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Old 12-06-2008, 08:36 PM   #1
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Question Can some one tell me what my report says PLEASE

Hello I got my report from a full MRI taking just over a year ago, 2 doc's have told me it's pretty bad but I'm not sure of what the report is saying. So I need this in laymen terms, so I can under stand what it is saying for sure. Here is what the report has......

Discussion: This is an abnormal MRI of the C-spine

1) Degenerative disc disease is noted at all levels.

2) At C4-5 there is minimal posterior disc bugle causing mainly CSF column narrowing.

3) At C5-6 level there is degenerative disc disease, posterior disc herniation. I see significant compression of the spinal column and bilateral nerve root canal stenosis.

4) At C6-7 level again there is degenerative disc disease, posterior disc protrusion to herniation also causing significant compression of the spinal column and bilateral nerve root canal stenosis.

At both these levels the narrowing of the root canal is more on the right side. There is also minimal posterior element hypertrophy noted at C5-6 and C6-7 levels.

Thanks For any help, I want to find out what this report is saying before seeing the expert NS on monday. As he took more test to see if it got worst in the last year, I would also love to have any thoughts on it as well.

Last edited by timpa; 12-06-2008 at 08:37 PM.

 
Old 12-06-2008, 09:47 PM   #2
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Re: Can some one tell me what my report says PLEASE

Hello - it is scarry when you don't understand - you are in the right place, lots of good information on these boards. Your MRI has some things that aren't that bad and some that are more serious. I will separate them out so you can focus on the most important.

I am going to assume you know the basic anatomy, but in case not, the spine is numbered by sections, C's are the neck, referred to as cervical spine.
There are C1-7. I will try to put this in the easiest way to understand. Sorry it is long there is no easy way to do this shorter.


You have degenerative disc disease - depending on your age this is really common especially for people in 40s and up. Some people have it earlier ages from prior damage like injuries. Also called DDD, it is an arthritis - and causing many things like bone spurs (osteophytes), drying/shrinking of your discs, and when discs dehydrate, or dry out, and lose their ability to act as shock absorbers between the vertebrae bones. So then friction and rubbing happen causing the bone spurs to grow. There are other factors but this is the biggie. As the discs weaken they are also susecptible to damage (bulges and herniations). Herniations are when the inner squishy contents of the disc bulge out of the disc and leak. Think like squeezing a marshmallow.

Most serious from your report these statements are the ones to focus on:

At C5-6 and C6-7 levels there is degenerative disc disease, posterior disc herniation and compression and bilateral nerve root canal stenosis.


First - I wanted to add that the wording on your report is a little different from what we usually encounter from Radiology. There are some key things missing that would make is easy for you to look all this stuff up. I am going to add it in in CAPS.

Answer: C5-6 is the most common level for people to have problems with. It is common to have 2 levels problems together and C6-7 is usally the one people get. Your material of the disc at these levels has bulged and leaked out where it shouldn't be. This usually causes inflammation and pain. Posterior is on the back side. In your case you should ask for clarification of WHAT is pressing on nerve roots at this levels - is it bone or disc material? I bet you have bad arm pain , maybe outerside, forearm - into wrist, maybe down side of chest and under armpit besides the back blades?? It is written kind of odd that there is compression on the spinal column this isn't the way it is usually said. Usually they say it is pressing on the thecal sac, or indenting the spinal cord. FYI within the spinal column there is the thecal sac that protects the spinal cord, within the thecal sac is spinal fluid (CSF) which cushions the cord. When you talk to the doctor ask them to clarify specifically about this compression. Also the bilateral narrowing is in what is called NEURAL FORAMINS (foraminal narrowing) this is common term you can find on internet. Think like little canals the nerve roots are like branches on the tree, they leave the trunk (spinal cord) and travel to you body parts. The little canals are narrowed,. again your report insn't clear if it is disc material or bone spurs that cause the narrowing. If it is bone spurring then the only thing to clear it out is surgery.


Anyway - herniations can heal themselves but it can take long time like 6-8 months. Some do not heal. Sometimes getting epidural injections will flush out some of the inflammation and make you feel better while you wait to see if it will heal. Since it doesn't say bone spur pressing (that doesn't heal itself), it would be worth going conservative therapy on this level if it is only the herniation causing this. If the doctor clarifies and tells you that it is bone spur then most likely they will recommend some type of surgical intervention. The only thing that can take care of the bone spurring is surgery.

Take it a step at a time, do not make any rash decisions and ask for conservative treatment modes, because sometimes people do get better using conservative therapies (rest, injections, PT, etc.). If you describe your symptoms we would help you more. How bad is it? Do you have any weakness or neurological issues or just pain?

I am not a doctor, but have been through a couple spine surgeries, have continuing spine problems , and understand everything you are going through. Take time to research the information so when you do meet with the doctor you will understand what they are saying.

Good luck.

 
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Old 12-06-2008, 11:16 PM   #3
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Re: Can some one tell me what my report says PLEASE

Thank you for your reply, I was in a auto wreck 20+ year ago I'm now 45 years old. It started about 6 years after the wreck, and has kept getting worst as time goes on.

I get bad pain in my arms and legs and lose feeling as well, my back has one blown disc as well. My left leg gets very painful as well as my back, the leg gets weak and I get odd feelings in my hands and arms mostly the right side. My arms feel very heavy all the time, and has pulling into my upper arms and head. Head pain gets very bad and very painful, some times I drop things from my hand, been cut and did not feel it even.

This comes and goes and most times, I can feel pressure in the tips of my hands and tangling, my left leg is painful and weak off and on but I think it's my back L5-S1 pushing the nerve. But my arms feel so heavy all the time, and there is always pulling in my neck and upper arms and head.

I found out after the MRI's report just over a year ago, my pain doc started steroid injections every 2 months. I'm having problems with bladder or bowel control, it started with the runs very bad I had to go to the ER. I find that if I drink to soon after eating, it's like all that I drink comes out as the runs. Also if I wait 3 to 4 hours to drink after eating, no runs but I'll then have to keep going till it pi**ed out of me. I did not know until I read about it, but it's related to the pinched nerve or injections or both.

Edited IN:

I forgot to say the MRI was done over a year ago, so the report is just over a year now. And I seen the MRI and it clearly shows, 2 places where it's pinched throw the CSF into the spinal cord nerve some. I can't tell much else from them, I'm worry I'll make the wrong choice as getting a operation or not getting one both have risk. The NS experts been doing this for over 43 years, and a grad of the 4th rated college but at first he seemed more like a saleman then a NS. But once he got the MRI on the LCD he just sat studying it for 15 to 20 mins, I'm 100% sure he one of the best experts. He said it was pretty close to a vital area, and ordered more test to see if it got any worst over the years time, he said I would have to make a choice then and that monday.

I'm trying to learn as much as I can, to make a well informed choice about it. He was giving me a exam that day, to check my fuctions and most of the time he was doing that. So I could not talk to him a lot about stuff, I hope I have more time to talk with him next time. When he come in the room the first he was upset because, my family doc did not send all the records he wanted. He said to the nurses what is he doing here, who sent him here I'm a NS I do operations and I don't know why he is here. 2 nurses was running around getting him the records, my family doc send them over the internet to them.

He did not bother looking at the MRI report, but once he got the MRI on the LCD he clearly changed gears. My family doc knows him he said, and agreed with me that he knows what he is doing. I thought he acted like he was all full of him self, people most likely treats him like a god or some thing. He study the MRI like no doc I even seen, he was clearly mapping it all out in his head. And it seemed as if he found my problem was worth his time, of course that just what it seem like to me and may not be the case. I'm ok with him though as it's has skills, that matters to me and he can be full of him self all he wants, as long as he a top gun that all that matters to me.

Last edited by timpa; 12-07-2008 at 03:30 AM.

 
Old 12-08-2008, 05:19 AM   #4
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Re: Can some one tell me what my report says PLEASE

Well I'm off to the NS in a few mins, so I'll know more after I get back from seeing him today.

 
Old 12-08-2008, 09:34 PM   #5
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Re: Can some one tell me what my report says PLEASE

I'll be watching for the notes on your visit.

I personally am all in favor of fixing problems that are pinching/compressing/impinging. That's how I made choices for myself. This doesn't always make all your symptoms go away, but it helps ward off worse damage in most cases. I am fused C4-7, I just turned 50 and am in pain management, I have cervical central canal stenosis that is getting tighter, I also suffer forminal narrowing, they cleaned it out, but now it is growing back, I also have thoracic problems, but am not going to do anymore surgeries unless I absolutely have to.

The thing you wrote about bladder worries me as a person - that seems like it should be the focus of concern and figure out what is causing it. You know I too read that not only pinched nerves but injections at lower levels can cause some bladder problems. But I also know there are a host of other diseases that can cause that too - my mom had kidney cancer and this was an issue for her - then they discovered it. My sister had a large bulge at L5 and until it shrunk back in she has tons of digestive problems.

A lot of the surgeons act as you describe yours to be, I think they want to convey "strength" to the patient, but it sometimes comes across as cocky.

 
Old 12-09-2008, 06:16 PM   #6
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Re: Can some one tell me what my report says PLEASE

I seen the NS doc yesterday, he said it got worst from just over a year ago till the new MRI now. I have C5-6 and C6-7 compressing the spinal cord nerves, he said at min they needed to be done, and another one later down the road.

He also said some of my reflexes are already hyper, he did agree with my family doc that I do run the risk of being paralyzed, with out any warning from it if I don't get a operation. And that a small shock could set it off, I see him again in 3 months and he told me, that if I get any weakness I'm to get back there right away.

He made it clear that weakness was a clear sign, that damage was being done to the nerves them self's. He also pointed out many people don't feel pain with it, and that pain meds mask it as well. The nerve test for my right arm and hand was good, and the xray's showed no sparrs on them that he could see.

I noticed when he did the reflex test on me, he keep talking to me to keep me from thinking about the test he was doing. I've noticed my self at times I would start to drop some thing, and my reflex would over reacted to where I could not catch it at all. That would seem to fit has finding, that some of my reflexes are over reacting already from it.

 
Old 12-10-2008, 09:02 AM   #7
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Re: Can some one tell me what my report says PLEASE

overactive or hyper reflexes are a true sign of spinal cord involvement. i have the very same from my spinal cord damage. getting this fixed as soon as possible would be the way to go here. NP gave you some really excellent advice here too. did they actually do another MRI on you or just an x ray? i am kind of confused on that? you simply DO need that new MRI to check on how far this has progressed. it can change very quickly up there even in just a matter of months. everything you have described as symptoms,even with your legs can possibily all be connected to your spinal cord compression. i ahve alot of leg problems from mine too. but there is always the possibility here too that you also could have damage/problems down inthe lumbar as well. that would be ruled out later on. right now,your main focus is getting that compression releived before it gets worse,and it will/can,believe me. i do hope they can get you in asap for this,you have been running on kind of a high risk mode here for potentially disasterous issues for way too long. the sooner the better. please keep us posted on how you are doing. good luck hon,marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 12-10-2008, 11:22 AM   #8
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Re: Can some one tell me what my report says PLEASE

My new NS did new MRI and xray's and nerve test, so he looked at both MRI beside each other and said it got worst. The NS said what you said about it changing in a very little time, with no warning and the damage can be done.

Last edited by timpa; 12-10-2008 at 02:38 PM.

 
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