Re: Need help with CT scan results post myelogram
Hi Rosemary - there is alot to explain here, I will try to get to the most important things that I understand.
I assume you understand the basic anatomy of the spine and how it is numbered C's in your neck (cervical) and L's in your lower back (lumbar). If you do not understand the basic make up there are lots of good resources available to read up.
In your neck (cervical) it says that at C4-5 you have a disc protrusion. This is commonly called a disc bulge. A disc protrusion occurs with the spinal disc and the associated ligaments remain in tact, but form a bulge that can press against the spinal nerves. The bulge is causing mild effacement (which means touching/rubbing) the thecal sac. The thecal sac is the tube that holds the spinal cord and spinal fluid.
At C5-6 it says there is mild degenerative disc disease, with mild uncovertebral spurring. This causes some slight asymmetrical left neural foraminal encroachment. Basically degenerative disc disease means the disc is drying out and not able to be the best shock absorber it can be,uncovertebral spurring is bone spurs growing in an area. And the neural foramins are little canals where the nerve roots that are exiting the spinal levels like C5-6 and going on to body parts is narrowed (encroached) by the bone spurring.
In your lumbar it says:
L2-3 there is minimal concentric broad-based annular budge with mild flattening of the ventral thecal sac. (same as described in C4-5)
L3-4 there is a minimal contrast broad-based annular bulge with mild flattening of the ventral thecal sac. (same as described above)
L4-5 there has been a prior posterior decompression, with well positioned bilateral pedicle screws and crosslinked posterior stabilization rods. There is a thin solid bony fusion bilaterally, just lateral to the posterior stabilization rods. Some bridging trabecular formation is seen extending across the L4-5 disc space. There is no residual neural foraminal or central canal stenosis.
Answer: It says that you have had surgery before, your hardware in intact and looks like no problem at this level.
L5-S1 there is mild degenerative disc disease, with a small broad-based midline disc protusion. There is no significant neural forminal or lateral recess encrachment. There is mild facet arthropathy.
Answer: Again mild disc degeneration, with a disc bulge. Also some arthritis in the facet (arthropathy). Very common to get arthritis in this area.
Your symptoms; Your problems in C4-5 could explain the numbness and heaviness in your right arm. Your laminectomy would have influenced problems controlled by lumbar levels, i.e. your legs. Is your pain very clearly following the dermatome patterns for the L's called out in your MRI?
The difference between your neck and lumbar is in your cervical the spinal cord is present. In your lumbar your spinal cord doesn't run that low it terminates in most people at L1. That means when the thecal sac is compressed in the L's it is compressing nerves vs. your spinal cord. FYI, I have bi-lateral radiculopathy (resulting in very bad sciatic pain). I have a very badly central herniated, destroyed disc at L5/S1. I get epidural injections to control pain from that level and it works very well for me.
I am curious - were the Cervical problems present at your accident or have them come on after?
Last edited by PNo; 12-17-2009 at 11:46 PM.