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Old 03-17-2012, 08:40 AM   #1
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Question Cervical MRI help

If anyone can help me understand this better I sure would appreciate it. In 2009 I started have extremely severe headaches that would start at the base of my brain, radiate around the right side of my head to my forehead. Almost continual throbbing pain. I also started having episodes of pain in my right shoulder. At the time I was 63 years old, and although I have never suffered from migraines my Dr. treated me with medication for migraines which did nothing. With physical exertion I would experience numbness and tingling, blurred vision in my right eye, slurred speech, and become so weak I would just suddenly fall to the ground. Echocardiogram, doppler, MRI of the brain were normal. By 2010 I started have problems with my balance and gait, at times my legs would go numb and I didn't have the ability to walk. By 2010 simple things like button a shirt, writing, became extremely difficult. Bilateral episodes of numbness, tingling and pain in my shoulders, arms, hands, and neck. I also had to stop driving because I would continually be veering off to the right. In 2011 I was seen by a neurologist and had an EEG done. There was no epileptic activity, but it did show "low amplitude recordings which may be found in neurodegenerative disorders". The neurologist also found hyperreflexia, two beats of clonus bilaterally, and strength testing slightly below normal. He ordered a MRI of my cervical spine which showed the following on a T1 and T2 weighted sequence in saagittal and transverse planes.
C2-C3: normal
C3-C4: Disc osteophyte complex is seen resulting in deformity of ventral thecal sac and narrowing of the the spinal canal which measures 9 mm in maximum sagittal diameter. Formaminal narrowing is seen bilaterally.
C4-C5: Disc osteophyte complex is noted resulting in deformity of ventral thecal sac and narrowing of the spinal canal to 8 mm in maximum mid sagittal diameter. Foraminal narrowing is seen bilaterally.
C5-C6: Disc osteophyte complex is noted resulting in deformity of ventral thecal sac and narrowing of the spinal canal which measures 9 mm in maximum sagittal diameter. Foraminal narrowing is seen bilaterally.
C6-C7: Mild disc osteopyte complex is seen resulting in deformity of ventral thecal sac without central canal stenosis. Mild foraminal narrowing is seen on right side.
He sent me to a neurosurgeon who said I had just mild osteoarthritic changes in my spine, and he would treat me if I wanted with epidural steroid injections if I wanted.
What's going on? Is this MRI showing more then mild osteoartritic changes. My quality of life is nothing anymore, and I just seem to be getting worse.

 
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Old 03-17-2012, 09:54 AM   #2
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Re: Cervical MRI help

I've seen a lot worse than 8-9mm cord, including my own. I'm not a believer, though, in absolute correlation between the amount of cord compression and problems caused by that compression. So 8-9mm isn't "bad", but I wouldn't say that it is necessarily not problematic.

It would also be helpful if the radiologist had indicated the amount of foraminal narrowing at C3-6. Since he says it's "mild" at C6-7, I guess we should infer that it's worse at the higher levels, whether "moderate" or "severe" we can't tell.

Given your MRI, and your symptoms, I think you need at least one more opinion. I would not yet be prepared to accept that NS's opinion. I'm not saying he's wrong, only that I would want confirmation.

Sorry I can't be of better help to you...

Last edited by WebDozer; 03-17-2012 at 10:48 AM.

 
Old 03-17-2012, 04:17 PM   #3
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Re: Cervical MRI help

Thanks for the reply and I agree that I should get the opinion of another NS. I do believe that a lot of what's going on with me is due more to foraminal narrowing. Maybe another NS might suggest a nerve conduction study or myelogram. Hopefully that might define more accurately what's going on.

 
Old 03-17-2012, 05:27 PM   #4
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Re: Cervical MRI help

You might want to read up a little on an operation called a laminoplasty. I had one at C4-C5-C6 last summer. I wrote up my thinking and decision process in a thread called Cervical Laminoplasty Chronicle.

 
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Old 03-18-2012, 11:06 AM   #5
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Re: Cervical MRI help

Football 41, Sorry to hear of your distressing condition. Did you in fact play football or have a sport or occupation in which you had any head trauma, and not neccessarily often or that forcefull ? Do you know if any of your forebearers suffered similarly?
James

 
Old 03-18-2012, 04:53 PM   #6
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Re: Cervical MRI help

I agree with Webdozer....you should look for a doc who does the new "laminoplasty" surgery. It is the perfect answer to your type of problem(mine too...I've had it).

Like you, my cord was being compressed down and down in thickness by bone spurs from arthritis and bulging disks along with thickening of the back of the canal. My symptoms were very similar to yours but not quite as dramatic maybe because I had pretty equal problems on both sides so not one particular side was affected like your right side seems to be.

Traditional surgery for the neck involves the surgeon going in from the front of the neck and removing bad disks and then using plates, screws and bone grafts, fuses the entire neck in place. But when you have a bad canal and not a problem with herniated disks, that does not help. So a relatively new surgery(at least new here but done overseas for a decade plus)was developed to address this canal problem..the laminoplasty.

In the laminoplasty, the surgeon goes in from the back and literally re-builds the back of the spine, doubling the amount of room in the canal itself so the spinal cord can expand. Takes some ingenious engineering but it works. My cord was down to 5-6mms at the worse and 7-8mms at the best spots. Now my cord is fully expanded. All pain and numbness was gone as soon as I awoke from surgery.

The biggest problem is finding someone who does the surgery. But we can try to help you with that.

Can you tell us which big city you live nearest to so we can see if we know of anyone around you for a second opinion?

This can and should be fixed.

hugs........Jenny

 
Old 03-18-2012, 05:53 PM   #7
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Re: Cervical MRI help

I'd say I don't know what's "perfect" for you. I thought of laminoplasty because you have a multi-level problem that MAY have a certain component of developmental stenosis. We don't know that, though, because the radiologist did not give measurements - or even adjectives - to tell us how big those disk/osteophyte complexes are.

To explain... if the radiologist had said you have "large" disk bulges, or that the bulge are "5mm", then I might say, OK, it's the bulges that are the problem, and they may need to be removed. This would require the traditional diskectomy/fusion (ACDF) surgery.

If, on the other hand, the radiologist had said the disk bulges were smaller - say 3mm - then your basic problem might not be the bulges themselves, but that the spinal canal is too narrow to start out with. This is kind of thing that can be addressed by a laminoplasty.

My suggestion you educate yourself about laminoplasties was based on a hunch, nothing more. And, or course, my opinions should never substitute for those from multiple medical professionals.

 
Old 03-18-2012, 08:58 PM   #8
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Re: Cervical MRI help

I did play four years as a strong safety at the University of Wisconsin and some pro for the Denver Broncos and Saints. I admit I did a lot of hitting with my head, but it was my knees at the time that did me in.

 
Old 03-18-2012, 09:14 PM   #9
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Re: Cervical MRI help

Thanks so much for the the info both you and webdozer have supplied. What a great web site! The closest city I live by is Kansas City. I have done some checking on the web for NS out of that area this past weekend. I'm curious if either one of you ever experienced a type of clicking noise in your cervical area?

 
Old 03-18-2012, 09:54 PM   #10
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Re: Cervical MRI help

fb41.... All those years of hitting with your head, or getting hit on the head, puts this into a new light. Doesn't the NFL - or the Players' Association - have people you can see about this? While some of your symptoms certainly MAY originate at the cervical spinal level, others would seem - to my uneducated eye - to originate higher up. Particularly the vision and speech problems.

I'm afraid that concentrating on the possible cervical spinal problems may distract you from more important things elsewhere.

I certainly wish you success at getting to the bottom of this....

 
Old 03-18-2012, 09:57 PM   #11
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Re: Cervical MRI help

Quote:
Originally Posted by football41 View Post
I did play four years as a strong safety at the University of Wisconsin and some pro for the Denver Broncos and Saints. I admit I did a lot of hitting with my head, but it was my knees at the time that did me in.
Were you ever asked if you had head truma by the doctors.
This may be a cause of your grief and the MRI results could mean nothing, that being seen is perhaps no different than from an asymptomatic person of your age.
A point against your brain being injured is that your post was eloquent fluid and articulate. I don't know if cognition and symptoms and signs that you have can exist together.
James

 
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