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Old 01-14-2010, 11:30 AM   #1
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Need help with c-spine MRI results

I hope someone can explain.

I just received this message from my doc.

"I received the report of the MRI on your c-spine. It shows that you have a protruding disk which causes impingement of the nerves and also causes a instability of the vertebrae called spondylolisthisis. I am sure that your headaches and neck pain are related to this". He is recommending that I go in for an epidural injection.

What does this mean? How successful are epidural injections for this?

 
Old 01-14-2010, 12:40 PM   #2
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Re: Need help with c-spine MRI results

Hi, I have only had injections in my lumbar and sacroiliac regions so I have no first hand experience with this for the neck but probably will soon as I am having tons of problems with it and have a bone spur and arthritis in it. Please ask to be numbed atleast for any injection, and if possible, sedated. I have had 4 total, 2 for my weak legs, and 2 for arthritis in my facet joints. Both of them helped me immensely. The injections are for inflamation, kind of like putting ice right on the inflamed part. I read up on them before i would consider having them and would never have them without the numbing and sedation, but they do work wonders for some problems, especially if it's for inflamation. I also had one for a herniated disk and it did nothing, but that is common because they are for bulging disks, and I had a huge herniation, but they really helped me for my other problems. They can last months or even years. I believe you can have 2 a year.

 
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Old 01-14-2010, 12:51 PM   #3
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Re: Need help with c-spine MRI results

Thanks Kasey443,

Are bulging discs the same as protruding discs? This is all very new to me. I have a lot of medical issues, but nothing to do with the spine, etc.

 
Old 01-14-2010, 12:57 PM   #4
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Re: Need help with c-spine MRI results

I think they are the same thing and docs just use different terms for them.

 
Old 01-16-2010, 10:45 PM   #5
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Re: Need help with c-spine MRI results

Hi - epidural injections are aimed at reducing pain and inflammation. They are not currative when there is something pressing on the nerves like bone spurs. However, when a disk is bulging/protruding there are sometimes when the disk will shrink back and get off the nerve. The epidurals and also oral steriod rounds will may help with this situation, calming down the tissues. This takes time, and usually conservative therapy like rest, gentle PT, anti-inflammatories, and even injections during this time to see if it will shrink back. The recommended time is up to 6 months to see if the disk will go back. As for the spondylolisthisis - that is a slippage. This is usually graded and can be very minor to significant. This is happening because your disk is not doing its job at the momment, I would guess it is minor. Ask the doctor what grade yours is at. To help your body the best thing is to watch your sleep positions, take care of your neck, and also don't do any heavy lifting, ask your doctor for restrictions he recommends, however most say don't lift anything over the weight of a gallon of milk. You might find side sleeping with your head supported and a pillow between your knees will help your headaches. Sleeping on the back is the worst.

I have had over 36 epidural injections in many parts of my spine over the last 5 years. They have helped me sometimes, other times not lasting as long. I have problems in multiple parts of the spine that I am trying to avoid surgery by managing pain and my condition. It is defintely worth the try for you. It is a little scary for new people, for the cervical find a provider who uses light sedation while they do the injection. You will be awake, but not anxious and should tolerate the procedure very well. It doesn't take very long and believe me they are not as bad as we build them up to be in our mind.

I did have 2 surgeries in my cervical, my first one was because I had slippage and very bad nerve impingement, I have permanent nerve damage. I have some nasty bone spur ridges along with herniated disks.

By chance do you have a copy of your MRI report? I am wondering if you had any osteophytes (bone spurs).

I hope your headaches get better and you get to a good pain state. Good luck!

 
Old 01-17-2010, 06:22 AM   #6
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Re: Need help with c-spine MRI results

Thnaks Neckpatient,

I do not have copies yet. The MRI was ordered by my PCP and he is going to send me to, I think a neurosurgeon. I'm not sure how much my doc knows about it in reading the report. He said there were other findings, but that is what he thought was causing my pain. He didn't elaborate, but said I needed to see someone. I am assuming that I probably do have bone spurs because I had rotator cuff surgery for a tear and the surgeon said that I had a bone spur rubbing up against the tear that was keeping it from healing.
I have had whip lash twice so I would be surprised if I didn't have a lot going on in the neck area. I cannot take oral steriods at the time because my stomach is a mess from taking too much ibuprofen. However, I was recently on high doses of steroids for another issue and it was after I stopped taking it that the pain got worse.
I am going to try and get a copy of my report. If I do I will post the findings and maybe I will get more insight from people on this board.

Thanks to all who responded!!

 
Old 01-18-2010, 03:10 AM   #7
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Re: Need help with c-spine MRI results

HI Neck patient and others

I would welocme some advice. My MRI scan shows a large disc/osteophyte bar narrowing the spinal canal to just under 6 mm. At this level (i think C6/7) the spinal cord shows a focal abnomality indicating the effects of compression. The neurologist says this is what is causing my neurological symphoms (pain in both arms). He says surgery is the only option and has referred me to a neuro-surgeon. Does anyone know what the success rate of such surgery is - how likely is it that such surgery will result in paralysis?

 
Old 01-18-2010, 07:44 PM   #8
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Re: Need help with c-spine MRI results

I don't know that injections will help the overall issue of spondylolisthesis. It can help with some of the symptoms but won't fix the underlying problem. Spondylolisthesis is the movement of one vertebrae over the vertebrae below (either moving forward or backward). Spondylolisthesis is graded:

Grade 1: 25% of vertebral body has slipped forward
Grade 2: 50%
Grade 3: 75%
Grade 4: 100%
Grade 5: Vertebral body completely fallen off (i.e.,spondyloptosis)

Are you currently being treated by an orthopedic spine surgeon or neurosurgeon? If not I would suggest you seek out one of these type of specialty physicians to learn what Grade your spondylolisthesis is and what the most useful and viable treatments are.

For my neck I saw both an OSS and NS and ended up choosing the OSS on the reccomendation of my primary care physician.

For my back I changed physicians to another OSS (long story but prior OSS seemed to discard my lumbar concerns).

I had spondylolisthesis L5 and L4 so was fused L4-S1. Now 17 years later L3 has moved forward so I'm having that level reeled in.
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Old 01-18-2010, 10:07 PM   #9
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Re: Need help with c-spine MRI results

Hi Ces59- I can see you are new to the boards. You have a good question, it would be best to start your own thread as the protocol on the boards is to stick to the topic of the person who started the thread. So while I wait for you to open a thread of your own I will think about any advice from my experiences I can offer!


Quote:
Originally Posted by ces59 View Post
HI Neck patient and others

I would welocme some advice. My MRI scan shows a large disc/osteophyte bar narrowing the spinal canal to just under 6 mm. At this level (i think C6/7) the spinal cord shows a focal abnomality indicating the effects of compression. The neurologist says this is what is causing my neurological symphoms (pain in both arms). He says surgery is the only option and has referred me to a neuro-surgeon. Does anyone know what the success rate of such surgery is - how likely is it that such surgery will result in paralysis?

 
Old 01-19-2010, 06:37 PM   #10
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Re: Need help with c-spine MRI results

I finally recieved my actual MRI report. It reads:

At C3-C4 there is no significant degree of canal or foraminal narrowing.

At C4-C5 there is degenerative anterior spondylolisthesis of C4 ob C5 by approximately 3mm. A disc osteophyte complex results in a mild degree of central canal stenosis. There is a mild degree of right and mild to moderate degree of left foraminal narrowing secondary to a combination of uncovertrbral joint hypertrophy and facet arthrosis on the left and uncovertebral joint hypertrophy on the right.

At C5-C6 there is no significant degree of canal or foraminal narrowing.

At C^-C7 minimal left foraminal narrowing is identified.

At C7-T1 there is no significant degree of canal or forminal stenosis.

I'm not sure what all of this means, but it doesn't seem like it explains why I am having so much neck pain and headaches. Can someone explain this to me.

Thanks!

~coping

 
Old 01-19-2010, 08:19 PM   #11
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Re: Need help with c-spine MRI results

The findings could explain your symptoms especially the findings at C4-5. That could create pain in your neck and headaches with cervical problems are relatively common. In my case if I get neck pain I tend to "tighten up" those muscles and end up with headaches.

Do you have any symptoms of pain, tingling or numbness in either or your shoulders or arms or fingers? When a cervical nerve is impinged you can get these symptoms as well.

Are you set up to see an Orthopedic Spine Surgeon or Neurosurgeon?
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Last edited by SpineAZ; 01-19-2010 at 08:22 PM.

 
Old 01-20-2010, 08:09 AM   #12
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Re: Need help with c-spine MRI results

Quote:
Originally Posted by SpineAZ View Post
The findings could explain your symptoms especially the findings at C4-5. That could create pain in your neck and headaches with cervical problems are relatively common. In my case if I get neck pain I tend to "tighten up" those muscles and end up with headaches.

Do you have any symptoms of pain, tingling or numbness in either or your shoulders or arms or fingers? When a cervical nerve is impinged you can get these symptoms as well.

Are you set up to see an Orthopedic Spine Surgeon or Neurosurgeon?
I have pain in my neck, shoulder (right side mostly) and I know this sounds wierd, but I only have tingling and numbness in my ring and pinky finger on my right side.

My doctor has set me up with his doctor at The Pain Institute for the epidural. I go and talk to them next week. I am not sure what kind of doctor he is, but my PCP has had several epidural injections and swears by this guy.

 
Old 01-20-2010, 08:41 AM   #13
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Re: Need help with c-spine MRI results

don't worry, that's not weird. It's very typical. I had pain that went down my left arm but not all the way, then I had numbness and tingling in my middle finger and pointer finger. If you look up a nerve dermatome chart you'll see which cervial nerves cause pain/symptoms in which area of the arms and body.

I recommend you push for an evaluation by a neurosurgeon and/or orthopedic spine surgeon in addition to seeing the pain doctor. In fact maybe bring it up with the Pain Med doctor - tell them you think maybe having a visit with an NS or OSS will also help. Many of us here have been in treatment with Pain Med and NS/OSS as the same time.
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Fusions: L5-S1 (87), L4-S1 (93), C5-C7 ('06), L3-S1 ('10)
C5-C7 foraminotomy 08

 
Old 01-20-2010, 09:03 AM   #14
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Re: Need help with c-spine MRI results

Quote:
Originally Posted by SpineAZ View Post
don't worry, that's not weird. It's very typical. I had pain that went down my left arm but not all the way, then I had numbness and tingling in my middle finger and pointer finger. If you look up a nerve dermatome chart you'll see which cervial nerves cause pain/symptoms in which area of the arms and body.

I recommend you push for an evaluation by a neurosurgeon and/or orthopedic spine surgeon in addition to seeing the pain doctor. In fact maybe bring it up with the Pain Med doctor - tell them you think maybe having a visit with an NS or OSS will also help. Many of us here have been in treatment with Pain Med and NS/OSS as the same time.
I guess one thing that is confusing for me is that most of the findings seem to be mild, so I don't really understand how my neck/head is bothering me so much. I have a pretty high pain tolerence but this constant pain is driving me crazy!

I probably will see about seeing a nuero or ortho eventually, but to tell you the truth I am seeing 5 other specialists for other issues right now and the thought of adding yet another doctor is not appealing. My PCP is fabulous and is coordinating all of my specialists and he made this appointment for me. I know I am taking the easy way out, but I am just tired of it all and if this doctor can help just a little, I will take it. I know that is not the right attitude, but that is where I am right now.

Thanks so much for your help!!

 
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