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Old 02-08-2008, 07:38 AM   #1
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Can someone help me understand my MRI?

Can someone please help me to understand my MRI results? I`m 35, normally very active. I had a minor fall over 2 months ago and have recieved epidural steroid injections and trigger spot injections. Nothing has helped. One doctor suggest physical therapy, the other told me it would only make things worse.

Findings: There is straightening of lordortic curvature of the cervical spine. There is no prevertebral soft tissue swelling. Brainstem and cerebellum are in tact. Vertebral body heights are well maintained. There is no intrathecal or intraaxial abnormality.

C2-C3- Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

C3-C4- Mild endplate DJD, Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

C4-C5-Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or formaminal stenosis.

C5-C6-Prominent left paracentral HNP with moderate impression on the left ventral cord. The HNP is associated with intervertebral disc space narrowing and advanced uncovertebral endplate degenerative changes extending into left foramen. No evidence of cord edema. Moderate left lateral recess stenosis. Superimposed mild facet DJD.

C6-C7- Small central HNP with minimal impression on ventrical thecal sac. Mild facet arthropathy. Mild endplate spondylosis. No significant canal or foraminal stenosis.

C7-T1- Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

Impression:

1. Prominent left paracentral HNP of C5-C6 with moderate left lateral recess stenosis and mild impression on the left ventral cord. With associated advanced chronic uncovertebral endplate degenerative changes, further reducing the caliber of the left foramen. No evidence of cord edema
2. Small central HNP of C6-C7 with no significant canal or formaminal stenosis.

 
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Old 02-08-2008, 05:42 PM   #2
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Re: Can someone help me understand my MRI?

Hi -there are some things that may have been caused by that simple fall, but there are also some things there that I would think aren't just 2 months old. Lots of these arthritic changes are very common and don't usually cause symptoms for majority of people until we are older.

You might have some problems from an old injury, car wreck, playing sports or just plain aging. Two months seems like a very short amount of time for these things listed here to appear and I would think these processes were already started before your fall:
-advanced uncovertebral endplate degenerative changes
-Mild endplate DJD (degenerative joint disease) - this is like arthritic bone spurring and changes.
-Mild facet disease (facet joints are synovial joints. Each joint is surrounded by connective tissue and produces a fluid to lubricate the joint. The joint surfaces are coated with cartilage to allow joints to glide smoothly against each other. These start breaking down and stiffening.

The herniations (HNP) could have been caused from your fall. Or could have been there and made worse. Herniation of the nucleus pulposus occurs when the gel-like substance of the disc breaks through outer surface - your discs are like shock absorbers. the material breaks through . It is also touching other stuff in your canal and causing narrowing. you have some of this stuff pressing on your spinal cord and also pushing in to the space called the foramens which are these canals where the nerve roots come off the spinal cord to your body parts. Think like a tree trunk with branches.

When there isn't good spinal fluid flow because of narrowing, the ESIs might not help as much.

I read that about 80-90% of patients with a herniated disc will respond to conservative treatment. Herniated discs can gradually reabsorb. Because this is one of your big problems, if it were me I would be trying all conservative therapy offered. I would go slow with PT, but definitely would do it.

I would guess C5-7 are causing the problems. Is this where you had the epidurals? I would also doubt trigger points are going to have any long lasting value since the root of the problem is still there. There are some less invasive procedures to deal with HNPs. But I would definitely be trying everything else but surgery. I think this reabsorption process can take 6 months or longer. To help it you really need to restrict activities, no lifting anything over 10 lbs, rest and take care of your self.

What else did the dr.s recommend for you?

 
Old 02-08-2008, 09:42 PM   #3
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Re: Can someone help me understand my MRI?

Shaun, I read your post on the "back problems" board...Physical therapy actually worsened my condition from Degenerative Disc Disease, which has recently spread to my cervical spine area. The internal medicine doctor told me before he re-located that I should also stay away from a chiropractor. I was wondering if you had any x-rays done before your MRI? If so, what did the x-rays show? I am curious because I have only had two x-rays on my cervical spine done but have had x-rays and a MRI done on my lumbar spine (which has abnormalities, due to the DDD). What type of pain are you in? Thanks, in advance.

 
Old 02-09-2008, 12:13 PM   #4
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Re: Can someone help me understand my MRI?

Hi, I hope you have better luck than I have had so far, but to answer you questions- I first had an x-ray in my primary care phycians clinic because of the pain I was experiencing after a fall, which according to him appeared ok. I went another 2 weeks dealing with pain at the base of my head, down my neck w/stiffness, burning between my shoulder blades, sharp pain in my shoulder that radiates down my arm w/numbness and sometimes tingling in my hand and fingers. Its just been unbearable, so I went in for my MRI thats when I found out what was going on. How long have you been dealing with this? I`m also curious what part of my pain is related to DDD? My doctor didn`t recomend that I see a chiropractor either. I`m not sure what to do about physical therapy,on one hand It would help w/my herniated disc, but just like you said, it would probably make the DDD symptoms worse. Its a little frustrating!! If I can find a doctor I trust then maybe things will get better for me. I`m seeing a new doctor soon and hoping he will the right doctor for me. If you could offer any advice, I would really appreciate it. Thanks-Shaun

 
Old 02-09-2008, 12:32 PM   #5
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Re: Can someone help me understand my MRI?

Thanks for taking the time to explain my MRI. You`ve managed to do a much better job than the 2 specialist I`ve seen so far. I didn`t think it would be so hard to find a good doctor but I`m still searching. Everything you said makes sense, I did have a terrible motorcycle accident when I was 14 w/head trauma.I am very active so I`ve probably injured it even further. The doctor did tell me I was a little young for the damage that was there.Neither one of the doctors I`ve seen offered a lot of options, just to take it easy for a while and take the meds they prescribed. I`m just not much for sitting around doing nothing. This is so painful, and I feel like I should be something to help myself. I`ve seen no improvement so far. Other than taking it easy, do you have any other suggestions to ease the pain? Thanks so much for your help. Shaun

 
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