Help Deciphering MRI - Spinal Cord Disorders Message Board

dvdmon · 06-14-2007, 07:31 AM

Hello,

Forgive me for posting about this again, but I feared since there was no response on my earlier post, that perhaps the title was too general and did not draw the reader who might be willing or able to answer my query. Here is my message:

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Hello, I just got a Cervical Spinge MRI last week and got the results today, but apparently cannot be seen by anyone about them until late July! So I was hoping that if I could post the results here, someone might be able to decipher them for me. I just have no experience with spine stuff.

A quick history of the problem: about 4 years ago I started experiencing some bad pain on the left side where my neck hits my shoulder. I also was experiencing some tingling in my fingers. I went to an orthapedist who did an Xray and said it was a pinched nerve, gave me Vioxx (which I luckily stopped taking after about a week and no improvement), and sent me to physical therapy, which I did for a few months. It seemed to improve slightly but then it kind of went away for a while after I had a stressful situation resolve itself. I didn't experience it to such a continuous degree after that, but did have issues from time to time with the same pain, but also pain/tightness in my chest and arm. EKG's checked out fine each time and at the latest time, I mentioned my diagnosis of a pinched nerve. The doctor asked if I had an MRI, I said no, an X-ray, and she said that X-rays would not see nerve issues, just bone, so she sent me for an MRI.

Here are the results:

TECHNIQUE: The cervical spine was imaged with a 3mm th/ 0.5-1mm gap sagittal T1SE and T2FSE and 4mm th/1mm gap t-axial FSPGR/20 (and optional T2FSE) sequences.

FINDINGS: The craniocervical junction and cervical cord are of normal contour and signal intensity. There is disc space narrowing C4-C5, C5-C6, C6-C7.

Axial sections are as follows:

C2-C3 is normal.

C3-C4: Diffuse annular bulge narrows the subarachnoid space without significant cord compression.

C4-C5: There is a posterior disc osteophyte complex lateralizing to the right markedly narrowing the subarachnoid space contiguous with the cord.

C5-C6: There is a diffuse annual bulge as well as a left lateral disc protrusion extending into the left exit foramen. Ther is significant central stenosis and bilateral foraminal narrowing at this level.

C6-C7: Annular bulge narrows the subarachnoid space, does not compress the cord and is associated with right foraminal narrowing.

CONCLUSION:
1) There is narrowing of the subarachnoid space due to annular bulges, C3-C4, C4-C5, C5-C6, C6-C7. Foraminal narrowing is noted bilaterally, C5-C6, right C6-C7.
2) Small focal disc protrustion is noted far latera C5-C6 extending into the exit foramen.

So I guess I am wondering if this stuff can truly produce the chest pain/tightness I've experienced, and how bad this stuff is. I've managed to avoid surgery my whole life (save for some minor one for swolen glands when an infant), and have no desire to go under the knife unless absolutely necessary. I know this stuff will be discussed in 6 weeks when I finally get to talk to someone, but it sure would be nice to get a hint of what to expect. Any references to places I could learn more about the issues involved for a non-doctor would be greatly appreciated as well.

Many thanks.

neckhurtin · 06-14-2007, 09:42 AM

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feelbad · 06-14-2007, 06:11 PM

just needed to FYI here but the word contiguous actually means "contact" or " close association",this from my take on it actually means you may actually have some level of either compromise or at the very least a bit of compression just caused by the close proximity to it.

from what it states at your c 4-5,it would appear that on the right side,that bone spur "complex"which sounds like more than one osteo makes up this "group"? is actually pushing/closing off the sub space(as in no longer an actual space anymore?) rather close to the cord in some way?i am no doc by any means,just have had to have 16 MRIs done over the past few years with the majority done on the old c spine.when they state 'marked' it is usually a pretty significant amount of whatever it is they are talking about.

i just wanted to let you know that you very possibly could have some level of affectation of your cord or at least that space is very small/limited right now.

you are unfoprtunetly going to really have to wait to consult with your actual doc on this.just what type of doc sent you for this MRI? if it is a neurosurgeon you should be able to obtain her read on the films too.sometimes the radiologist who actually does the initial read(which becomes the radiology report you have there)depending on their specific level of knowledge and experience can sometimes be way off base with some findings.thats just the nature of film interpretation.it is only as good as the rad who reads the initial films and nothing more.this is why all surgeons want to see the actual hard films for themselves.the really good NSs will not in most cases,even bother to look at what the radiologist sees.they prefer their own reads.sorry you have to wait so long.please keep us posted as to what you find oput,K?i wish you lots of luck with all this.Marcia

dvdmon · 06-16-2007, 11:31 AM

Guys,

Thanks for your messages. I'm with a Kaiser HMO plan so the doctor who referred me to get the MRI was actually a nurse practitioner. Once she got the results back, she referred me to their cervical surgery center to talk to a surgeon I guess. I tried to get her to give me more info about how to interpret the MRI but she said it was beyond her expertise. So my question is, is there anyone I could see in the mean time that might provide more information before going to an actual surgeon. I don't WANT surgery (well, who does?

), so going all the way to a surgeon seems like I might be skipping a step. Is there someone else like an orthopedist or something that might be able to look at an MRI and tell me whether I need to see a surgeon in the first place?

I've been doing a little more research and see their are a few different types of surgeries, and also some non-surgical therapies that might help. My thought is to take the most conservative approach until either I can't live with the pain anymore (I'm far away from that, I hope) or there is real danger of seriously screwing up my spinal cord by not having some more agressive treatment (ie surgery). My wife has a distant relative who is a back surgeon who we might be able to fax the MRI to before the 6 weeks is up.

In the mean time I'm just wondering if I can do anything to avoid further problems. I just wonder if lifting my 21-month-old daughter each time is doing some kind of minuscule damage, or doing my long car rides, sitting for hours at my desk job, etc., etc. Or whether I should be applying cold packs whenever I can to decrease inflammation (I'm trying to stay away from drugs - even over-the-counter - unless absolutely necessary), etc.

In any case, I hope to peruse this board a lot more and pick up some of the information and knowledge that you guys have, although a lot of the messages I've read seem to be about only surgical options, which, as I've mentioned, are my last choice...

Thanks again.