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Old 02-11-2010, 03:05 PM   #1
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MRI Findings

Hello all,
I had Fusion done a few years back C5 throughC7. Benn doing ok. But been having some pain in mt left arm again and neck issues with back pain an tingling.
Just wondering if anyone can tell me exactly what my findings mean:

There is no preverebral soft tissue swelling. There is fusion of the C5 throughC7 vertebra. The heights are intact.

There is a reversal of the cervical lordosis with the apex at C4 to C5. The posterior endplates are in alignment. Bone marrow signal away from the field warping artifacts from the anmterior fixation plate is uniform.

The C2-3 and the C3-4 intervertbral discs are intact.

There is degenerative change of the C4-5 intervertebral disc. There is superimposed left paracentral dis herniation mildly compressing the left side of the spinal cord. There is also enroachment into the left neural framen. There is no canal enroachmment at C5-6. There is begining right neural foraminal enroachment. There is no canal enroachment at C6-7. There is begining left neural foraminal enroachment. The C7-T1 intervertebral disc is intact. There are no intradural masses. The spinal cord demonstrates normal intramedullary signal intensity. The craniocervical junction is normal.



This sounds like alot. What in the world does this all mean.

Thanks all!
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Old 02-16-2010, 11:35 PM   #2
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Re: MRI Findings

Hi! I saw this and no replies so I will try before I have to get off the computer. I was wondering if you have forearm pain?

There is a reversal of the cervical lordosis with the apex at C4 to C5. The posterior endplates are in alignment. Bone marrow signal away from the field warping artifacts from the anmterior fixation plate is uniform.

(on this the natural curve of your neck is off in the zone of C4-5 this can happen when a disc bulge or slip throws the alignment out of whack. Artifacts is a MRI term in that sometimes we get echos or "noise" in the pictures from the instrumentation in our neck. Sometimes when we get a fusion the levels adjacent to the fusion can take extra pressure and have to do the movement of the fused levels - this is causing some stress on your C4-5)

There is degenerative change of the C4-5 intervertebral disc. There is superimposed left paracentral dis herniation mildly compressing the left side of the spinal cord. There is also enroachment into the left neural framen.

(on this paragraph basically your C4-5 disc is having some bulging with herniation where the inner contents of the disc have bulged out of the outer ring of the disc and is pressing on the spinal cord and also into the foramin so it will irritate the nerve root. Encroachment in the neural foramin is the little canal where the nerve roots come off your spinal cord and exit through these channels to go on to your body parts. When this happens it usually causes arm pain or numbness or weakness type issues. The pain will be pretty specific and follow a certain route if being caused by your neck and you could look up dermatome chart to see the path and match it against your pain.)


There is no canal enroachmment at C5-6. There is begining right neural foraminal enroachment. There is no canal enroachment at C6-7. There is begining left neural foraminal enroachment. The C7-T1 intervertebral disc is intact. There are no intradural masses. The spinal cord demonstrates normal intramedullary signal intensity. The craniocervical junction is normal.

(basically these levels look good, some minor changes starting. )

Hope that helped if you need anything explained let me know I will check back in a day or two or someone else might jump in.

 
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Old 02-17-2010, 10:21 AM   #3
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Re: MRI Findings

Hi and thnaks so much for your replies!!
As for any forearm pain...YES! My arm has been dealing with on and off pain, not like my fibro pain, like the pain I had before my surgerey unfortunately. Even some on and off weakness.

I am suposed to go through some more theropy again to try to help it. It is definately the C5 nerve. I know thaT NERVE JUST TOO WELL.

My concern is, I know that there is mild compression on the spinal cord again, I understood that finding...could there be a seond surgery in the future? What are the chances? Is it common for one to go for a second surgery?

I also believe that this whole neck issue is what triggered my fibro too.
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Old 02-18-2010, 09:17 PM   #4
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Re: MRI Findings

I don't know statistically how many people have multiple surgeries, but there are a number of us on here. They would call it a revision for you and would most likely pull out the old hardware, clean everything up and add another level with a new smaller plate when the previous levels are fused. Very similar but a little tougher because of scar tissue and ligament hardening. Generally a little more pain during recovery. There are lots of people who never even do a first surgery so it is kind of how able you are to live with the symptoms. Sometimes even additional surgeries may not take it all away but at least they can create more room in there.

It is common to have the adjacent levels go bad. It is like the chicken and egg - based on how you look at it. For some people they were destined for the degeneration, others believe it was the pressure of the fusion.

Somtimes people wait a very long time to try to see if it settles down and doesn't progress.

PS - I went and looked up the statistics and from the The Journal of Bone and Joint Surgery (American). 2008;there is a study that says for cervical- 2.9% of fused cervical spines per year will require revision surgery at adjacent levels, and it said 25.6% of patients who undergo ACDF will have new disease at an adjacent level within the first ten years after surgery.

Last edited by PNo; 02-18-2010 at 11:22 PM. Reason: add

 
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