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Old 12-01-2012, 01:55 PM   #1
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Myelogram Report

I recently had this Myelogram, now I don't see the Doctor for almost 3 weeks because he's on vacation. Could someone explain to me the results, and if I should be concerned on seeing someone sooner? Mild flattening of the spinal cord has me concerned.

FINDINGS:
ALIGNMENT AND GENERAL ASSESSMENT: There is 2 mm retrolisthesis of C4 on C5. Small posterior degenerative osteophytes are seen from the C4-C5 through C6-C7 levels. There are no vertebral body fractures. The prevertebral soft tissues, atlanto-dental interspace and craniocervical junction regions are unremarkable. The facet joint, spinolaminar and spinous process alignments are unremarkable.

DISC SPACES:
C2-3: The disc is unremarkable. Mild bilateral degenerative facet disease changes are seen. There is no central or foraminal stenosis.

C3-C4: There is a tiny central disc protrusion. There are moderate left and mild right degenerative facet disease changes. There is no central or foraminal stenosis.

C4-C5: There is a small left paracentral disc osteophyte complex noted with mild flattening of the left side of the spinal cord. There are moderate bilateral degenerative facet disease changes with mild uncovertebral joint hypertrophy. There is no central spinal stenosis. There is severe left and moderate to severe right foraminal stenosis.

C5-C6: There is a tiny central disc osteophyte complex noted. There are mild bilateral degenerative facet disease changes with mild uncovertebral joint hypertrophy, left greater than right. There is no central spinal stenosis. There is mild right and moderate left foraminal stenosis.

C6-C7: There is a broad-based left paracentral and foraminal small disc osteophyte complex noted. The facet joints appear unremarkable. There is mild uncovertebral joint hypertrophy. There is mild flattening of the left side of the spinal cord. There is no central spinal stenosis. There is mild to moderate left and moderate right foraminal stenosis.

C7-T1: There is a tiny central posterior degenerative osteophyte is noted. There is mild diffuse disc bulge. There are mild bilateral degenerative facet disease changes. There is no central or foraminal stenosis.

Opinion:
1. Broad-based left paracentral and foraminal small disc osteophyte complex at the C6-C7 level. Assessed mild uncovertebral joint hypertrophy. Mild flattening of the left side of the spinal cord. No central spinal stenosis. Mild to moderate left and moderate right foraminal stenosis.
2. Tiny central disc osteophyte complex at the C5-C6 level. Associated mild bilateral degenerative facet disease changes with mild uncovertebral joint hypertrophy, left greater than right. No central spinal stenosis. Mild right and moderate left foraminal stenosis.
3. Small left paracentral disc osteophyte complex at the C4-C5 level with mild flattening of the left side of the spinal cord. Associated moderate bilateral degenerative facet disease changes with mild uncovertebral joint hypertrophy. No central spinal stenosis. Severe left and moderate to severe right foraminal stenosis.
4. Tiny central disc protrusion at the C3-C4 level. Associated moderate left and mild right degenerative facet disease changes. No central or foraminal stenosis.

 
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Old 12-01-2012, 03:47 PM   #2
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Re: Myelogram Report

What he's saying about C6-7 seems contradictory. No canal stenosis (narrowing), but flattening of the cord? That makes no sense, and it's certainly something I'd ask the doc about. You also have flattening at C4-5, but at that level the radiologist at least does not say anything about a contradictory lack of stenosis.

Calling the flattening "mild" likely means that the radiologist does not think this is currently cause for concern. However, if the flattening were causing symptoms, they could be anywhere downstream - legs, and arms - but should be limited to the left side.

The worst problem seems to be at C4-5, where you have severe or moderate-to-severe foraminal stenosis. The radiologist does not specify the exact cause of this narrowing, but does list three possible osteoarthritic areas. Severe foraminal stenosis means a likelihood that the peripheral nerves (at this level, the C5's) are being impacted, which could mean symptoms attributed to radiculopathy. The symptoms could be neck pain, or a variety of affects in the shoulder and arm - tingling, deadness, weakness, pain - but not reaching down into the thumb and fingers.

What are your symptoms?

Another thing to take up with the doc is the possibility that your spinal canal is too narrow to start out with. It seems odd that supposedly "small" protrusions would go so far as to flatten the cord.

Last edited by WebDozer; 12-01-2012 at 03:49 PM.

 
Old 12-01-2012, 08:19 PM   #3
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Re: Myelogram Report

Thank you so much for the information, and the guidance in what I should ask the doc. I just had my SCS changed and have talked to the doctor and Medtronic rep concerning a lead to help with the pain, my current SCS has helped with the lower extremities for almost 22 years now. I just hope they can correct what needs to be done, and give me some relief from the pain. I've had neck pain for years and had some relief from therapy, exercises, and my hometrac. Lately it does little to nothing at all in relieving the pain. Also have been experiencing pain in left shoulder that gets intense and throbs. From time to time I move the neck wrong and it feels like something is biting into something. I hate the thought of pain meds and avoid them till the pain reaches an 8 or above. My stimulator was put in to help with my RSD back in 1991 after a failed back surgery in 1989. Been a long road, 25 of my 50 years of back problems. Hope this shared enough of what problems I've had. If you want more information by all means ask. Thanks again.

Last edited by tboltjr; 12-01-2012 at 08:29 PM. Reason: Left out info

 
Old 12-01-2012, 08:42 PM   #4
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Re: Myelogram Report

Your left shoulder pain is consistent with left C5 radiculopathy. It's possible that this can be corrected with a simple foraminotomy, which is a fairly non-invasive surgery. I had one for C5 radiculopathy a few years ago, and it turned out to be an outpatient procedure with little recovery period.

Of course, that's probably the best-case scenario...

 
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