2012, 09:28 AM   #2
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Re: Help, please? MRI interpretation on my neck & back

anyone? Thank you if you can tell what my MRI states on both neck & back.

 
Old 03-12-2012, 11:27 AM   #3
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Re: Help, please? MRI interpretation on my neck & back

Welcome to the board.

I found your radiology reports a bit odd in their reporting. Usually there is a very standardized form and language that is used. Yours, particularly the lumbar, is lacking in any detail. It is hard to believe that every segment is exactly the same, which is what the report indicates!

I suggest you post the cervical report on the "Spinal Cord Disorders" board that you will find by scrolling further down the page on the "Health Issues" page. Most of the cervical spineys hang out on that particular board.

As to your lumbar MRI, the report indicates that at each level of the lumbar spine the disc is bulging (report does not indicate if it is mild, moderate or severe) and that there is arthritis in the facet joints, also at each level. Again it doesn't indicate if any one particular segment is worse than another....

The facet joints are synovial joints that connect the vertebrae and allow the spine to bend and twist. They also act as a "brake" and keep the spine from bending too far (to the point where we would fall over!)

Due either to trauma to the spine like a car accident or fall, or from normal wear and tear from daily living, the facets can become enlarged due to the growth of bone spurs, rough edges, etc.

Both the facet arthropathy and the disc bulges at each level are contributing to a very small amount of stenosis in the foraminal openings.

The foramen are the openings through which the spinal nerves exit and go out to the body. When anything is taking up space that is needed by these nerves, it can result in some pain. This is due to the nerve getting "pinched" or just irritated. This stenosis is worse at the L5-S1 level where the report moves it from minimal to mild. Minimal means it is noted but highly unlikely it is causing much of a problem. Mild is the next category up from minimal....again, not a big amount, but any time a nerve is irritated, it can be a source of pain.

[B]There is a straightening of the normal lumbar lordosis, with minimal retrolisthesis of L2, L3, L3 on L4 and L4 on L5. There are Schmorl's nodes of the L1, L2 and L3 vertebral body endplates, consistent with degenerative disc disease. There are type II, fatty endplate degenerative changes at L5-S1.
[/B]

This reports that the normal curve of the lumbar spine is somewhat straightened out and there is a very small amount of retrolisthesis at the segments from L2 to L5. When you look at a MRI or x-ray from the side, the edges of the vertebra usually line up. With a retrolisthesis, the vertebra will be slightly back of the adjoining vertebrae. In your case three vertebral segments seem to be very slightly backward from the adjoining vertebrae.

Schmorl's nodes are protrusions of the soft tissue from the disc that press into the edge of the bony vertebra. Again, it is something like makes your vertebrae look a little different from a textbook "normal" vertebrae, but it isn't anything that usually causes pain or problems. It is a part of the normal wear and tear of the spine, and is a good marker for a doctor that the patient has some degenerative change going on in the spine.

Most everyone past a certain age will have Schmorl's nodes showing on MRI. Unfortunately in the human spine "degenerative" processes begin in our 20s...so one doesn't have to be elderly to show degenerative changes.

All in all, your report does not throw up any red flags that would indicate you are in much pain. Yours is the kind of report where patients are told "Your MRI is normal," and yet, they may still have back pain.

Hope this helps tide you over until you can get an official interpretation from your doctor. I am not a doctor, but am giving you my understanding of the language.

Always keep in mind that any imaging is just one piece of the diagnostic puzzle. The doctor will also perform a physical and basic neurologic exam and listen to your description of symptoms before deciding what he thinks is causing your pain and "issues." Sometimes something that appears insignificant on MRI is actually causing a great deal of pain. Other times someone will have a terrible disc bulge that is completely asymptomatic...so these reports are of limited usefulness.

 
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