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Old 06-23-2012, 05:20 AM   #1
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Question C5,C6,C7 Borderline central canal & foraminal stenosis

Hi,
I'm new to this board (but a regular on the back problems board as I'll be having a decompression surgery on L3,L4,L5 sometime this year for severe spinal stenosis and extensive facet arthritis).

I just got the results of my C-spine T-spine MRI: Any insight would be appreciated.

C2-C3, C3-C4, C4-C5: Unremarkable! (THANK GOD!!!)

C5-C6: Irregular left foraminal & paramedian disc spur complex causes mild anterior impression upon the cord and mild to moderate left foraminal stenosis. Central canal is lower normal caliber. Right foramen is patent.

C6-C7: Shallow disc-spur complex is present. There is some anterior cord flattening. Central canal & foramina are lower normal caliber.

C7-T1: Unremarkable! (THANK GOD!!!)

T- Spine: Unremarkable! (THANK GOD!!!)

IMPRESSION:
1. Mild to modrate left foraminal stenosis C5-C6 due to left paramedian and foraminal uncovertebral spur.
2. Borderline central canal & foraminal stenosis C6-C7 due to shallow broad-based disc spur complex.

I understand foraminal stenosis and basic stenosis but this is what I don't understand:

1) central canal & foramina being lower normal caliber?

2) Right foramen is patent...what is that?

3) Anterior cord flattening?

4) What is the difference between stenosis and then cord flattening? I know that the spinal cord stops at T12....so I am really concerned about the cord flattening....like is there potential for paralysis?

Thanks for reading and hopefully commenting on this.

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Old 06-23-2012, 08:48 AM   #2
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Re: C5,C6,C7 Borderline central canal & foraminal stenosis

<< 1) central canal & foramina being lower normal caliber? >>

I haven't seen that terminology before. Unless it has some specific medical meaning, I would go with the obvious, which is that the canal and foramina are less than optimal, but still acceptable.

<< 2) Right foramen is patent...what is that? >>

Patent = unobstructed

<< 3) Anterior cord flattening? >>

The cord, which should be roundish, has been flattened in front.

<< 4) What is the difference between stenosis and then cord flattening? >>

"Stenosis" just means "narrowing", and is usually applied to a passageway, like the spinal canal or the foramina. A person may be born with a stenotic spinal canal (I think you may have been), or the canal may become stenotic over time because of intrusions by disks, osteophytes, or swollen ligaments. Cord flattening is a possible consequence of spinal canal stenosis, in that the canal can only be narrowed so much before the buffer for the cord is gone and the cord itself is affected by whatever is intruding into the canal.

<< so I am really concerned about the cord flattening....like is there potential for paralysis? >>

There's POTENTIAL for it, and if you were to suffer some kind of severe trauma (e.g. auto accident) it could be said that you have a head start, but it's more likely that you will develop symptoms more slowly. I wouldn't be surprised if a sizable percentage of people over 60 have some kind of cord impingement, but how often do you see actual paralysis?

What are the symptoms that led you to get the MRI?

Last edited by WebDozer; 06-23-2012 at 08:50 AM.

 
Old 06-24-2012, 05:11 AM   #3
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Re: C5,C6,C7 Borderline central canal & foraminal stenosis

Thanks for your reply,

I'm 48, fit, active, healthy, thin, tall, etc. I've had both knees replaced, arthritis in my L ankle...2 surgeries on that and now the L spine issues and the C spine issues. I've been tested for all kinds of arthritis but it's been suggested to me that I have an aggressive-systmeic form of OA...not the normal wear and tear OA we get as we age but much worse. It is not Rheumotoid arthritis but I'vebeen referred to Rheumatology to do more testing as all docs who see my images, my, age, and then see me in person are all dumbfounded at the extent of my arthritis.

My L spine surgeon wanted to do an MRI on the rest of my spine b/c the Lumbar spinal arthritis is so extensive. He wanted to make sure that my C-spine wasn't as bad. The symptoms I have that relate to the C-spine are tingling down my arms, weakness in my thumb and pointer finger, intermittent tightness on my L neck and shoulders and sometimes difficulty swallowing. These symptoms are manageable...unlike the L spine isses (that have progressively gotten worse over the past 4 years). I am still fearful for the paralyses part in my C spine...as the canal stuff shouldn't be there in someone as "young" as me.

In looking at the L MRI..my surgeon showed me where the stenosis is at L3,L4,L5...and then showed me the rest of my L spine, which is nice and large and open...so, I don't think that I was born with stenotic spinal canal... (??). My L-spine surgeon referred me to neuro surg for the C-spine issues. I meet with them in August.

Thanks again for responding...if you any other ideas please let me know!

 
Old 06-24-2012, 08:14 AM   #4
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Re: C5,C6,C7 Borderline central canal & foraminal stenosis

The radiologist says you have only mild-to-moderate left C5-6 foraminal stenosis, but it's clearly worse than that, as you are developing symptoms of C6 radiculopathy.

I didn't meant to imply that you were over 60, only that there are a LOT of people walking around with undiagnosed spinal problems. I had a C3-4 ACDF at age 44 to fix a badly herniated disk, followed by a foraminotomy at 52 and a laminoplasty at 59.

The reason I thought you might have hereditary cervical canal stenosis (which I have) is that it doesn't seem to take very much before your cord is affected, which makes me think it doesn't have as much buffer as it should. A good radiologist will mention if he thinks the canal is too narrow, but the average MRI report is not very good.

Considering your OA problem, you might want to keep an eye on the cervical issues. It may not be long before surgery would be appropriate (if it isn't already). I'm thinking that a decompression (laminoplasty) with accompanying foramintomies might be the best approach. I'm not sure how much good an ACDF would do you. Since laminoplasties still are not that common in the U.S., it might be a good idea to find a VERY good surgeon who has a lot of experience with them and get him to look at your MRI, just so you've started the process.

If you want to know a little more about laminoplasties (from my perspective), I wrote a thread here called Cervical Laminoplasty Chronicle.

 
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