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-   -   MRI help for a new comer (http://www.healthboards.com/boards/spinal-cord-disorders/911085-mri-help-new-comer.html)

Scrappylucie 07-24-2012 12:11 AM

MRI help for a new comer
 
Hi everyone :-)

I've been a visitor to this site for a while now, while I waited on the slow wheels of our Canadian health care to fit me in.

I've had my cervical MRI and just received the results from my GP, who has referred me to a Nerosurgeon , again this will entail a lengthy wait....
She said very little as to what the results mean in lay man's language, I'm hoping some of you very knowledgable people might help me break it down :-)

A little history,
46 -healthy other than spine and arthritic issues
( USED- TO rock climb, marathon and generally into any thing athletic and outdoors. )
Torn Bicep 5 yrs ago - on the job accident, durring imaging (x-ray discovered I had DDD, didn't think much of it. Occassional neck strains that I worked through with physical therapy.

Last year I started to have " issues " with my hands - pins and needles, deep aching pain through pinky, ring and some of middle finger, started with one hand and quickly became both hands ( left hand to a greater degree ),
Weakness in grip and difficulty doing buttons and such, etc.

At the same time my elbow and general outside of forearm had a deep dull ache on the left side ,
With a weird spot on my right upper arm that just " burned " felt like a hot iron just hit my skin - painful and weird!

No neck pain at that time,

Since then my neck now is where I feel the bulk of my pain, the pain has drastically diminished in my arms and hands, ( still clumsy, weak and weird sensation )
My neck and shoulders just kill me, like a cross, down from skull to below shoulders and straight across the shoulders, pretty much every day, worse if in one position for too long. Lack of sleep due to pain.
It can be piercing, deep and throbbing and at times it hurts with a pins and needles sensation running down,
Lots of headaches, they wake me up on occassion, and yes ..I cry...that bad.

In the last 4 months my legs are really bothering me, stairs are the worst,
I'm not out of breath but it's like my legs are ...

It feels like they weigh a ton when climbing the stairs or steep incline on a walk,
Walking is kinda weird as well, hard to explain or describe, just a change I feel...
As a runner I never thought about running, you just run, like walking , one foot in front the other, for whatever reason my it seems that my right foot dosen't quite keep up to my left foot???
This happens essentially every day when walking longer than 20 mins,

Long walks ( anything over 45 mins ) usually leaves me wracked with pain up through my neck and into shoulders,
Also I get a numb - pins and needles feeling in my vaginal area and a portion of the upper leg, but this passes soon after ,when I rest.

I have had several painfully episodes of what the doctors called " costochondritis " but I am wondering now if this is related to the cervical spine or referred pain?
Sometimes it can last for days.


MRI findings

The cervical lordosis is straightened. No signal abnormalities are identified in the posterior fossa structures.
Truncation artifact is seen in the cervical spinal cord from C3 to C6

C2-3
C3-4 Both normally maintained

C4-5 The disc, spinal canal and neural foramina are normally maintained, trivial left uncovertebral joint osteophyte formation is noted.

C5-6 Moderately severe degenertive disc changes and mild spondylosis identified. Bilateral uncovertebral joint osteophytes are identified. Mild spinal stenosis. The AP diameter of the canal is 9.8 mm. There is minimal narrowing of the neural foramina.

C6-7 Mild degenertive disc changes and spondylosis . The spinal canal and neural foramina are normally maintained. Small bilateral uncovertebral joint osteophytes are present.

C7-T1 normally maintained.
No focal disc protrusion is identified from T1-2 through T4-5


Currently taking Tramacet and Apo-Nortriptyline for pain and using heat therapy via heat wraps and pads.

Any insight on what to expect in a way of progression or resolution would greatly be appreciated as well as translation of my MRI, thank you!!

WebDozer 07-24-2012 03:01 PM

Re: MRI help for a new comer
 
Lucie - The uncovertebral "joints" are really just the way the vertebrae fit together. C3-C7 have U-shaped ridges on their upper sides that kind of form "saddles" that the next disk/vertebra up "sit" in. This allows for some movement of one vertebra on top of another, but stabilizes each vertebra from moving too much. Since there's a lot of movement, over time, osteoarthritis will set in and bone growths (osteophytes) will be added on. These will project backward, possibly into the spinal canal and/or the foramina (the openings in the side of the spine through which pass the spinal nerves).

The radiologist says that at C5-6 you have mild spinal stenosis. I would assume that he means mild spinal CANAL stenosis, which means that your spinal canal is a little bit narrowed. Actually, 9.8mm AP (front-to-back) is fairly narrow. I suspect that your canal was too narrow to start out with (a not-uncommon hereditary condition), so it didn't take much of an intrusion from the osteophytes to get it down that low.

The C5-6 level is the ONLY level where this radiologist seems to think you even MIGHT have a problem. Even there, he does NOT say that your spinal cord is affected (only the CANAL in which the cord sits) and he does NOT say that the nerve roots are affected (radiculopathy) where they pass through the foramina.

If the canal stenosis at C5-6 is indeed affecting the cord (the radiologist DEFINITELY should say that if he thinks so), and the stenosis is fairly serious, it could explain most of your symptoms, but the report really does not support that.

Long story short, your extensive and long-lasting symptoms do NOT seem to be explained by your cervical MRI..... AT LEAST NOT THE WAY THE RADIOLOGIST WROTE IT UP. Maybe the radiologist read your MRI poorly, or maybe he habitually understates things. Maybe he read someone else's by mistake.

I'd strongly suggest calling the GP who referred you to the surgeon, telling him you have the radiologist's report in front of you, and asking him EXACTLY what it is on the report caused him to think you need a surgeon. (or is he just going by your symptoms?)

My concern would be that there may be something else going on with you - separate from any cervical spinal problems - and it would be a shame to wait for months only to find out you've been waiting for the wrong doc.

Scrappylucie 07-24-2012 03:48 PM

Re: MRI help for a new comer
 
Hi WebDozer and thank you very much for your reply :-)

I initially thought carpal tunnel when I first saw my GP, but after her examination she sent me for x-rays,

( I've had many cervical x-rays done at the hospital over the last decade after a car accident where I went through the windshield, sounds worse than it was, broken arm and concussion only )

Anyways, the radioligist asked for the MRI based on significant change from previous x-rays and scans,
There was only minimal DDD 2 yrs ago.

When I started having the other symptoms the doctor did suggest possible MS, but that with my age that was unlikely.

Yesterday at my appointment when she went over my MRI, all I got from her was that I had pressure on my spinal cord and nerves and needed to see the neurosurgeon.

I'm at a loss as what to do next, it's very hard to contradict your GP here , as we have a waiting list just to get a family doctor, never mind anything else,
and I really don't want to be left in limbo because I questioned her, I wish it were different and I had the freedom to see a second, third or even fourth doctor.

Thank you again for taking the time to answer :-)))


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