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Old 06-14-2014, 05:03 PM   #2
ChuckStr
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Re: Cervical MRI - Neck,Shoulder & Arm pain

I'm not a dr but have learned a bunch about cervical MRI lingo since I've been suffering for years with troubles of my own and I like to understand what's happening.

If you don't know your cervical spine has 7 vertebra that protect your spinal cord and nerve roots coming off of it in roughly your neck area. They are labeled c1 - c7 from the top to the bottom.

These vertebrae normally form a slight curve with the concave part facing behind you. Your MRI indicates there is a straightening of this ("straightening of cervical lordosis"). There is no further information as to severity or possible causes (such as instability) so it's hard to determine clinical significance. In my case, I have some slipping and instability of the vertebrae which contributes to neck pain.

Normally, these vertebrae are made up of flat bony constructs separated by gel-filled disks that cushion your movement while allowing for flexibility of your spine. These flat constructs have bony ridges of the back that form a ring for your spinal cord and protect the back and sides of the cord as well as the nerve roots coming off of it. Each pair of the vertebrae have a disk between them and provide an opening for a nerve root on the left and right of the spinal cord. The circle is your central spinal canal, and the openings between the vertebrae for the nerve roots are neural foramen. Due to age or overuse, you can get degenerative changes in the disks (the gel hardens and the disk shrinks) and in the ridges around the cord and nerve roots (they rub together creating arthritic changes known as disk osteophytes, basically spurs of bony growth). Stenosis occurs when the disk, or these spurs impinge into either the central canal or the foramen.

Back to your MRI :

C2/C3, C3/C4, C4/C5 have only minimal changes, the bone spur at c4/c5 is relatively small (2mm), and causes no stenosis so no impinging on your cord or nerve roots

C5/C6 - a large bone spur complex (5mm) coming from the front of the spinal canal ridges are pushing on your spinal cord and flattening it. This is a significant finding. Compression of your spinal cord can cause more symptoms than pain including weakness in arms/legs, reflex changes and others. From your description, this isn't happening but it's probably something you want to discuss with your spine dr. Also, a bone spur on the left ridge above your nerve root at that level is pressing into the space for the root "moderately severely". Generally, they will use mild, moderate, severe so you can see that there is significant encroachment on the space for that nerve root. This could definitely cause pain, numbness and weakness along your left shoulder and arm.

c6/c7 - similar pathology to c5/c6. Could cause similar symptoms. If you look up dermatome map you can see where problems at each level would cause pain, numbness etc. A myotome map will show the muscles that may be weak due to problems at a particular nerve level. There is some overlap, however.

T2/T3 - Bone spur at back of ridges (facet) causing nerve root space narrowing on both sides. Thoracic problems are less common but this could cause pain and associated symptoms in the chest and mid-back.

It looks like you have some pathology that *could* be causing pain (and other things) at various places in your mid/upper body. If that's been going on for 2 years I would think you'd want to discuss that with your spine dr soon.

Good Luck.