Originally Posted by D81165
I have been having neck pain and issues with numbness and tingling in my right arm and hand, almost feeling like getting an electric shock. Had an MRI and I wanted someone to help me understand in plain english what they are saying. Is it serious? I am having a cervical epidural block, and then physical therapy. I am a 46 year old female in otherwise pretty good health. Is this something that is just going to keep getting worse? How long will the block typically last?
Hi Dee....I'm Jenny and one of the posters here who tries to help others understand their neck MRI's. Most of us neck people post down on the Spinal Cord Disorders board rather than the Back Problems board as necks are very different from low backs.
But I'll answer your MRI question here. In the world of the spine, the radiologist primarily looks at the area between 2 vertebrae because most problems are with the disk.....the disk being a cushion of squishy cartilage type material that acts to keep the vertebrae apart and to act as shock absorbers for the spine. The other big problem is the tiny joints that come off of the vertebra and help to stabilize the twisting movements we make. These are the facet joints and the uncovertebral joints. And being joints, they can get arthritis. So let's start
1. At C5-6 and C6-7, borderline central canal stenosis, related to disc degeneration with mild loss of disc height and small disc osteophyte complexes, in combination with hypertrophic bilateral uncovertebral osteophytes and bilateral moderate neural foraminal narrowing, moderately prominent at C5-6 level.
So here we have the lower part of the neck. In your spine, you have an area at the back where the actual spinal cord canal is and to the front of that is the main bone of the vertebra with the disks in between. They can see from C5 down to C7 that you have canal stenosis. This means the canal where your spinal cord is, is narrower than it should be. In your case, they say it is related the disk starting to age and shrink up slightly and this has caused arthritic bone spurs to form(osteophytes are bone spurs) and they are starting to fill up your canal. And you have significant arthritis of the uncovertebral joints and those small joints on the sides of the bones have developed bone spurs that are blocking the holes(foramina)where the spinal nerves come through to the body. At each vertebra level, a pair of spinal nerves peels off the spinal cord like peeling a banana and goes out to the body, in this case your arms. To get out of the spinal canal they have to go through a small hole(foramina) and in your case, the holes are blocked by these bone spurs to a "moderate" level. More on "moderate" later.
2. At C4-5, left more than right disc osteophyte ridge and hypertrophic uncovertebral osteophytes, with prominence adjacent to the ventral left nerve root, and moderate left neural foraminal narrowing.
At C4-5, which is higher up, you have more bone spurs that have developed around the disk area but this time, instead of being straight across the canal, they are to the left side more than the right side. These bone spurs along with the bone spurs from those arthritic uncovertebral joints again, are filling up the area in front of the left spinal nerve causing "moderate" blockage of that hole where the nerves come through to the body.
3. Straightening at the cervical lordosis
If you look at your spine from the side, it starts below the skull and then curves toward your front in the neck area, then curves outward in the major part of the back, then inward again at the waist and then a tiny outward curve at the bottom. The inward curves are called "lordosis" and the outward curves are called "kyphosis". Your neck is starting to go straight and loose it's normal lordotic curve. This happens with age and with injury and if allowed to go all the way to "kyphosis" can cause a great deal of pain.
So, you have 3 areas with a disk that is shrinking and aging and has developed bone spurs along it's edge. And you have the uncovertebral joints that are along the sides of the bone that also have bone spurs. And all of these bone spurs are pressing on the spinal nerves that go out to the body and at the lower region, are also filling up the spinal cord canal but not touching or compressing the cord in any way.
The radiologist who has looked at the MRI has ranked the amount of pressure being put on the nerves as "moderate". They use the following words to rank the amount of pressure...minimal, mild, moderate and severe. So you are well along in that process of the bone spurs hurting the nerves. BUT, most surgeons will not operate to alleviate that pressure until you hit "severe".
Until your neck gets worse, the best thing you can do is work with a pain management doc in having the pain treated with the epidural injections. They start with doing a block and if that works, then they can do steroid injections to help give more long term relief. Unfortunately, there are very limited ways to treat this.
Come on down to the Spinal cord Disorders board and meet others with the same problems and learn how they have coped with the pain. And learn about when surgery is indicated and what kinds of surgery are available.
Hope this helps you................Jenny(fused C3 to T1)