Re: Newbie needs help understanding mri and hearing others experiences!
The first thing is to take note of the adjectives, as radiologists use a fairly standard set: minimal, mild, moderate and severe. The definitions that I would put on them are:
minimal - there, but barely noticeable
mild - clearly noticeable, but unlikely to be problematic
moderate - borderline problematic, refer to symptoms
severe - DO something about this!
At the C3-4 level, you have bone overgrowths coming into the spinal canal from in front (disk osteophyte complex). It is unclear - from your transciption - what effect this has on the spinal canal, because the transciption says both that there's "no central canal stenosis" and that "Moderate central canal stenosis is present". My guess would be that the latter is what was meant. So the spinal CANAL is narrowed a little, but the radiologist does not say that the CORD is affected. Note that the cord is cushioned within the canal by cerebrospinal fluid, so you have some leeway for the canal to be narrowed but the cord to remain unaffected.
More important, at this level those osteophytes are growing into the foramina on both sides. The foramina are the openings in the front/side of the spine through which pass the C4 peripheral nerves after they leave the cord. Impingements of the C4 nerves could create symptoms that appear to come from your shoulder. They would not create symptoms that appear to come from the fingers (that would be C6, C7 and C8).
C5-6 seems to be the only level where a disk is out of place. It is pushing back into the canal far enough to touch the front of the cord. No flattening or indentation of the cord is mentioned, so the radiologist, at least, does not seem to think that this is currently problematic. Once again, the foramina on both sides are narrowed, this time by the disk. While the radiologist calls this narrowing "moderate", keep in mind that "moderate" is just one step below "severe", and radiology is often as much interpretation as observation. If the peripheral nerve at this level (C6) were affected, you might feel it in your upper arm (triceps), but the clearest signal would be symptoms in your thumbs.
If you develop symptoms in your legs, this may be an indication that the disk bulge at C5-6 has gotten bad enough to affect the cord at that level.
As far as surgery goes, the only thing I can see that would be called for is to clear out the left foramen at C3-4. Some doctors might want to do an ACDF, where they come in from in front, remove the C3-4 disk and fuse the C3 and C4 vertebrae, but if I were you I would look into less drastic/invasive alternatives. There is an operation called a foraminotomy, which comes in diagonally from behind and cuts away the bone growths that are narrowing the foramen. This is minimally invasive (I had a C5 foraminotomy and left the hospital that afternoon). I don't know, however, if the foraminotomy can access the disk-osteophyte complex to cut it back.
If you do go to see a surgeon, most likely he will just suggest you wait and see. If he recommends an ACDF, I would get both a second and a third opinion.
Last edited by WebDozer; 10-24-2012 at 05:51 AM.