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Old 06-19-2010, 07:09 AM   #1
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HELP - Need a direct, honest MRI Report Interpretation

Hi:

Could someone that has the knowledge and technical ability take a look at my Cervical Spine MRI report. I was not satisfied with the explaination and advise from the doctor i went to.I was hoping that maybe someone could look at this and provide an honest, professional opinion on option to take to correct or alleviate.
FINDINGS

Comparison is made to an exam performed at another facility, dated 08/21/2008.
No focal abnormalities are seen from the foramen magnum to C3. There is loss of the lordosis, with reversal that is centered at the C5 level.

C3-4: The disk height is normal. There is a small and focal, posterior disk protrusion very slightly to the right of the midline, While the left foramen is clear, there is moderate stenosis of the right foramen and some deformity of the right anterolateral margin of the thecal sac, caused by a posterolatera combination of disk protrusion and prominent Luschka joint spur.

C4-5: The disk height appears very slightly decreased, with minor degeneration. A very minimal posterior and right posterior disk bulge does not deform the cord. The foramina are clear.

C5-6: . The disk is moderately narrowed and degenerated, more obvious than on the previous exam. There are also now some prominent zones of increased T2 signal involving the anterocentral and left lateral portions of both endplates, especially C5. A wide combination of moderate-sized disk protrusion and spondylitic ridge is slightly deforming the anterior margin of the cord. Luschka joint spondylosis causes moderate narrowing of the left and right foramen. Finding show mild progression.

C6-7: The disk height is normal with mild degeneration and a small posterior disk bulge that does not contact the cord. The foramina remain clear. -


IMPRESSION:

1. CS-6: Moderately severe degeneration of the disk, now with some secondary edema involving the adjacent endplates, and this was not present on the previous exam. A wide combination of disk protrusion and spondylitic ridge is accentuated by the slight reversal of the lordosis, and is very mildly deforming the anterior margin of the cord, although without spinal stenosis. Luschka joint spurs cause moderate foraminal stenosis on the left and mild stenosis on the right. These findings have all progressed since previous exam

2. C3-4: The right foramen is moderately narrowed and there is some deformity of the right anterolateral margin of the thecal sac caused by the very prominent and asymmetrical combination of disk protrusion and Luschka joint spur. No significant change from old exam. Tiny right posterocentral disk protrusion

3. Small right posterior disk bulge at C4-5 may represent minimal protrusion. Even smaller disk bulges at C6-7 and C7-Tl. These cause mild deformity of the thecal sac, without contacting the cord. These foramina appear clear. These deformities were not definitely present on the old study, and slight progression of disease cannot be excluded, although it is possible that these minor deformities were just not well visualized on the old study, due to motion artifact that limited that exam somewhat.


Thanks

 
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Old 06-19-2010, 03:11 PM   #2
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Re: HELP - Need a direct, honest MRI Report Interpretation

kevin, as noted at the top of the forum, no one here can advise you or diagnose you. Since you are not satisfied with the doctor's explanation/advise, most everyone here would encourage you to get another opinion. MRIs are only as good as the person reading them AND combining the films with your symptoms. It is not unusual for a radiologist's report to be different from what the neurosurgeon/ortho spine surgeon sees on the films. And there are times, that despite seeing the films and coordinating symptoms, that at the time of surgery, more damage appears than anticipated. No one wants anyone to rush into surgery. There are other tests, like EMG, than may help you and your doctor come to a decision.

I would suggest you look for another opinion......mainly because you and your doctor are not on the same page and you need to trust your doctor.

 
Old 06-19-2010, 04:04 PM   #3
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Re: HELP - Need a direct, honest MRI Report Interpretation

Sk84life is right in that no one here is a professional. Some of us have gotten pretty good at taking the "doc speak" of an MRI report and translating it into regular people talk but we don't do anything other than that. We can share what we experienced with similar problems and what we chose to do with that problem but that is all. No one can tell you what to do and if anything, we are less trustworthy than your spine surgeon.

If you don't trust the answers you've gotten, get another opinion. Most will tell you to get 2 or 3 opinions. A spine is that important. Or do what I did, get the opinion of a neurologist...they don't do surgery and so have no financial incentive to push you one way or the other.

good luck..........Jenny

 
Old 06-20-2010, 09:11 AM   #4
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Re: HELP - Need a direct, honest MRI Report Interpretation

the others are very right about what they stated to you about interpretation and the need to seek out that very crucial(in your case) that second opinion too. what i am wondering here is just exactly WHAT did that other doc tell you about the findings and what this ment for you that you are having problems with it in not being 'satisfied" and what actual "advice" did he give you?

what specific type of specialist did you see for this consult and eval? i personally would obtain a second opinion from a good neurosurgeon whether you just saw one or not? only becasue of the underlying nature of the type of findings you have alone? not all even the very same types of specialists are even close in how 'they" would do things or even see any given finding at all in some cases. its all pretty much what 'they" just have in overall experience and knowledge of whatever YOUR particular findings are that would dictate how "they" would see the findings and what they 'feel' is the best treatment options for YOU. they can be very different, esp when you have more rare types of findings too(i had to obtain 3 seperate NS opinions for what i had, all different from one another too?)? then it gets insane in what you actually even get told?

what actual symptoms are you having? the symptoms you display, along with when any good neurosurgeon simply does the hands on neuro exam can really tell alot about whether the impact with your cord/thecal sac findings actually ARE or are not impacting the cord just by the way you own body will respond to that hands on form of testing too? but just knowing what your actual symptoms are, or have been at times(the intermittant types?) would help alot in seeing just how truely impactful at least some of the findings actually are? and of course what the other doc actually told you that you are having the problems with? Marcia

i am seriously wondering what it states about what is termed a 'small bulge" can actually even begin to impact that thecal sac?? usually its more profound and larger bulges that only would do that to the thecal?? just kind of odd.
__________________
3-22-01,herniated C-6-7
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.

 
Old 06-20-2010, 01:07 PM   #5
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Re: HELP - Need a direct, honest MRI Report Interpretation

Hi all:

I am sorry about posting my inquiry in the manner I did. I did not intend to go against the policies of this discussion site.

What I should have asked is if i could have someone read my report and break it down into a more simplified way so that I understand what it is exactly I'm working with. My doctor did not spend the time to sit with me and explain what was in the report, which I was not pleased about. He is strictly a spinal pain management doctor and quickly jumped into "pain management" options he suggested, (accupunture, chiropractic, possible steroidal injections) but was so flippy floppy and didnt give me a strong opinion as to which one he thought was best. Since I dont really understand the real significance of the report....Im working blindly on my decision for next steps.

Pain wise, I have had a constant nagging back ache (sometimes a little burning in my lumbar region, mid back surround my spine, inner sholder blades, and in the down the middle of the back of my neck. My neck has gotten progessively worse, and the pain pain (ache and burning) more intense, with an increase in limited mobility forward and backward.

So I guess what I reall want to get advise on is whether I should go to a spinal surgeon and discuss options for correction (if theasable) or try another route like the pain management route. My worry is that...I may be able to manage the uncomfortableness and pain, but not work toward resolving or retarding the condition.

 
Old 06-21-2010, 09:38 AM   #6
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Re: HELP - Need a direct, honest MRI Report Interpretation

don't worry about the 'way' you asked your question there kev, anything 'new" IS kind of trial and error here ya know?

what i would simply do here isf i were you is to actually seek out a good neurosurgeon for a full hands on neuro evaland consult ON the MRI films that they will WANT you to also bring with you too? most good specialists really do not spend too much time really reading thru your report when 'their' overall level of real hands on innerworking knowledge and experience that they just 'have", they simply prefer to do their own 'read' and interpretation of your actual films themselves? they may see other things that a mere rad may have missed there or see findings there in that report a bit differently too? the actual eval and consult checks YOU out neurologically with hands on testing of certain things and how a persons body simply responds when a particular area is being impacted by certain things? but it is also kind of a 'second opinion" on your actual films too. your pain doc siimply does NOT have even close to the overall amount of real knowledge/understanding of things like most neurosurgeons just do so that opinion is only that, "his opinion" and nothing more. that is why you just DO need that more experienced and surgical consult and eval done by the specialist. but DPO seek out a good neurosurgeon for this and NOT someone like just an orthosurgeon? when up in that c spine area,there is just ALOT of very critical and much more highly innervated areas that are all sqeezed into a very limited space,unlike the rest of that spinal is? so you just DO need that more advanced and specialized NS for the really best opinion of what HE actually feels are your mosrt critical findings and what any possible treatment options may be that may not always BE a surgicvcal one. but in your particular case, some of the findings would appear to need at least some levels of more surgical intervention like the c 5-6 findings that ARE impacting the front part of your actual spinal cord? and i still cannot understand what that rad called 'small" bulges at i think it was c 6-7? that are actually even ABLE to be realistically impacting that thecal sac at all there?? that one just has me wondering how much actual space you have there anatomically(between the vertebrae and the thecal sac)? the thecal is also what is called the "dura"? thats just the outter surrounding 'sac" that runs around the entire CNS basically? it surrounds the brain and the cord all in one long running interconnected 'sac' of the CSF fluid that simply keeps the brain and the cord bathed in that fluid all the time? and it also acts as somewhat of a 'cushion" for the cord itself for impact protection?

but DO seek out the referral for that NS eval/consult from either your primary doc or the pain doc. you just seriously DO NEED that level of opinion and options, along with the NSs eval too. he also REALLY needs to see those hardfilms himself too so HE can give HIS real opinion on the findings in HIS educated and experienced way. hopefully you can get in to see one more quickly than it generally takes for seeing ANY real specialist. but DO please keep us posted kevin, marcia
__________________
3-22-01,herniated C-6-7
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.

 
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