I am new to this forum, but not at all new to neck and back issues. I have had a movement disorder for 16 years, & I believe it is slowly causing problems throughout my spine. I am in severe pain daily (And nightly). I recently went to a new pain clinic, and the PM dr. requested a cervical MRI to start an action plan. However, he never explained what my results of the c-spine MRI meant. He essentially said the pain could be due to my muscles or my spine.
If anyone has knowledge of the issues listed, can you tell me if they could be causing my neck pain & migraines. Are these findings significant, or basically normal? The person who read the results put nothing in the IMPRESSION section but : Degenerative changes as above.
I would appreciate any input to increase my understanding.
C3-4: Small broad-based central and bilateral paracentral disc
protrusion with subtle flattening of the thecal sac and cord. No
C4-5: Small broad-based central and bilateral paracentral disc
protrusion. Flattening of thecal sac and cord. AP sac
approximately 9 mm.
C5-6: Minimal diffuse annular bulge/spur with slight flattening
of the thecal sac and cord. Mild left facet hypertrophy. No
C6-7: Small bulge/spur. Mild right foraminal narrowing due to
Hello - it is possible your spine problems are causing the pain and migraines, is the pain you have down your arms or in your neck? C3 is known to contribute to headaches. There is quite a different feel from muscle type pain to true nerve or nervous system pain. Your MRI isn't too terrible, but it is also not problem free. I assume you understand the findings and are more interested in the symptoms you are having, if you describe them in better detail I am sure a few people will compare with you. It is "normal" as we age for the spine to have problems from wear and tear, the majority of people do not experience symptoms. The doctors start watching it more closely when we start having flattening of the cord. I will watch for further explanation from you.
while what NP stated is very true about when it comes to feeling 'just" muscle pain and what you would feel with the overall nerve related pain which is referred to as radiculopathy in most cases, there is also a very direct connection between what would be the spinal cord and spinal nerves and muscles if the nerves or cord are actually sending out 'signals' to the muscles they innervate. it creates kind of an 'overtightening' of the outside covering of the muscles called fascia? its when the nerves are inflammed(this can aslo occur when the cord area is also being impacted as well. it did to me) they will send out like little firings or 'distress' types of signals to muscle that cause that outter covering to first thin out around them, then kind of overly tighten around the muscles, causing pain and a very real overly tightened feeling or make muscles harder to just move at times(this is referred to as more like myofascial pain? depending upon overall muscle involement here?).
the thing is, the fascia we have inside our bodies actually covers every single muscle, organ and blood vessel too. it is also like one really huge interconnected "spiderweb like' sheet that litterally runs from around our brain on down to the last tiny toe on your foot. so one area can be getting the inflammatory signals that can create a problem with other nearby muscles as well. in some cases where there is a huge amount of inflammation/signals, little wads of tissue form called trigger points? this is when that fascia combines with some of the actual muscle tissue and will form "knots' kind of under the skin that if you press into they will produce like a radiating type of pain?
you just do have alot of levels with actual thecal and cord impact going on there. but luckily your overall cord amp is more normal than you would think given the many levels of impact you just have there, so thats good. just what does your 'movement disorder" actually consist of or been diagnosed as? how long did you have movement issues before the MRI was actually done? how did that disorder actually first present to you when it originally started?
i have to say that whoever actually did your rad read of the hardfilms really was not as good as it could have been overall and considering just what is being impacted there. seeing an actual neurosurgeon for a simple eval and consult and more importantly what would be a really well educated and MUCH more knowledgable second read of those films really should be done just considering the multiple levels of actual thecal and cord contact you have there right now too. as NP mentioned above, this type of finding just really needs monitoring to see certain things/changes that can simply occur when the cord contact is even present as a hard finding.
the one thing that i do not actually see listed anywhere considering the thecal AND the cord involvement being there at all is just how much real CSF fluid is still there between the cord and the inner wall of that thecal sac surrounding the cord itself? that IS pretty crucial to actually know since that very delicate neural tissue just needs constant 'bathing' with that CSF just to keep things 'normal' and to not dry out areas of the spinal cord? it, like with the brain, just NEEDS to be bathed constantly with CSF to keep it well hydrated and nourished with the right stuff thats just IN CSF. that is just something that should have at least been mentioned in that summary of your report. whoever did that read did a pretty crappy job considering, ya know? i am just wondering how truely experienced the interpretting rad was who did that read on your films actually was. i am just kind of suprised here too that your PM doc did not think of the need to just let you even know what was going on or fully explain certain things to you, espescialy that need for an eval/consult with a good NS to identify things that could easily been missed by this particular rad, and to just get THAT level of second read of your films as well? while most PMs are familiar with MRIs and certain findings that can be there too, they are not anywhere near as good as seeing that NS would be for HIS or her overall impression and prognosis for the findings you have there. and i really do feel that this particular type of report/findings, really needs regular monitoring of your cord and visits to recheck your overall neuro status here too? its just the type of real in depth neuro eval that NSs actually do is soo much more in depth and uses many different type of testing(just hands on looking for certain signs)that just seriously can reveal certain things that are being impacted within that cord area by your responses to certain testing and stimuli that most docs or PMs just really do not do all that much, or no where near as in depth as any good NS would. for instance, just how are your leg reflexes? normal, kind of more hyper or brisk compared to the more subtle type of lower level "bounce out' that would be considered more "normal' in any given patient? any patient who has what you have going on up in that c spine area needs to find out if they have hyper reflexia since it just IS a solid sign of deeper cord involvement/affectation. or things like myelopathy or clonus too which are also signs that the cord is being more impacted than what was stated upon that pretty slim little rad report you have there. all of this stuff can simply be found out with your very first visit with that NS and that in depth eval and hands on testing they just do. along with just your actual symptoms and reading that set of MRI films you will have to also bring in too. this is why i just really do think you seriously need a referral to a good NS at this point.
that can be done by either the current PM or your own primary care doc since they are the ones who are in charge of your overall healthcare coordination and you may actually HAVE to go thru your primary doc for ANY referals like this per your ins co like i do too. you just really do need to know what it is you are dealing with here and how truely impacted that cord actually is. the NS should be able to tell whether or not you actually have ANY CSF still surrounding any areas where it states cord contact by that thecal sac too. that IS an important thing to just know for good cord health overall.
as NP asked, just knowing exactly what your pain actually consists of and where it is besides the head, along with ANY other symptoms you are actually feeling like anywhere in your body(espescially down any arms to particular fingers?) at all would seriously be very helpful for us to really know. hopefully you can get in to see the NS sooner vs later. but this is what i would do if this were my particular report, espescially with the way that it is actually written with no real good details that are supposed to be in that summary at the very end at least? good luck with this and please do keep us posted. marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.