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Please help to explain MRI...due to new neck pain after procedure....thanks so much !


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Old 09-15-2017, 05:55 PM   #1
amandil
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Please help to explain MRI...due to new neck pain after procedure....thanks so much !

Hello everyone,

I appreciate any help you can please give me to explain MRI results. My son had his second LESI procedure about one month ago. He woke up the very next morning with neck stiffness, neck spasms and tension. He has never had this kind of pain before . It all began after the procedure...

Can anyone please help us understand the results ? Just really worried.....Also, not sure if this explains the neck pain , tension, stiffness and severe neck spasm on the right side ?


MRI Cervical Spine w/o contrast

1. Mild multilevel degenerative disc disease. No significant spinal stenosis. Mild to moderate multilevel neuroforaminal narrowing, as detailed above, worst at C2-C3, C3-C4 on the right. Straightening of the cervical spine, which may reflect muscle spasm.

2. Nonspecific 1.1 x 0.8 x 0.9 cm area of lobulated fluid signal at the left skull base, likely incidental and of uncertain clinical significance; this may represent a congenital lesion, opacified cavity, or mass; consider IAC protocol MRI for further evaluation if indicated.


Can you also please tell me if the MRI reflects his symptoms ? I am not sure what is going on and we are just very worried...The doctor had not been in touch yet...

Thanks so much for any help you can please me...I truly appreciate it .

 
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Old 09-16-2017, 10:10 AM   #2
teteri66
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Re: Please help to explain MRI...due to new neck pain after procedure....thanks so mu

Welcome to the board. When you say LESI are you referring to a lumbar epidural steroid injection? If so, I cannot think of a reason why the two could be related. Did the doctor think they were related? The only thing I can think of is due to the positioning of the body during the injection, perhaps the neck was in an awkward position. Otherwise, there is nothing about the procedure or the medication, at least that I know about, that would bring on neck pain, spasms, etc.

It looks like you only copied part of the report so I can't give you any details, but there is "degenerative disc disease" in several segments of the neck. You can look up this term and do further reading to understand the disease process, but, basically, it just refers to the aging process in the disc that often results in pain, pressure, nerve damage and other symptoms.

Stenosis refers to narrowing. It occurs in two places in the spine...in the central canal and in the neuro foramina, which are openings at each vertebral level that allow the spinal nerve to exit the spine to go out to the area of the body it innervates. If interested, take a look at a "dermatome map" (found online) which will show you the areas that are covered by the C2, C3 and C4 spinal nerves. These are the areas that are the most affected by the stenosis on the RIGHT side.

When something like a disc bulge or an enlarged facet joint or even soft tissue that is swollen, it can push into the side of this little opening, which has the effect of squishing the nerve. The technical term is compressing the nerve, but squishing or pinching describes it in laymen's terms. This causes pain. If the compression is worse, it can cause tingling or even numbness that can be felt at the site of compression or anywhere along the path of the nerve...radiating pain going into shoulders, arm or hand for cervical spinal nerves.

The second point is something that was picked up during the MRI, something they were not looking for..a possible mass or lesion at the base of the skull that has possibly been there since birth...something that is not related to the cervical spine symptoms...and something you may want your doctor to look at more closely in the near future.

 
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Old 09-16-2017, 06:39 PM   #3
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Re: Please help to explain MRI...due to new neck pain after procedure....thanks so mu

Hello and thanks for all your time in helping me ! I truly appreciate it !

The procedure my son had was a Lumbar Epidural Steroid Injection. I am not sure where it was done, but lower back area . After he had this done, he has been in so much pain in his neck area. He never ever had any pain there at all. Tonight its very bad . I think the doctor wants to be sure there is not a abscess from the LESI procedure.

I am not sure if the Epidural can cause the lesion ? That is what I am very worried about..Not sure if you happen to know about this ?

I am also not sure why the MRI seems incomplete, I also thought the same thing, but was not sure ...I copied it again here to be sure...Thats the entire report they gave us.

MRI Results


1. Mild multilevel degenerative disc disease. No significant spinal stenosis. Mild to moderate multilevel neuroforaminal narrowing, as detailed above, worst at C2-C3, C3-C4 on the right. Straightening of the cervical spine, which may reflect muscle spasm.

2. Nonspecific 1.1 x 0.8 x 0.9 cm area of lobulated fluid signal at the left skull base, likely incidental and of uncertain clinical significance; this may represent a congenital lesion, opacified cavity, or mass; consider IAC protocol MRI for further evaluation if indicated

Signed by Dr. >>>>>>



Also, I am not sure if the radiologist possibly forgot to finish the report ?

I am going to research all the information and help you have given to me.

Thanks so much again for all your help, I really appreciate it

Last edited by amandil; 09-16-2017 at 06:53 PM.

 
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Old 09-17-2017, 12:02 PM   #4
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Re: Please help to explain MRI...due to new neck pain after procedure....thanks so mu

The radiologist did not forget to finish the report. Rather, I think the first part was not included.

Generally a spinal MRI has a main part often labeled "Findings" that goes through each level, ( for example, C2-3, C3-4, etc.) ticking off any "abnormalities" that are found. Then there is the conclusion, called "Impressions" which is like a summary...which is what yours appears to be.

Note where it says, under point 1, "Mild to moderate multilevel neuro foraminal narrowing, AS DETAILED ABOVE, ....This indicates there was more detailed information in a previous paragraph that is not included here.

However, I don't believe it is all that relevant to your son's pain...as the part that is indicated could explain his symptoms. However, it is not related to a lumbar injection.

None of us members post here as trained medical professionals, so I may be wrong, but I have been dealing with serious back issues since 2000 and have many epidural steroid injections, facet blocks, etc. and I cannot see how your son's lumbar ESI had anything to do with his neck pain. An ESI is done under fluoroscopy which is live X-ray that shows the physician exactly where to place the needle. The medication does not go into the blood stream or spinal fluid. It is floated in around the disc or whatever is suspected to be the cause of pain, where it helps to reduce inflammation and pain.

The only thing I can think of is if the needle was way off the mark and went into the spinal canal, and caused some spinal fluid to leak out...but this causes a bad headache...not muscle spasms, etc.

I doubt the small mass that is mentioned is of much significance. It sounds like a small cyst-like thing that is not pressing on any nerves, and therefore, is not causing pain or symptoms.

 
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Old 09-17-2017, 12:40 PM   #5
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Re: Please help to explain MRI...due to new neck pain after procedure....thanks so mu

I read this slightly differently and don't think the report is incomplete. Neuroforaminal narrowing and spinal stenosis are different ways of saying the same thing. From the report it looks like there is no significant narrowing though mild to moderate stenosis is seen to be greater in the named cervical sections. To me "as detailed above" refers to the preceding sentences.

The reading also raises the possibility of muscle spasm which may be the cause of your son's pain. Whatever the cause, hope the doc gets back to you soon and your son finds relief.

 
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