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Old 06-27-2012, 11:16 AM   #1
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Mri over past few years comparison

Hi. I've been having neck/back problems ever since I can remember. I didn't find out until after I had my first daughter that I had all this stuff wrong with my cervical spine. The earliest MRI I can find (I think my friend in VA has my MRIs from 1989-90) are from 2006. So I've typed them up and I'm hoping someone can take the time to look at them and let me know if they think anything has changed from the findings listed.... I would be forever grateful! (Sorry...it's kind of long.)

DATE OF SERVICE: 08-14-2006
MRI CERVICAL SPINE WITHOUT CONTRAST
FINDINGS: A severe cervical rotoscoliosis with convexity to the right is noted. No subluxation or retrolisthesis is seen.
A partial congenital interbody fusion is noted at the C4-C5 and C7-T1 level with hypoplasia of the adjacent endplate. The cervical vertebrae reveal no compression fracture or marrow replacement. Diminished signal of the C5-C6 cervical disc is seen with mild spondylosis. The posterior elements reveal no subluxation of the facet joints or occult fracture. No occult spina bifida is identified. The C1-C2 relationship is anatomic with normal segmentation.
The cervical cord as well as cervicomedullary junction reveal no intra or extramedullary mass. No cord syrinx is present.
The C2-C3 level is normal.
At C3-C4 an annular disc bulge with small ventral osteophytes are noted. Moderately severe hypertrophy of the left facet joint is seen with severe narrowing of the left neuroforamen.
At C4-C5 a partial interbody fusion is noted. No focal disc herniation or canal stenosis is present. Mild narrowing of the right neuroforamen is seen.
At C5-C6 disc desiccation with an annular disc bulge is seen flattening the thecal sac. Mild narrowing of the right neuroforamen is present.
The C6-C7 level reveals no focal disc herniation. Mild narrowing of the right neuroforamen is seen.
At C7-T1 a partial interbody fusion is seen without canal stenosis or foraminal narrowing.
IMPRESSION:
1. A SEVERE CERVICAL ROTOSCOLIOSIS IS SEEN WITH A CONVEXITY TO THE RIGHT.
2. A PARTIAL INTERBODY FUSION IS NOTED AT THE C4-C5 AND C7-T1 LEVEL WITH HYPOPLASIA OF THE ADJACENT ENDPLATE. THE POSTERIOR ELEMENTS ARE INTACT.
3. AT C3-C4 MODERATELY SEVERE HYPERTROPHY OF THE LEFT FACET JOINT IS SEEN WITH SEVERE NARROWING OF THE LEFT NEUROFORAMEN.
4. THE C4-C5, C5-C6 AND C6-C7 LEVELS REVEAL MILD NARROWING OF THE RIGHT NEUROFORAMEN. NO CANAL STENOSIS OR FOCAL DISC HERNIATION IS PRESENT.
**************************************** ******************
DATE OF EXAM: 10-11-2007
PROCEDURE REQUESTED – C-SPINE 2 OR 3 VIEWS
FINDINGS: FRONTAL, LATERAL, AND OPEN MOUTH ODONTOID VIEWS OF THE CERVICAL SPINE, DATED OCTOBER 11, 2007:
Dextro convex scoliosis of the cervical spine with a segmentation abnormality of the C5 vertebral body. There is suggestion of fusion of the right posterior elements. No acute fracture is identified.
Lateral mass of C1 and C2 are aligned. Odontoid process in intact. Predental and prevertebral soft tissues are unremarkable.
IMPRESSION: As above.
**************************************** ******************
DATE OF SERVICE: 01-18-2008
PROCEDURE: CERVICAL SPINE X-RAYS
FINDINGS: This patient has a moderate slight convex scoliosis. There are multiple congenital vertebral body anomalies of the cervical spine. There appears to be a hemivertebra at C4 and likely a butterfly vertebra at C7.
The prevertebral soft tissues are normal. There is no evidence of acute trauma.
On the lateral radiograph a fairly normal cervical lordosis is noted.
IMPRESSION:
1. MULTILEVEL CONGENITAL VERTEBRAL BODY ANOMALIES. IF THIS PATIENT HAS NOT HAD A CT EVALUATION IN THE PAST IT IS SUGGESTED THAT A CT OF THE CERVICAL SPINE WITH RECONSTRUCTIONS BE PERFORMED.
2. NO EVIDENCE OF ACUTE FRACTURE PERCEIVED ON PLAIN FILM.
**************************************** ******************
DATE OF EXAM: 02-22-2008
PROCEDURE: CERVICAL CT WITHOUT CONTRAST
FINDINGS: The craniocervical junction is normal. Atlantooccipital joints are normal.
C1-2: The atlantoaxial joints are symmetric. Exit foramina are patent.
C2-3: The C2 vertebra is symmetrically formed. C2-3 exit foramina are patent. There is congenital disc-space narrowing at the C2-3 disc level, with partial fusion across the disc space posteriorly. The C2-3 facet joints are narrowed although not completely fused. There is some congenital asymmetry of the posterior elements of C3.
C3-4: There is degenerative disc-space narrowing and minimal annular disc bulge. No cord flattening. Congenital asymmetry of the C3 posterior elements results in moderate left exit foraminal narrowing. This could affect the left C4 exiting nerve root. The right foramen is patent.
C4-5: There is segmentation anomaly at this level. No disc space is visible. The combined C4-5 vertebrae has two right-sided pedicles with the right C4-5 foramen widely patent. The right C4-5 facet joint/articular masses are fused. The left half of the vertebrae has only a single combined pedicle and is diminished in cephalocaudal dimension. This results in focal dextroscoliosis at this level.
C5-6: There is a degenerative disc-space narrowing and discogenic endplate irregularity between the combined C4-5 anomalous vertebra and the C6 vertebra. There is congenital asymmetry of the C6 posterior elements. Hypertrophic changes are seen at the facets joints. The exit foramina are patent. Central canal is patent.
C6-7: Disc space is maintained. No obvious disc herniated or central stenosis. The exit foramina are patent despite congenital asymmetry of the posterior elements. The left C7 transverse process is somewhat elongated and may represent a hypoplastic cervical rib.
C7-T1: There is a partial segmentation anomaly of the C7 and T1 vertebrae. No obvious central canal stenosis is present. There is soft tissue attenuation in the left C7-T1 foramen, this is nonspecific. No obvious bony foraminal compromise.
There is only limited evaluation of the cervical spinal cord. No bony septation is seen within the cervical canal.
IMPRESSION:
1. MULTILEVEL CONGENITAL ANOMALIES OF THE CERVICAL VERTEBRAE INCLUDING PROMINENT SEGMENTATION DEFECT AT C4-5. THIS RESULTS IN FOCAL DEXTROSCOLIOSIS. THESE ANOMALIES EXTEND DOWN TO THE CERVICOTHORACIC JUNCTION WITHOUT OBVIOUS CENTRAL CANAL STENOSIS.
2. LEFT C3-4 FORAMINAL NARROWING COULD CONTRIBUTE TO C4 RADICULAR SYMPTOMS.
3. IF FURTHER EVALUATION OF THE CERVICAL SPINAL CORD, OR EXIT FORAMINA, IS CLINICALLY INDICATED, CERVICAL MRI WOULD INCREASE SENSITIVITY AND SPECIFICITY.
4. NO OBVIOUS CERVICAL FRACTURE OR DEGENERATIVE SUBLUXATION.
**************************************** ******************
DATE OF EXAM: 04-24-2008
PROCEDURE: CERVICAL CT WITHOUT CONTRAST
FINDINGS: Comparison is made to previous CT from 02-22-2008.
The craniocervical junction is grossly unremarkable. Atlantooccipital joints are symmetric and unremarkable.
C1-2: Unchanged. Atlantoaxial joints are symmetric. Exit foramina are patent.
C2-3: Unchanged. The C2-3 exit foramina are patent. Central canal is patent. There is congenital disc-space narrowing at the C2-3 disc level with partial fusion across the disc space. There is narrowing of the C2-3 facet joints, possibly with some partial fusion although complete fusion is not present. There is congenital asymmetry of the posterior elements at C3.
C3-4: Unchanged. There is left exit foraminal narrowing which could affect the C4 exiting nerve root. This is related to congenital asymmetry of the posterior elements and left facet hypertrophy. The right foramen is patent. There is mild degenerative disc-space narrowing and annular disc bulge. No cord flattening.
C4-5: Unchanged. There is asymmetric segmentation anomaly at this level. No disc space is visible. There are two right-sided pedicles with a patent right C4-5 foramen. The right facet joint/articular masses are fused. There is a single combined on the left. This results in focal dextroscoliosis centered at this level. No subluxation.
C5-6: Unchanged. There is a degenerative disc-space narrowing and discogenic endplate irregularity. Central canal and exit foramina appear patent despite hypertrophic changes in the facet joints.
C6-7: Unchanged. There is congenital asymmetry without obvious disc herniation or cord flattening. Central canal and exit foramina appear patent.
C7-T1: Unchanged. No canal or exit foraminal stenosis. Asymmetric segmentation anomaly is again noted.
T1-2: There is soft tissue attenuation in the left lateral recess and foramen which is nonspecific although raises the possibility of the disc herniation. Due to the congenital segmentation asymmetry, the normal venous plexus also is asymmetric and could contribute to this appearance.
IMPRESSION:
1. MULTILEVEL CONGENITAL SEGMENTATION ANOMALIES DESCRIBED IN DETAIL ABOVE AND ON THE PRIOR STUDIES. THERE IS FOCAL DEXTROSCOLIOSIS RELATED TO THIS. THESE ARE UNCHANGED.
2. LEFT C3-4 FORAMINAL NARROWING COULD CONTRIBUTE TO C4 RADICULAR SYMPTOMS, UNCHANGED.
3. ASYMMETRIC SOFT TISSUE ATTENUATION ON THE LEFT INVOLVING THE T1-2 FORAMEN AND LESS SIGNIFICANTLY THE C7-T1 FORAMEN. THE SIGNIFICANCE AND ETIOLOGY ARE UNCERTAIN. IF THERE IS CONCERN FOR LEFT C8 OR T1 RADICULAR SYMPTOMS, MRI WOULD BETTER DELINEATE.


I'm also going to post the findings for my shoulder, lumber and thoracic spine separately. Thanks!!!

 
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Old 06-27-2012, 11:18 AM   #2
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Re: Mri over past few years comparison

Shoulder:

(This one I'm very confused about. Of course I have no idea what this really means but it seems like it's saying that I had a tear back in 2009 and now I don't? All I know is that my shoulder still hurts like it did back then...and the surgeon I was seeing at that time wanted to do surgery.)

DATE OF SERVICE: 04-03-2009
FINDINGS: There is moderate supraspinatus rotator cuff tendinitis with a small focus of intermediate-grade partial-thickness bursal surface tear of the distal supraspinatus portion of the rotator cuff tendon that may traverse up to 75 percent of the thickness of the tendon over a small region without full thickness tear, cuff rupture or retraction.
There is mild glenohumeral and acromioclavicular osteoarthritis with some inflammatory changes of the acromioclavicular joint producing what may be borderline findings of rotator cuff impingement associated with some mild subacromial-subdeltoid bursitis. There is also minimal proximal bicipital tendinitis and tenosynovitis. There is no acute or active bone process.
IMPRESSION:
1. SUPRASPINATUS ROTATOR CUFF TENDINITIS ASSOCIATED WITH A SMALL FOCUS OF INTERMEDIATE-GRADE PARTIAL-THICKNESS BURSAL SURFACE TEAR OF THE DISTAL SUPRASPINATUS TENDON WITHOUT CUFF RUPTURE, RETRACTION OR FULL-THICKNESS TEAR.
2. MILD ASSOCIATED SUBACROMIAL-SUBDELTOID BURSITIS, BICIPITAL TENOSYNOVITIS AND MILD INFLAMMATORY CHANGE OF A MILDLY DEGENERATED AND HYPERTROPHIC ACROMIOCLAVICULAR JOINT WITHOUT FINDINGS OF ACTUAL CUFF IMPINGEMENT.
**************************************** ************
DATE OF SERVICE: 06-18-2012
FINDINGS: Mild degenerative arthrosis at the AC joint. Thickening and intermediate signal intensity supraspinatus tendon compatible with intermediate-grade tendinosis. There is no evidence of rotator cuff tear. The small partial tear described previously not as well delineated on today’s exam. There is mild subacromial and subdeltoid bursitis. There is mild tenosynovitis long head biceps tendon. There is no evidence of detached labral tear. Muscle bulk is intact.
IMPRESSION: INTERMEDIATE-GRADE TENDINOSIS SUPRASPINATUS TENDON. THERE IS MILD SUBACROMIAL-SUBDELTOID BURSITIS. THERE IS NO EVIDENCE OF FULL-THICKNESS ROTATOR CUFF TEAR. MILD TENOSYNOVITIS LONG HEAD BICEPS TENDON. MUSCLE BULK IS INTACT.

 
Old 06-27-2012, 11:20 AM   #3
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Re: Mri over past few years comparison

LUMBAR:

DATE OF SERVICE: 08-14-2006
MRI LUMBAR SPINE WITHOUT CONTRAST
FINDINGS: The alignment of the lumbar spine is anatomic revealing no subluxation or retrolisthesis. Narrowing with diminished signal of the L5-S1 intervertebral disc is seen. The lumber vertebrae reveal no compression fracture or marrow replacement. The posterior elements are intact revealing no spondylolysis.
The conus medullaris as well as cauda equine reveal no intra or extradural mass.
The L1-L2, L2-L3 and L3-L4 levels are normal.
At L4-L5 an annular disc bulge is seen without focal disc herniation or foraminal encroachment.
At L5-S1 disc desiccation is seen. A focal 3.0 mm subligamentous disc herniation is present. Mild facet joint arthrosis with mild thickening of the ligamentum flavum is seen. Mild bilateral foraminal encroachment is present.
On sagittal T2W images a retroflexed uterus is noted.
IMPRESSION: ANATOMIC ALIGNMENT OF THE LUMBAR SPINE IS SEEN. AT L5-S1 MILD DEGENERATIVE DISC DISEASE WITH A FOCAL 3.0 MM SUBLIGAMENTOUS DISC HERNIATION IS PRESENT. FACET JOINT ARTHROSIS WITH MILD BILATERAL FORAMINAL ENCROACHMENT IS SEEN.
A RETROFLEXED UTERUS IS PRESENT.
**************************************** **************************************** ****
DATE OF SERVICE: 01-31-2007
FINDINGS: The conus medullaris is normal in size, shape and signal intensity, terminating at the L1 vertebral body level. Nerve roots of the filum terminale layer dependently within the thecal sac, normal in appearance. Marrow signal is normal in appearance throughout lumbar vertebral bodies, without evidence of occult fracture.
Sagittal and axial images were obtained through the L5-S1 disc level demonstrate disc desiccation and slight disc height loss. Annular bulge is complicated by central disc extrusion with caudal migration. Disc material measures 12 mm in craniocaudal dimension, both traversing S1 nerve root sleeves. No canal or foraminal stenosis is observed. Posterior facet arthropathy is not present.
Sagittal and axial images were obtained through the L4-5, L3-4, L2-3 and L1-2 disc levels demonstrate normal hydration and height. No focal protrusion or bulge is seen. No canal or foraminal stenosis is evident. Posterior facet arthropathy is not present.
IMPRESSION:
1. CENTRAL DISC EXTRUSION ORIGINATING FROM THE L5-S1 DISC LEVEL MIGRATES CAUDALLY BENEATH THE POSTERIOR LONGITUDINAL LIGAMENT. THE DISC EXTRUSION IS CONTAINED BY EPIDURAL FAT, BUT DOES APPEAR TO CONTACT BOTH TRAVERSING S1 NERVE ROOT SLEEVES, POTENTIALLY IRRITATING EITHER ONE. NEITHER APPEARS DEFLECTED, AND NO CANAL OR FORAMINAL STENOSIS RESULTS.
**************************************** **************************************** ****
DATE OF SERVICE: 04-03-2009
FINDINGS: At L4-5, there is a mild broad posterior disc protrusion associated with some loss of disc height and loss or normal T2 disc signal. This is associated with mild facet arthrosis and this produces mild lateral recess stenosis bilaterally with crowding but not actual deformity or impingement of exiting L5 and descending S1 nerve roots and this is therefore a possible although not necessarily likely explanation for L5 or more likely S1 symptoms.
The remaining lumbar disc levels are normal in appearance. Vertebral body signal, height and alignment is preserved with the exception of some mild straightening of normal lordosis at the L1-2 disc level. There is no paraspinal soft tissue abnormality noted and there is no abdominal aortic aneurysm.
IMPRESSION: MILD BROAD POSTERIOR DISC HERNIATION AT L5-S1 INDENTING THE VENTRAL THECAL SAC AND PRODUCING MILD CANAL STENOSIS. CONTACT WITH S1 NERVE ROOTS BILATERALLY MIGHT EXPLAIN S1 SYMPTOMS ON EITHER SIDE DESPITE THE ABSENCE OF FINDINGS OF ACTUAL NERVE ROOT DEFORMITY. THERE IS NO OTHER SIGNIFICANT ABNORMALITY NOTED.

 
Old 06-27-2012, 11:21 AM   #4
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Re: Mri over past few years comparison

THORACIC:

DATE OF SERVICE: 08-14-2006
MRI THORACIC SPINE WITHOUT CONTRAST
FINDINGS: The alignment of the thoracic spine reveals no thoracic scoliosis or subluxation. The thoracic vertebrae are normal is size and configuration revealing no marrow replacement or compression fracture. The posterior elements including pedicles, lamina and spinous processes are intact. No paravertebral soft tissue mass is seen.
Transaxial as well as sagittal images reveal at T1-T2 an annular disc bulge. At T6-T7 and T7-T8 mild disc desiccation with an annular disc bulge is seen. No focal disc herniation, cord compression or foraminal encroachment is noted.
The thoracic cord and conus are well seen and reveal no intra or extramedullary mass. No cord syrinx or demyelination plaque is present.
IMPRESSION:
ANATOMIC ALIGNMENT OF THE THORACIC SPINE IS SEEN. AT T1-T2, T6-T7 AND T7-T8 DISC DESICCATION WITH AN ANNULAR DISC BULGE FLATTENS THE THECAL SAC. NO FOCAL DISC HERNIATION OR NERVE ROOT IMPINGEMENT IS NOTED.
NO THORACIC COMPRESSION FRACTURE IS SEEN. THE THORACIC CORD IS NORMAL.
**************************************** **************************************** ****
DATE OF EXAM: 10-11-2007
FINDINGS: FRONTAL AND LATERAL VIEWS OF THE THORACIC SPINE, DATED OCTOBER 11, 2007:
There is no fracture or dislocation of the thoracic spine. No compression deformity is identified. Scoliosis of the cervical spine is noted.
IMPRESSION: No fracture or dislocation of the thoracic spine.

 
Old 06-27-2012, 11:35 AM   #5
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Re: Mri over past few years comparison

No cervicals in last four years?

 
Old 06-27-2012, 11:45 AM   #6
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Re: Mri over past few years comparison

Quote:
Originally Posted by WebDozer View Post
No cervicals in last four years?
Ya know...now that you say that...I went to see a neurosurgeon to see if he thought surgery was needed and I brought him a CD (since I moved here in 09). And I think I left it there with him. So maybe the "findings" document was in the envelope. I called after that appt to tell them that they still had it but they insisted that they gave it back to me. Which is not true because I keep all of it together. So I think I'm going to see if I can get another copy tomorrow. And if/when I do...I'll post that info.

He said he didn't want to do surgery because he would have to cut me from the front and the back and unless my spinal cord was in danger...he didn't want to put me through that. I'm glad you reminded me of that! Thanks. (Do you see any changes from what I have listed?)

 
Old 06-27-2012, 11:51 AM   #7
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Re: Mri over past few years comparison

Quote:
Originally Posted by WebDozer View Post
No cervicals in last four years?
FYI: I just looked and I have the actual films from Sept 2010 of my cervical but I don't see the CD or the document with the "findings" so I did have some done since the last one I have listed.

 
Old 06-27-2012, 12:14 PM   #8
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Re: Mri over past few years comparison

I don't see significant changes. Of course, most of what they're describing is congenital, so one would not expect changes.

You may have a problem with left C4 radiculopathy. Not sure what the symptoms would be, other than local pain and maybe trouble breathing?

If fixing the C3-4 foramen would help, I would think a foraminotmy would suffice.

 
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