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Old 01-26-2010, 11:00 AM   #1
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Need to understand how life altering cervical injuries could be

Below is a summary of my MRI report. Been referred to a neurosurgeon. I'm a proactive, get as much information as I can, type of person. If anyone can give me first impressions of the following, I'd appreciate it. I need to know what treatment options might be, as well as what the projected long term effects of these injuries could be. What is my risk for future paralysis or loss of upper body movement?

How life-altering could these injuries be? I'm trying to determine whether I will have to give up my career as a medical massage therapist which is very physical. Will I have to give up horseback riding, backpacking, hiking, kayaking and all the other athletic things I was doing? I already figured out that I'll never ride another roller coaster. What else will I not be able to do?

MRI Results

spinal cord is normal. cervical lordosis reversed at C3-4. Multilevel disc desiccation and spondylosis present.

Disc dessication and disc narrowing are present from C2 - C7. Some level of disc bulge is present from C2 - C5.

C2-3: bulging disc, annular tear, no nerve root or spinal cord compression. parasagittal diameter is 1.2 cm
C3-4: bulging disc, compression of anterior thecal sac, no spinal compression, bilateral moderate uncovertebral hypertrophy, severe right foraminal stenosis, nerve root compression and moderate left foraminal stenosis with nerve root compression. parasag diameter is 1. cm
C4-5: bulging disc, inferior and superior subligamentous disc extrusion, more to the left. moderate central canal stenosis, compression of anterior thecal sac, mild deformation of the left anterior aspect of the spinal cord. left uncovertebral hypertrophy, no nerve root compression. mild facet degenerative changes present.
C5-6: generalized disc-osteophyte complex resulting in moderate central canal stenosis. severe right side uncoverterbral hypertrophy, foraminal stenosis, and underlying nerve root compression. moderate left side foraminal stenosis with underlying nerve root compression. no spinal cord compression. parasag diameter is 9 mm.
C6-7: generalized disc-osteophyte complex asymmetric to the right. right side uncoverterbral hypertrophy and facet hypertrophy resulting in moderate foraminal stenosis and underlying nerve root compression. no left side stenosis or compression. no significant central canal stenosis or spinal cord compression. parasag diameter is 1.2 cm
C7-T1: no posterior disc herniation, central canal or foraminal stenosis, or nerve root compression. parasag diameter is 1.4 cm.

Impression (interpretation by MD reading MRI)
multilevel degenerative changes with the most significant findings seen at C3-4, C4-5, and C5 where there is moderate central canal stenosis and foraminal stenosis with nerve root compression.

Thank you for your help, whomever you are.
Debra

 
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Old 01-26-2010, 11:58 PM   #2
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Re: Need to understand how life altering cervical injuries could be

Hi Debra

Welcome to the board.

There are a lot of friendly experienced board members who have helped me in the past and may be able to help you interpret your MRI results and let you know some questions you need to be asking your neurosurgeon.

It can sometimes help them if you give them a bit of history. Have you been having problems for a long time and what are your symptoms? What medications are you on?

Hope you are having a comfortable day.

Kind regards

Bobbyboo x
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Surgery: ACDF C6/7 5th February 2009 with plastic cage & BMP (No collar)

Last edited by Bobbyboo; 01-26-2010 at 11:59 PM. Reason: Amendment

 
Old 01-28-2010, 08:48 PM   #3
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Re: Need to understand how life altering cervical injuries could be

It would be helpful for all of us to hear about your symtpoms, MRI is only one part of the picture. There people on both ends of the spectrum - some have mild findings and horrible symptoms, and then there are those with severe findings and mild or absent symptoms. In the meantime I will take a shot at answering your questions. Also just curious - what age group do you fall in?

Last edited by PNo; 01-28-2010 at 08:50 PM.

 
Old 01-28-2010, 09:23 PM   #4
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Re: Need to understand how life altering cervical injuries could be

Hello! The good news out of this is your spinal cord is not compressed , but there are signs of compression on the thecal sac that surrounds the cord by a bulding disk. Overall you have osteoarthritis in the spine and that is probably true of the general world population - it's just the people who get symtpoms who find out about having this arthritis. When the disks dry they weaken and harden and don't do their job and that is evident in your report by all the hypertrophic (enlarged) joints in the spine - as the ligaments get damaged and joints aren't lubricated, bones start rubbing and then growing osteophytes (bone spurs). Sometimes bulges and even herniations will repair themselves, or at least shrink back and not rub on other structures. However, I would guess that by the widespread degenerative changes - the discs might have been this way for a while. There is no conservative treatment to get rid of bone spurs and bone ridges - only surgery.

When the nerve roots get compressed we get lots of radicular arm pain - and that might interfere with your profession. Sometimes if caught early you can get the pressure off the nerve roots and the pain will go away. Sometimes even though they free them - they will still be painful or damaged. Or sometimes they will give you numbness type problems. Some people respond well to medications for nerve pain like neurontin or lyrica. I don't think I know anyone with total loss of use from these type problems because the arms have so many nerve networks, some get damaged others keep working. Usually it is a spinal cord injury that causes loss of use.

There is no way to know what is ahead for you - basically they will decide if you need surgery but usually they do try conservative treatments first. Things like some rest, anti-inflammatories, medications , physical therapy, activity modification, sometimes epidural injections. Generally they don't like us to have chiropractic when nerves are compressed - it usually ends up irritating that situation more.

Paralysis is on the more extremely rare side, I won't say it doesn't happen but that would be more from having a significant accident - than the problems themselves causing it out of the blue. Someone with spinal cord compression or severe central canal stenosis like <6mm would be more risk than yourself.

As far as athletic activities - that is really what you can tolerate, how it impacts your work/life, and if you want to put that extra stress on your spine. I doubt they will tell you that you cannot do them, more they would recommend you start finding more lower impact activities. Really it's all about protecting your neck from whiplash and pounding type injuries - like you identified no roller coaster.

I hope this helps - do post about your symtpoms and I will be looking for updates after you have seen the neuro. NP

 
Old 01-29-2010, 07:30 AM   #5
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Re: Need to understand how life altering cervical injuries could be

Thank you to those who replied. I'm a 48 yr old female with no health problems. The osteoarthritis is not surprising since I've had many severe whiplash injuries over my lifetime. This particular car accident (rear-ended at about 35 mph while standing still) has seemed to impact my spine in a way that no other accident has. What is not included in the MRI report was the fact that T4 is rotated and also pressing on the central canal and there is significant compression at L5/S1. I have pain radiating from T4 through my rib cage. Pain is radiating from the sacrum in spasms and jolts. The accident happened Jan. 4th. I've had intermittent days of extreme pain and some days with manageable pain. It doesn't seem to matter whether I'm active or not. The tingling in the ring finger of my left hand started a few days ago. The pain in the upper arm has gotten better. The jammed feeling in my wrists and ankles has subsided. Have had two severe headaches but there is no sign of concussion. Sleep has not been affected. In fact, I don't want to get out of bed in the morning because I'm pain free and have to risk pain when I get moving.

Minimize risk of whiplash? Ha. I was minding my own business when this happened. I was doing backbends, jumping up and down, and dancing on New Year's Eve. I have been athletic my whole life and now just moving my hips causes pain. Singing causes pain. I'm ******. And, now I have to think about the long term effects of nerve degeneration and do "activity modification". This sucks.

Debra

 
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cervical canal stenosis, disc bulge, mri, nerve root compression, stenosis



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