I'm so scared. I was involved in an auto accident last week. Went directly to ER had Cscan & MRI -Currently waiting to get in to see neurologist yet having severe tingling in hands, arms and feet. See parts of MRI: C4-C5 there is a posterior disc protrusion with narrowing if the ventral thecal space, but no central canal stenosis or neuroforaminal narrowing. At
c5- c6, there is a posterior disc protrusion eccentric to the right with mass effect on the right aspect of the cervical spinal cord with mild central canal stenosis. There is mild left and no right neural foraminal narrowing. At c-6-c-7 there is no posterior disc abnormality, central canal stenosis, or neural foraminal narrowing. Impression: no evidence of ligamentous injury. I'am trying to stay still yet, it's hard with children. Please help to explain ???
Re: Please help me read parts of my MRI & direct me on what I need to do
Hi! Three weeks isn't that long, sometimes people wait for 2 months so consider yourself lucky! I saw your post in the other thread to so I am going to combine my answer. So sorry you had an automobile accident. It kind of sounds a little like you have a whiplash type injury. Where your head yanked and that is probably how you got the disc bulge protrusions. Because you don't have bone spurs which would indicate an older injury - it does appear this came from the accident.
There is a ligament that runs the length of our spine that helps hold everything in place - they are saying there is no injury there! Central canal is the middle where the spinal cord runs.
Tingling and numbess are quite common when you have anyting touching/rubbing against the spinal cord. That is what is happening to you. The disc bulge is compressing your cord ("mass effect"), but it does not say to what degree or measurement. Even very tiny rubbing or compression can cause symtpoms. The 6th nerve root could cause sensory loss or tingling on the lateral surface of the left arm and/or weakness of flexing at the elbow.
Ventral is just where on the cord on the anterior side - toward front side I think is how to describe it.
I see you have kids. The best thing to do is try to rest as much as possible, let them help you if they are old enough. Don't lift, try not to bend with your head down. Sometimes those bulges shrink back off the structures. See what the neurologist tells you. The good news is it appears like no disc fragment leaked out and into that ligament which is not good and usually needs surgery. Post when you get more info.
Last edited by Administrator; 03-21-2010 at 06:31 PM.
Re: Please help me read parts of my MRI & direct me on what I need to do
Thank you for the reply . My concern is the nerve root 6 - I have severe tingling on the left side of my body mainly hands, fingers, legs and feet. How large does the mass have to be in order to have complete sensory loss? I also have severe tingling in my right hand and leg & just now noticed my right hand was a little puffy. why is this? What do I need to be watching out for? Should I be back in er requesting another MRI? I took about 600 mg of ibuprophin that does not seem to help. I'am also taking flexiral. My fam phy recommended physical therapy- should I be moving so soon? With all of this going on.
Last edited by Administrator; 03-21-2010 at 06:31 PM.
Re: Please help me read parts of my MRI & direct me on what I need to do
Hard to say what you need to do at this point, other than to keep a journal of some sort of your injuries, when each change in your sensations occured. You will have a lot of things that will run together in the months to come, this will help you to stay focused and not get anxious because you forgot an 'important' fact when you are visiting with the neurologist.
I would suggest that the PT for your cervical injury needs to be handled on the top tiers of your care - what I mean is, do not let your primary doc administer PT, when you have not been evaluated by the nuerologist yet. Your specialist doc will order the necessary testing and three or four weeks out of your accident, they don't usually order another MRI. I know that the primary care docs have their own little PT/OT centers set up,but for spinal - especially cervical spine areas - this is too delicate an area to leave to chance.
This is something I strongly believe in. I have a disc herniation and a disk tear from a t-bone auto accident in 07. I trust my spine doc absolutely, the PM doc - not so much. She never even asked to look at the MRI, could of cared less about the other treatments I already had gone through with the spine doctor and wanted to write a script for PT ... I told her no, that I was in good hands with the orthopedic spine doctor. No chiropractors either for cervical spine - that is a big no no.
Take it one day at a time, you have wonderul resources here on this board and give each one some thought. You will get through this, however overwhelming it may seem at this time. We are here to help.
Rose
Re: Please help me read parts of my MRI & direct me on what I need to do
Very good advice. I defintely wouldn't really proceed without direction from the neurologist. Continue to do the things you are doing. Another MRI isn't going to help at this point until you see the neuro. The biggest warning signs to drive you to the ER urgently would be loss of bowel/bladder control. Or complete loss of function in your limbs etc. Otherwise, keep doing what you are doing - and try to rest - ice/heat on your neck. My dr. lets me take 800mg of ibuprofen - you can ask if that is ok, and also if you are in severe pain talk to your personal doctor about your pain level.
The swelling might be because you are using that side more because your left is hurting so bad. I think this is more the cause.
There is no specific "size" of compression that would cause loss of function (by the way it is rare for someone to have full loss), usually it is more specific to a muscle group. All this stuff is really dependent on a person's anatomy.
I really can't stress enough that you need rest right now until you see the neuro.
Re: Please help me read parts of my MRI & direct me on what I need to do
I cancld my pt appt & will rest rest - what is the best way for me to do that - what position? I lay on my couch w/ my head propped up a bit - yet when I get up that is when I feel the pain in my back - like a burning pinch that seems to appear when I stand. I try to move my hands & feet around just because the tingling is uncomfortable. Also should I schedule a vist w/ an othopedic spine center since I'm basically just sitting & waiting until I see a neuro which is 16 days away?? Also I have been using a heating pad Only ---now I will rotate cold hot 10 min for one & 10 for the other but, how many times a day ?
Re: Please help me read parts of my MRI & direct me on what I need to do
Hi Rose--question - when my pt called me today due to my cancellation she stated that they would work with lumbar stabilization exercises which decrease what is pushing on the disc as well as the nerve ? Will this make me feel better? Should I ask about possibly making my situation worse with the protrusions which needs rest rest. I just don't feel right without a specialtist referral - yet can you help w/ what she Is suggesting? What does she mean?
I personally would not go to PT until I saw the neuro. The PT is motivated to get you in there to have a patient to treat but your MRI has not been reviewed by the specialist to even say they want you to have the PT. I would not go because family physician referred you to go. This is not just a simple muscle pull. Really! Wait until you see the expert!
You have something pressing (mass effect) on your spinal cord - personally if it were me, I wouldn't let anyone touch me without the neuro saying what they want done. My neuro personally ordered the type treatment they wanted which did not include lumbar stabilization, it was only light electrical stimulation treatments, ice, heat at the beginning. Truthfully I find that kind of crazy what the PT said. When it comes to the spine, I am ultra careful and only want my care directed by the highest skilled medical professional. Plus your neuro may have a specific PT they use that is a specialist in spinal care.
Just take it easy - 3 weeks is not going to hurt you - where the wrong move could really hurt you long term.
There is no specific protocol for the ice heat/ just don't leave the ice on your skin longer than around 10-20 mins and don't put directly on your skin use, a cloth in between. Keep your head in neutral positions - no kinks or bending down with your head leaning down.
Stop trying to second guess yourself - these things take lots of time to heal. Get used to this idea. Nothing you do it going to speed it up, your body is going to work on it's own time. In 3 weeks you are not going to become totally deconditioned. and the best thing you can do it take care of that neck. Believe me, you want to work to try to prevent long term problems. Instead use your energy to get your neuro appointment moved up, ask the scheduler to put you on wait list for cancellations - they happen all the time.
Listen to your instincts they are correct. Take care!!!
Re: Please help me read parts of my MRI & direct me on what I need to do
Quote:
Originally Posted by MJml
Hi Rose--question - when my pt called me today due to my cancellation she stated that they would work with lumbar stabilization exercises which decrease what is pushing on the disc as well as the nerve ? Will this make me feel better? Should I ask about possibly making my situation worse with the protrusions which needs rest rest. I just don't feel right without a specialtist referral - yet can you help w/ what she Is suggesting? What does she mean?
As others say here on this thread - please be cautious - and do not work with the PT folks UNTIL you are evaluated by the neurologist. Don't let them sweet talk you with fancy words that you have no idea what they mean. This is all new, overwhelming and as many of us, now know - not a quick fix. I do not mean that you will be bedridden or anything like that - but if you do not follow your gut and keep on the right track - you can be injured by the PT folks - I know all about that. Some of them are just worthless - sad but true, others are fabulous - I never did tolerate traction very well for the cervical spine - I just hit the little panic bell and they stopped the machine. Some folks really like it. Not me. Often the PT folks will do machines instead of hands on. I prefer the hands on,which if it is done right can be heaven.
You will find the right PT person, after the neurologist does his diagnostic work and prescribes what you need to begin the mending process. Don't forget to write in your pain journal. Some PT sessions will be so nice and others will be work, but the kind that benefits you.
I've been out of pocket - sorry to delay this in getting back to you.
Rose
Last edited by Administrator; 03-21-2010 at 06:32 PM.
Re: Please help me read parts of my MRI & direct me on what I need to do
Hi, I'd see my PCP if you can and see ifyou can get some muscle relaxers and/or pain meds. A medrol dose pack would help as well to help deal w/ swelling. I'm all for not seeing the PT until neuro consult. Unless PT just wants to treat w/ ice/tens/ultra sound and no exercise. I have just been diagnosed w/ c5/6 herniation and my Pain Mgt doc prescribed medrol dose pack (prednisone) and I'm already taking pain meds and he gave me sample muscle relaxers. I'm to start PT Monday UNDER HIS GUIDANCE AND SCRIPT. I do not having tingling or anything but just neck and thoracic pain.
Re: Please help me read parts of my MRI & direct me on what I need to do
Help... I'm in pain & it seems like it's getting worse instead of better the only change I made recently was to take meloxicam ? I took it for 2 days then accidently skipped a dose. I'm wondering could that cox2inhibitor release the inflammation and since I skipped a dose did it bring it back again but worse ?? My pt wants to see Me daily & therefore consulted w/my neuro's nurse for therapy permission yet was advised that I may need to see a neurosurgeon instead of a neurologist -- how they came to this conclusion is beyond me. But it raises more concern on my end that I do not need. Why do I feel more burning and tingling today then yesterday..? I would like to take the conservative approach and skip the surgeon any opinion?
Last edited by MJml; 03-11-2010 at 04:09 PM.
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Re: Please help me read parts of my MRI & direct me on what I need to do
MJml ... I sense and feel your frustration and pain very much - If it were me - I would not leave my care to the nurse of the neuro I have not seen yet. I would ask to speak 'consult' with them 'the neuro' myself. It is sad to say, but I have asked my husband at times to call the doc, just to get him to talk to us and then spoken with them. If when you speak with the neuro and they believe based on your MRI and symptoms, that the neurosurgeon is your best choice, then by all means, push for their earliest consult. Yes, missing a dosage can cause your symptoms to be harsher. be aware of the ER signs, loss of bowel/bladder control, sudden loss of sensation in extremities and etc. Don't let the PT folks push you around and frighten you. Be persistent about your desires and needs, Be a squeaky wheel! One of my surgeons told me that I should be more outspoken - I learned the hard way to speak up!
Last edited by Administrator; 03-21-2010 at 06:33 PM.
Re: Please help me read parts of my MRI & direct me on what I need to do
Maybe I should stop taking the meloxicam. I will ask for that patch. I called my Ortho today since the referral went thru - they can't see me until April - they see no immediate urgency. So that's good news!
Re: Please help me read parts of my MRI & direct me on what I need to do
Well here is the latest my pcp is telling me that I can resume my everyday duties. He is telling me that my MRI shows no breaks no damage to the spinal cord. No compression. I was lucky enough to get a cancellation for my neurologist I will let you know what he says tomorrow. I don't feel in any way capable of handling my everyday tasks, yet my pcp is telling me that if I don't --things may get worse & then scheduled me in to see his pt. I will wait & see what the neurologist says... I can't even lift a stick over my head or pick up a half gal of milk --my pcp told me to try ... Again, I will wait for specialist on that one. Let me know if you can think of any specific questions I should ask. Thanks everyone!
Re: Please help me read parts of my MRI & direct me on what I need to do
Hello - I sense your frustration, but here is what I would do based on my own experience. First, you are in pain - so that means to me your body is telling you to slow down - there is nothing wrong with you hanging back until you see the neurologist. Your symptoms can even increase from something as simple as a weather change, sleeping wrong, riding in a car, pretty much anything! This is the life we have, when our bodies have these things we are going to have symptoms. You don't seem to have the big red flag signs so just try to be patient. The Mobic wasn't even in your system long enough one way or the other to cause symptoms to get worse - so it is probably something more simple than that.
Who cares if the doctor says "resume your activities" obviously something is hurting - so don't. We patients sometimes need to be our own advocate to get to the bottom of our issues. There is no rush to see a neurosurgeon either because your case will most likely be treated conservatively like they do with almost everyone - except in extreme emergency - which doesn't look like to our laymen eyes to be an emergency. If the neurologist wants you to see a neurosurgeon they will arrange it and lots of the time they work in same practices together.
Please do report back what the neurologist's opinion is - let me tell you like I said in the beginning, an ounce of prevention is worth it, even the smallest bulges may cause symptoms and problems in some people depending on their anatomy, and for sure when you have the words "mass effect" on your report, it shouldn't just be dismissed by a primary care doctor and make sure it gets either dismissed as nothing by an expert in the spine or determined to be important. There are so many excellent primary care doctors out there, but I can tell you there are really some that are not good too. So I like to always ensure I have expert people making decisions on my difficult issues.
Let me warn you that sometimes a radiologist will read and report on a MRI and when the specialist looks them over they may agree, or disagree with the findings. Or even sometimes find things that were not seen by the radiologist. Or you may have a set of troubling symptoms that don't even match the xrays/mri. They do not treat the "MRI" they treat the patient and they need to look at all your clinical symptoms and the pictures and go from there.
PS: (not sure how ortho came in this picture - I think you are jumping all over the place and really need to get a good diagnosis and plan before you start doing all that, which means going tomorrow and getting the opinion of the neurologist and then proceeding from there. Just because other people on here go to neurosurgeon or orthopedic does not mean for you to begin making all these appointments. You do not have a firm diagnosis from an expert - which will come tomorrow.).
For questions just ask what does the report mean - have them explain what is going on in your neck, are your symptoms related to what is going on in there, what is the treatment plan for you. How can they get your pain under control.
Re: Please help me read parts of my MRI & direct me on what I need to do
Just returned from neurologist. She examined me & then took a look @ my MRI & consulted w/ the nerosurgeon & they want to see me. Therefore they advised me not to see the pt @ this time & to wait for an appt w/neurosurgeon. I asked if I wod be harming myself further if I tried to move more, she said no, but would not recommend it @ this time. She also stated I had no compression but it was touching the spinal cord. I then asked if that is what is causing the tingling. She said no- she believes it is the nerves in my muscles throughout my back from the trauma that is causing this. She also stated that the surgeon may not recommend surgery but may have some sort of relief mechanisms for me. That is about it. Oh & she put me on baclofen for my muscles. Thanks so much for you response I actually read it this morning in the waiting room. Keep you posted they marked me as urgent for the nerosurgeon & also placed me on the cancellation list.
Re: Please help me read parts of my MRI & direct me on what I need to do
I have a definite sense of ahhhh, as I read your last post MJml - it is so good that you posted on this thread to seek advice and reassurances of sorts as to the best pathway for yourself. Welldone!
Your issues are still unresolved and quite frankly, with whiplash and the cervical injuiries that verify it, you will have to just take this one day at a time. There is no quick fix, no matter what you may of heard from some others for these things. I am hoping that your youth (I assume you are not old like me - 55) will work in your favor. There is something to be said for younger bodies. I had one once and remember it well.
The neuro sounds like someone who knows their stuff - Keep us posted.
Rose
Re: Please help me read parts of my MRI & direct me on what I need to do
I had a sense of ahhhhh as well. But, I'm having major pain in my back. It's my upper back. Like , if you reach your hand behind your shoulder and touch as far down as you can ... That is the area of the pain I think it's right by the bulge ? Could it be getting worse or is the pain from healing ...? It really hurts & burns . I have been taking Tylenol 3 & now I'm taking 2 .. Every 8 hrs ... Seems a little scary . Also I heard in some other threads about people having a hard time coming off of the baclofin -- maybe I should just stick w/ the flexiral? I have been on the baclofin for about 2 days. Also... How do I sleep ? What is the best way for me w/ the protrusion being at c4- c5 & c5-c6 ?
Re: Please help me read parts of my MRI & direct me on what I need to do
MJml, your muscles are what some call 'guarding' , they are guarding the injuries. This causes a new pain. Your body is trying to compensate for the insult of the injury you have sustained. Myofascial (sp) release therapy is something that my ortho spine doc recommended for me, a ways into treatment, it was the most amazingly theraupeutic therapy I have ever had. The therapist works with the fascia, which holds the body together basically. The therapy settled me and dealt with the overall bodily injury of being slammed into a car door - which caused all sorts of stuff to go on, emotionally and physically. It is one of many treatments that could possibly help you as you recover. Very interesting and wonderful. Your pain needs to be managed at this point. If the pain becomes unbearable, call your nuero doc , they have answering services 24/7 for this very purpose. Where you are hurting is normal for your injury. Pain is pain, I am sorry to say, and the added frustration for having your life interrupted without your permission is also something that lays at the back of your mind as well. Please be careful and mindful about neutral positions for bending, looking down and so on. < edited > Hope this is helpful.
Rose
Last edited by Administrator; 03-21-2010 at 06:36 PM.
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