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Old 01-07-2010, 05:52 AM   #1
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So new and don't know what to expect.

I've been having neck probs for a while now, but about 4 or 5 months ago I started having numbness in both arms. I could cough or sneeze and it would send tingles all down them. I get what I call "brain freezes" in the back of my head when I cough, laugh really hard, or get tensed up in my neck. I finally consulted my Primary care physician who scheduled an Cervical MRI and below is the results of this. I am scheduled with a Neurologist on the 11th and have my copy of the MRI in hand. I would luv some input, on what to expect and some opinions of the results of my MRI. Anti inflammatories is not an option, because of gastritis and GERD my Gastro doc has taken me off of NSAIDS. I feel like I'm a hot mess right now and would like some advice.

Vertebra body heights are normal with normal alignment. Hemangiomas are noted at C5 and C6 vertebral bodies. The remaining marrow signal is normal. Schmorl's nodes are noted at C5 and C6. No fracture identified. Multilevel bialateral facet arthrosis is noted. Multilevel mild disc desiccation is noted. Disc height is mildly decreased at C5/6 and C6/7. There is a T2 hyperintense lesion seen in the cervical sping cord at C6/7 level, likely representing myelomalacia. The pre and paraspinal soft tissues are unremarkable. Partial fusion is noted at C2/3.
C2/3 There is partial fusion noted
C3/4 : There is central and cranial disc extrusion effacing the anterior CSF space producing mild spinal canal narrowing. Anterior osteophytes are noted.
C4/5 : There is central and cranial disc extrusion effacing the anterior CSF space producing mild spinal canal narrowing. Anterior osteophytes are noted.
C5/6 : There is posterior disc osteophyte complex with broad based disc protrusion effacing the anterior CSF space producing moderate spinal canal narrowing and causing mild compression of the cervical spinal cord. There is bilateral uncinate and facet arthrosis casing moderate bilateral neural foraminal narrowing. Anterior osteophytes are noted.
C6/7 : There is posterior disc osteophyte complex with broad based protrusion effacing the anterior CSF space producing moderate spinal canal narrowing and causing mild compression of the cervical spinal cord. There is bilateral uncinate and facet arthrosis causing moderate to severe right and moderate left neural foraminal stenosis. This may aaffect the right C7 exiting nerve root. Anterior osteophytes and degenerative endplate changes are noted.
Impression
1. Partial fusion at C2/3
2. Myelomalacia at C6/7 level. Reccomend clinical correlation
3. Multilevel spondylodegenerative cervical disc disease as ddescribed above with impingement of right C7 exiting nerve root and mild compression of the cervical spinal cord at C5/6 and C6/7.

 
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Old 01-08-2010, 07:34 PM   #2
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Re: So new and don't know what to expect.

Hi - the good news is your appointment isn't far off and you can get some answers from your doctor. You do have a lot of different things going on.

Out of the MRI report this is the most important to understand from the surgeon:
There is a T2 hyperintense lesion seen in the cervical cord at C6/7 level, likely representing myelomalacia.

Myelomalacia is abnormal and refers to the softening of the spinal cord. Sometimes this crops up with a herniated disc with extrusion of disc material or an acute injury from an accident damaged the cord. Myelomalacia can cause motor disturbances, unusuall reflex responses, paraplegia and some other odd things. This is the area you would want to focus discussion on with the neruologist. Don't talk about the rest until he really goes into detail about what this means - this could be a serious thing.

Hemangiomas on the vertebral bodies are not much concern to them generally since yours look to be on the bone. They are pretty common and most do not cause symptoms. The Schmorl's nodes are protrusions of disc material into the surface of the vertebra which may contact the marrow of the vertebra and lead to inflammation. They too are common, especially with minor degeneration of the aging spine. Schmorl's nodes usually cause no symptoms, but show that "wear and tear" of the spine has occurred over time

Multilevel bialateral facet arthrosis is arthritis. The facets are joints and have a lining that wears down and arthritis grows - this too is pretty common. Multilevel mild disc desiccation is noted - that means your discs are drying and these things are common as we age. Disc height is mildly decreased at C5/6 and C6/7. So up to this stuff most everything has been pretty generic and "normal." When the discs dry out and shrink they don't do the shock absorber job they are supposed to and then all these other problems start happening. The spine is really smart and it tries to short itself up by building arthritis and spurs etc..

You seem to have multiple levels of mildly herniated discs with extrusion where material has escaped. When the discs dry out they weaken and the soft material inside the discs blows through the outer lining and causes pain, compression and inflammation. With some discs causing narrowing and putting mild compression on your cord and also having the mylemalacia they may want to do surgery. If they do recommend surgery do not be surprised.

Come back and let us know what surgeon says.

 
Old 01-11-2010, 10:03 AM   #3
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Re: So new and don't know what to expect.

Thank you for your insight! I really appreciate it, you just don't know how much. I just got back f rom my visit and am still processing what he said. Seems I get to skip passing go and go straight to jail (surgery) lol. I took my hubby with me thankfully cause a lot of it is a blur once he mentioned surgery was my only feasable option at this point. Funny how , like headaches, these neck pains we ignore and treat it as normal aging process. In hindsight I guess I should have paid more attention now. He asked if I had any questions, but I was blank at that point. On check out from there, the receptionist wanted to go ahead and schedule my surgery, but I wanted a few days to ponder over it. My mom had the same thing about 2 years ago resulting in 2 months in hospital and 6 months with a stomach tube, so I am petrified and trying to regain some optimism before I commit to this. The doc mentioned front neck incision, donar bone and plates. lol! I have no clue at this point what this surgery is even called, but I will start researching and get myself informed. Thank you again for your kindness and your replying to my post.

 
Old 01-11-2010, 12:51 PM   #4
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Re: So new and don't know what to expect.

charleyblitz I can relate to how you feel when you first hear that you need a surgery on your neck. It can seem overwhelming, but I just want to encourage you that I had a cervical ACDF, which is what you are describing with donor bone and a titanium plate at the C7-T1 level in June of 2008 because my spinal cord was being compressed, which it sounds like that is what is happening to you. I had numbness and weakness in my hands and arms, as well as my legs, and if I had not had the surgery, I would be much more handicapped as time went on. There are many folks on this board who have had this procedure, and there is much information already on this board, just look up ACDF. There are risks with any surgery, but this procedure is usually very effective, especially when you have spinal cord compression. It is necessary to prevent more damage. I still have some neuropathy in my legs and arms, since I was not diagnosed for nearly a year, so there has been some permanent damage, but the good news is that I can use my hands and legs, and live a fairly normal life. If you are not comfortable with the surgeon you have, seek a second opinion. I went with my second dr., since he was able to explain things to me better than the first one I went to.
Get informed, and make your decision when you feel inner peace, but I encourage you to not delay too long. Spinal cord compression is not something to take lightly. Keep us informed, and may you get better with the proper treatment.
God bless,
Kay

 
Old 01-13-2010, 04:07 AM   #5
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Re: So new and don't know what to expect.

I talked with my Neuro's nurse yesterday. I will be having a 2 level ACDF with corpectomy. I am waiting today to set up the surgery date. Thank you Kay for the kind words. I am making the best of time with getting informed and doing some research. I am glad to see so much information out there.
My thanks for the replies.

 
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