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Old 12-18-2012, 12:01 AM   #1
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Question MRI - disc protrusion/thecal sac effacement

Hello - can I get some advice with the following MRI result:
“There is a moderately large left paracentral disc protrusion at C4/5, causing thecal sac effacement and left articular recess narrowing, without significant exit foraminal narrowing.
High intensity zone in this region suggests possible underlying annular tear. Mild spinal canal stenosis at this level and bilateral joint mild arthropathy.
C5/6: there is a mild/moderate left unconvertebral joint discophytic protrusion causing mild left exit foraminal narrowing. There may be slight impingement on the exit C6 nerve root.”
Thanks

 
Old 12-18-2012, 03:58 AM   #2
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Re: MRI - disc protrusion/thecal sac effacement

“There is a moderately large left paracentral disc protrusion at C4/5, causing thecal sac effacement and left articular recess narrowing>>

The disk between the C4 and C5 vertebrae is bulging backward into the spinal canal and the thecal sac (the membrane that surrounds the spinal canal) such that it has pushed away (effaced) the spinal fluid from around the spinal cord. (He doesn't say so, but it's quite possible that it has only pushed away the fluid on the front (ventral) side of the cord.) No effect on the cord itself is mentioned.

<< without significant exit foraminal narrowing >>

The opening (foramen) through which the C5 nerve passes on its way down into the shoulder and arm does not seem to have been significantly narrowed by the bulging disk.

<< High intensity zone in this region suggests possible underlying annular tear.>>

He thinks the disk may be bulging out because the tough outer ring (annulus) has torn. In other words, it has herniated, or may be about to herniate.

<< Mild spinal canal stenosis at this level >>

Somewhat redundant, given the thecal sac effacement.

<< and bilateral joint mild arthropathy. >>

I assume the "joint" is the facet joint, on the side of the spine. A little bit of bone overgrowth there.

<< C5/6: there is a mild/moderate left unconvertebral joint discophytic protrusion >>

The uncovertebral "joint" on top of the C6 vertebra is laying on extra bone (osteophyte), which is protruding backward.

<< causing mild left exit foraminal narrowing . There may be slight impingement on the exit C6 nerve root >>

A little bit contradictory, in that "mild" foraminal narrowing should not impinge on the nerve. If there is impingement (causing "radiculopathy"), you might have symptoms along the route of the C6 nerve, going down into your left thumb.

All in all, nothing's screaming for surgical attention, at least in this report. However, a spine surgeon may see it differently, so you should at least follow up with a specialist, or go back to the ordering doc.

What are your symptoms?

Last edited by WebDozer; 12-18-2012 at 06:33 AM.

 
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