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Old 10-16-2009, 03:11 PM   #1
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Cervical spine advice requested

Hello

I would appreciate any opinions on my below MRI report.

< edited >

CLINICAL HISTORY: Known to have cervical spondylosis. History of radiculopathy.
MRI CERVICAL SPINE:

Straightening of the cervical spine is seen with loss of normal lordosis. The cervical vertebral heights and alignment is preserved. Evidence of a haemangioma is seen in the posterior aspect of the C6 vertebral body. This is stable in comparison to the previous MR of 24/08/2007.

C5/6 discs show signs of desiccation. C6/7 disc is degenerated with reduced height. Evidence of cervical spondylosis seen with prominent posterior vertebral osteophyte at C6/7.

Evidence of posterior disc osteophyte complex is seen at C6/7 slightly indenting the thecal sac and encroaching both neural foramina mildly right slightly more than left. However the nerve roots are normal. These findings are stable in comparison to the previous MRI. The cervical cord is unremarkable. No focal area of any abnormal signal intensity seen.

Conclusion: Cervical spondylosis most marked at C6/7. C6/7 disc degeneration. Disc desiccation also involving the C5/6 and upper dorsal discs. Posterior disc osteophyte complex at C6/7 indenting the thecal sac mildly and encroaching both neural foramina, right mildly more than the left. In comparison to the previous MRI of 24/08/2007 no significant differences are seen.


Any advice most appreciated

Last edited by hb-mod; 10-16-2009 at 04:18 PM. Reason: Please don't post links to pictures, or images, per posting policy. Thanks!

 
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Old 10-16-2009, 11:42 PM   #2
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Re: Cervical spine advice requested

Hello - we are all patients just like you. I think you tried to post pictures and although some of us are familiar with films, a true read of them needs to be done by your treating doctor. But we can take your MRI text and explain it to our knowledge and experiences. I will break it down by paragraph and the response will follow each paragrah.

Overall it looks like your condition is stable and not getting worse from the words they have written here. That is good! The question is - have your symptoms changed or worsened? The MRI is only one part of the picture. I am assuming you have had pain since you have a history of radiculopathy - is this under control or is it getting worse? That is pretty good news because there are some of who the bone spurs grow very fast and even within a year are markedly larger. That bone spur that is "slightly" indenint the thecal sac could be a trouble maker, but it is really hard to say any opinion with knowing what is going on with you - what are you experieencing?


Straightening of the cervical spine is seen with loss of normal lordosis. The cervical vertebral heights and alignment is preserved. Evidence of a haemangioma is seen in the posterior aspect of the C6 vertebral body. This is stable in comparison to the previous MR of 24/08/2007.

ANSWER: Lordosis is the natural curve of the spine. THe cervical spins has a natural curve and sometimes how we are positioned on the table will straighten it, or even muscle spasms will make it look straight. Sometimes we get out of alignment, however, since it says your heights and alignment are preserved it would be likely it was your positioning. Hemangiomas are common benign vascular tumors, they are usually small - the doctors say most of these are not symptomatic, but sometimes they do develop symptoms and other problems. Your's is not growing so it looks like it is just an incidental finding at this point.


C5/6 discs show signs of desiccation. C6/7 disc is degenerated with reduced height. Evidence of cervical spondylosis seen with prominent posterior vertebral osteophyte at C6/7.

ANSWER: Dessication is drying. When the discs dry out they weaken, and the outer ring (annulous fibrosis) of the disc can weaken and the inner material (nucleus poplus) can bulge or leak out. As they dry they also shrink. An osteopnyte (bone spur) is growing which is cervical spondylosis (aka arthritis).

Evidence of posterior disc osteophyte complex is seen at C6/7 slightly indenting the thecal sac and encroaching both neural foramina mildly right slightly more than left. However the nerve roots are normal. These findings are stable in comparison to the previous MRI. The cervical cord is unremarkable. No focal area of any abnormal signal intensity seen.


ANSWER: That bone spur complex (this is usually like a ridge of bone spurs) at C6/7 level is inding the sac that surounds the spinal cord and also is
growing and narrowing where it shouldn't be in the canals (foramins) that the nerve roots leave the spinal cord and go to body parts. The good news is it seems stable because it looked the same as your 2007? MRI.

Conclusion: Cervical spondylosis most marked at C6/7. C6/7 disc degeneration. Disc desiccation also involving the C5/6 and upper dorsal discs. Posterior disc osteophyte complex at C6/7 indenting the thecal sac mildly and encroaching both neural foramina, right mildly more than the left. In comparison to the previous MRI of 24/08/2007 no significant differences are seen.

 
Old 10-17-2009, 01:16 AM   #3
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Re: Cervical spine advice requested

Thank you for the reply with so much helpful explanations, Symptom wise, mmm I used to get muscle spasms but rarely now. I get stiffness and pain into shoulders and upper arms. It isnt so bad that I need p[ainkillers though I have found when I have taken painkillers that I am less tense and so get better range of movement Oddly I think more after walking. Cycling I can do and usually no pain . Driving can make my neck stiff and painful. I get some numbness on inner forearm on the left side but I think this is since I had a different illness.
I have what was (somewhat vaguely) described as (in 2004) multi level cervical and lumbar degenerative disease with sciatica. The Doctors did not however arrange either a MRI of my cervical spine at the time only X Ray and not evewn an X Ray or MRI of my lumbar spine. So at the moment there is no information as to the rest of my spine except the mention of dorsal disks which came within range of the MRI images this time.
I had a problem a few years ago with low readings of (corrected) calcium which was never re tested or followed up. I doi not know whether that has implications

When I was seen in 2007 the Consultant said a car accident with whiplash would be likely to paralize me where as another person would not be so affected.
This bothers me as I do drive and I want to ask them again.
One of the things that concerns me is that my spine might be left until it is an emergency and more tricky to operate on, than do it earlier to prevent such a difficult procedure and also reduce the chances of trauma forcing that bony ridge in through that thecal sac with catastrophic consequences. Then most people and docxtors say that surgery is a 'last resort'
I suppose there are balances. One is I am a NHS Pastient , the other is risks vs benefits. So is the risk of catastrophic irreversible injury greater than elective surgery and will the NHS (state health servicde in the UK) pay for non emergency spinal procedure even if it wouldnprevent later catastrophe.
Noted the contradictions in my report. It said disk heights were preserved and yet it said in another part that disk height was reduced at a certain level. Also it said aspects were stable in comparison with 2007. However, the foraminal narrowing is noted now on left and right (two sides whereas 2007 was only one)
there is observed dessication, osteophyte complex noted etc

2007 report here


MRI CERVICAL SPINE :

As on the recent radiograph of 13.08.07 of the cervical spine, there is marked loss of disc space at C6/7 which is associated with a minor degree of kyphos. Although there is minor narrowing of the cervical spinal canal produced by the vertebral bodies at C6/7 no evidence of cord compression is demonstrated. There is a small haemangioma within the posterior vertebral body of C6.

There is minor narrowing of the exit foramen of the C6 nerve root on the left but no convincing evidence of neural compression can be seen. No other significant features of note.

Bone marrow signal is otherwise unremarkable throughout the cervical spine. There is evidence of disc dehydration at C5/6 and throughout the remainder of the upper thoracic spine although no other disc pathology is demonstrated.

Last edited by DRAGON2009; 10-17-2009 at 01:20 AM. Reason: posted inadvertently before completed

 
The Following User Says Thank You to DRAGON2009 For This Useful Post:
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