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    Old 12-30-2009, 03:16 PM   #1
    Tashaisinpain
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    Cervical Spine MRI RESULTS

    Can anyone help me understand the results from my recent MRI?

    Impression: At C5-6, there is a small diffuse disk osteopyhyte complex indenting the sac and mildly narrowing the foramina, without central canal stenosis. The ventral surface of the cord is slightly deformed at this level, although CSF surround the cord. Elsewhere, there are more mild degenerative changes.

    Ok...I think the "diffuse disk osteophyte complex" is osteoarthritis, but what is the deformity to the cord?

    Any help would be greatly appreciated!!~~

     
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    Old 12-30-2009, 04:16 PM   #2
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    Re: Cervical Spine MRI RESULTS

    You may want to post on the "Spinal Cord Disorders" board as that's where much of the cervical spine discussion is. Here it tends to concentrate on the low back (lumbar area).

    What are your symptoms? It's important to look at your test findings in conjunction with your symptoms. There are some really knowledgeable people on the spinal cord disorder board but I can tell you that often the cord defect means there is either disc material or osteophyte (bone spurs) impinging on the spinal cord.

    Do you have an appointment scheduled with a Neurosurgeon and/or Orthopedic Spine Surgeon? They can help evaluate your symptoms with the findings of the test and let you know what treatment options are available.
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    Old 12-31-2009, 08:34 AM   #3
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    Re: Cervical Spine MRI RESULTS

    from the way this is actually being described in the 'impression, it sounds like that bone spurring(the osteo complex?) you have at that c 5-6 level is what is actually somewhat 'deforming' the outside and anterior thecal sac and nothing more? that is what 'ventral" actually means? the front or anterior side of the spinal area of your thecal sac, but appears only slightly since you still DO have what is supposed to be there surrounding and bathing that cord as far as the very crucial CSF? so i think AZ up there kind of hit the nail on the head with what she stated above.

    the key thing here is what AZ asked, what are your actual symptoms with what was found up there, anything? was there ANY other real hard findings listed within that summary at the very end of the report or just this? and as AZ suggested, the one thing you really do need to do here only to truely find out just how really impactful that bone spur complex is for you( an osteo complex kind of means its a bit more spread out and not like only just in one tiny spot?) and what it could be also impacting that would take a really good thorough neuro eval by a good neurosurgeon to just really 'see' some of the more subtle telltale signs of impact you could actually have but not really feel or realize is even there? but a good neuro would be able to tell. that is the bigger reason that the eval really IS very important, to find out what the findings could be doing to YOU or creating as far as real risks of some kind too.

    but just from what was written up there, it really does not appear that your actual cord is being compromised at all, based upon the MRI, ONLY that dura/the thecal sac that surrounds the cord containing a nice cushion of fluid is slightly impacted and not even enough to stop the normal ebb and flow of that needed CSF either, and that REALLY a good finding.

    it also does not appear to be impacting any actual nerve roots either or showing any roots being compromised by any stenosis or anything else that can just create 'impingement", which can and does cause alot of pain in people who happen to show these findings?

    but the more important thing like i mentioned above is ANY actual real symptoms that you are showing or feeling that would help to really give the bigger and more clear picture of what is actually going on since MRIs and any other types of scans just cannot possibly always show every real hard finding we may have in any area of our bodies. they are ONLY a scan and not a kodak moment like a true picture of an area would be? just from what i have learned having my own ongoing c spine saga with 17 actual MRIs among other things and what i have just read about for years here on these spinal borads and back boards shows just that. only kind of a 'rough guideline' is what you really get in many cases with any real scan and not the whole picture. this is the bigger reason that what the neuro exam shows combined with the patient complaints really helps to fully 'see' what may be being impacted in the spinal areas. everything that is done is just another little piece of the puzzle when combined all togehter, ya know what i mean? but i would seek out the opinion of a really good neurosurgeon just for that initial eval/consult. this really does not, by just what has been stated, sound like an actual surgical thing at this point? but it does need further evaluation just so you know where you are at here and what the long term prognosis actually is for this too.
    good luck with this and please do keep us posted. Marcia
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    Old 12-31-2009, 12:39 PM   #4
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    Re: Cervical Spine MRI RESULTS

    My symptoms:
    Constant neck and shoulder pain. It feels like my head is too heavy for my neck to hold up!! The last 2 yrs it has progressively gotten worse. Used to be every now and then, now the pain is everyday, every minute. From where my head and spine meet to the middle of my back, shoulder blades. Burns, stings, and now it is also moving down my right arm. My wrists also feel weaker now as well. I don't know if this is associated or not, but I also get pain in the front of my neck. Its not a sore throat, but sore neck by my glands. Sometimes to the point it hurts to talk.

    For 2 years i have been told i had fibromyalgia. I recently went to a different Dr because i am so tired of antidepressants, and he ordered an MRI. I am 37 yrs old and feel like i am 87!! I feel like the Dr's aren't listening to me!

     
    Old 12-31-2009, 01:31 PM   #5
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    Re: Cervical Spine MRI RESULTS

    Sounds like your symptoms would mandate getting a consultation with a Neurosurgeon and/ or Orthopedic Spine Surgeon soon (my neck and back were done by am OSS).

    I totally understand what you are going through as it sounds similar to what I experienced. My cervical spine symptoms started one morning upon waking up when I was 38! No reason, no injury, just started as a pinched nerve and didn't get better as I thought it would.

    Let me know if you have any questions as you go thru this. I'm around until 2/2 as I'm having major lumbar surgery (fusion L3-S1) on 2/3. I don't know how long I'll be off the boards before I feel able to get back on the computer (though my husband says I won't be able to stay off long).
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    Old 01-01-2010, 08:38 AM   #6
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    Re: Cervical Spine MRI RESULTS

    Thank you so very much!~I don't feel so crazy now!
    The last day I sat in my family Drs office I just cried and cried because I hurt so bad. She patted me on the hand and gave me a script for another antidepressant!! Im NOT depressed, I hurt!! I do realize there are anti's with pain relieving effects. My problem with them is in my situation only. My Dr "assumed" it was fibro without a single test, not even an x-ray to check my neck and shoulders. The pain was so unbearable one night i went to urgent care. He ordered an x-ray that revealed i had lost some of the curve in my neck. He then asked for an MRI. Here's what it says:

    Findings: Mild loss of the normal cervical lordosis. C5-6 disk space is mildly narrowed. Signal intensity of the cord is unremarkable.

    At C1-2 and C2-3 no major abnormalities.
    At C3-4 and C4-5 minimal annular bulge without canal or foraminal stenosis.
    At C5-6, small diffuse disk osteophyte complex 3mm in AP diameter indents the sac without canal stenosis. Sac AP diameter is 10 mm. The ventral surface of the cord is slightly deformed adjacent to the disk, although there is CSF between the disk and cord. Mild bilateral foraminal narrowing.
    At C6-7 and C7-T1, no major abnormalities.

    I have an appt with a neck and spine clinic at OSU---earliest they could get me in is April.
    I also called to schedule appt with neurologist----my Dr has to call and give referral then they will call and tell me when my appt is!! So aggravating....


    What did the Dr do for you?

     
    Old 01-01-2010, 10:03 AM   #7
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    Re: Cervical Spine MRI RESULTS

    For my neck I started with a Neurologist who was able to rule out carpal tunnel syndrome. With the arm symptoms they often want to see if there are any signs of CTS (makes sense). Then I saw a Neurosurgeon. He reviewed my MRI, did an examination and said that at that point surgery wasn't the first option and he recommended pain management to include meds and Epidural Steroid Injections (ESI) which they may recommend for you as well. I found a PM doc and did ESI. I did ESI every 2 weeks, under conscious sedation. Because they are steroids I could do 2 sets of 3 ESI per year (a set was 1 ESI every 2 weeks for 6 weeks so a total of 3 ESI in the 6 week period). I did quite well with these for nearly 2 years (if ESI had continued to work I would have done two sets a year for life!). Then the symptoms returned and intensified. My PCP was ok with me going back to the NS but had an Orthopedic Spine Surgeon he thought I should see and also sent me for another MRI since it had been 2 years since the last one. The OSS reviewed the old and new MRI and showed me the changes, did a full exam, etc. Given that ESI were no longer working and I had to increase my pain meds it was decided that an ACDF was needed (Anterior Discectomy and Fusion). So I did that soon after and had substantial relief. That worked for nearly two years and I had some new symptoms, did ESI which didn't work and ended up with a second surgery. After that one I had sever pain and the OSS surmised one nerve was irritated from surgery and recommended ESI to calm the nerve which did indeed work.

    Please keep in mind that I am an orthopedic nightmare so some problems continue. Many who consult this board and do well after surgery and then slowly wean themselves away from the boards and no longer post. So the good news is that those of us here have a wealth of information if we've been here a while but just know that we are in the minority as many with neck or back surgery do well.
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    Old 01-02-2010, 03:19 PM   #8
    Tashaisinpain
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    Re: Cervical Spine MRI RESULTS

    That is funny you said that about carpal tunnel.....the urgent care Dr who ordered the MRI said (after I told him I was having wrist weakness) that he wanted me to see the neuro because he too wanted to rule out CTS! Not in a million years would I have ever thought my neck pain could be associated with my wrists!!~~ And you are right....it does make sense!

    I just want so desperately to feel better! It affects every part of my life. I have a 3 yr old granddaughter and after one night of her spending the night with us I have to take at least 2 days to recuperate.

    I was prescribed prednizone once for the pain and inflammation and had an allergic reaction to it. My face swelled up and was really red, like I had been in a wind storm. Hard to breathe. The steroid injections you referred to, would they be like the prednizone? And as far as pain meds, what is typically given? I will be totally honest with you..........after taking anywhere between 3600-4800 milligrams of ibuprofen a day for pain and it not working, my mom gave me 2 vicodin a few weeks ago and I thought I had died and gone to heaven!! I could actually breathe and I slept better than I had in at least 6 months. I live in such a fog of pain that something just has to give....

    After researching some of the MRI results on my own, from my own interpretation, looks like I have 2 bulging discs, and a bone spur. Do you happen to know what they tend to do for bone spurs? I realize you are not a Dr, but trust me when I tell you that you have educated me more than any Dr I have talked to in the last 2 yrs!! I told my husband just today that irregardless of how many letters are after a Dr's name, I know my own body better than anyone else!! It hurts me so badly to recall the last time I saw my family Dr. I sat there and cried with such pain and she just looked at me!! I have never felt so helpless in my entire life! I do realize I probably don't fit into the category of most likely to have neck problems, but I do still warrant enough compassion to try to help me!!~~

    Thank you so very much for taking the time to "talk" to me. I appreciate it more than you will ever know. No one truly understands any of this unless they have gone through it themselves. What a blessing you have been to me!!

    P.S.
    How's the weather in Phoenix? Here in Ohio it's about 21 degrees and snowing!!
    My husband keeps asking when I'm ready to move to Florida!! Lol.....seriously though, does the weather help you at all? Have you ever lived anywhere cold?

     
    Old 01-02-2010, 06:10 PM   #9
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    Re: Cervical Spine MRI RESULTS

    Yep, the hand/arm symptoms for CTS can be similar to that of cervical spine issues. My doctor did some manipulation as well to try and re-create the symptoms (if they can then sometimes it's CTS). I've actually heard of people having CTS surgery only to find out it was cervical problems all along.

    It does affect every part of your life when the pain is ever present. That's why these boards are so useful as you can find people in the same boat. Sometimes friends and family don't understand more ongoing pain.

    I believe in most cases they use cortisone for the injections. But let the doctor know of any adverse reactions you've had to other steroids. It may still be an option but they may keep you for a few hours to watch you to see if there's any reaction. Sometimes meds that are closely related will not affect you in the same way, but there's no way of knowing. I tend to itch on oxycontin but not on other narcotics. I also get very ill (stomach) on demerol but not other similar medications.

    There is a wide spectrum of pain medications available. Often they will start you on a low dose of a more mild medication and then see if they have to increase it. There are things like ultram, tramadol and a ton more. For quite a while I was on vicodin twice a day but as my symptoms got worse they added a long acting pain medication called Opana ER. This has helped a lot. I also use muscle relaxers. I used to do well on Flexeril but the doctor thinks I've built up a tolerance so he changed me to Soma.

    I was at a party on New Years Eve with a friend and her husband. My friend also has severe back pain and is on heavy duty pain medications. We've both been able to function quite well on these as our bodies seem to use them well and we no longer feel any of the effects such as dizziness, loopiness, etc. Her husband just had an arm injury and surgery and was given vicodin. He was telling me he can't figure out how both of us function as he was so out of it on vicodin. I told him that if using medications such as vicodin for pain management and used at therapeutic doses it helps those of us with severe pain function and we function better as we come out of that pain fog you mentioned. When I first had neck pain problems I was given percocet but didn't take it at work. But I was in a pain fog. My boss thought it was the medications that were causing me to be in a fog but I told him I don't take them at work. He actually encouraged me to try taking them and working - if I could function better it was worth it for him and the entire company. He was right. I'll be honest and tell you in advance that one drawback to ongoing use of meds such as vicodin, percocet, etc is constipation. It's a well known side effect and even has the name of "narcotic constipation" but many of us learn to function around it with diet changes, other medications, etc. I recently saw a post where the person chose to be in pain vs. constipation but with the right work around I'd rather relieve my pain. I'm also very lucky that I have no addictive tendencies. I feel sorry for those that have a history of their own addiction, or in their families, and they end up in severe pain and now are given narcotics. I'm blessed that it's not an issue for me at all.

    Bone spurring is a side effect of disc problems in many cases. If there is actual bone spurring (osteophytes) impinging on the nerve they can seek to get the bone spurs out via surgery. After my 2006 neck fusion I had some new symptoms part of which were caused by bone spurs. The doctor when in via a more minimally invasive way and removed those which helped tremendously. I also had some narrowing (stenosis) and he took care of that at the same time as well.

    Thanks for letting me know I was able to help you. I think that even good doctors get so lost in their own world and their own terminology that they forget most of society doesn't understand what they are saying. I used to work in disability claims and at times I'd hear my employees explaining stuff in our lingo and at a high level. I tried to explain that just becuase they were immersed in it every day, the person on the other end of the phone was not. I had a good friend who is a realtor write up a memo. She explained real estate escrow in "real estate pro" language. I gave it to my employees and asked them to summarize for me what the memo said. All the employees said "how do you expect me to understand this?" and I said "it's no different than the way you talk to the claimants sometimes". I'd tell them "explain it to your claimant the way you'd explain it to great aunt ruth who is stuck int he 19th century". Many improved a lot after that.

    Years ago I had a great spine doctor. He did a good job on my back and seemed to understand. Then he broke his collarbone in a bike accident and had to walk his bike home and get himself to the emergency room, etc. When I went to my next appointment he said "that day when you were in tears over pain...I get it, I finally get it". Most spine docs have never had spine pain. Most primarey care docs have little experience with any significant amount of problems that they encounter in their patients.

    The weather here is Phoenix is good. Days start in the 40's and end in the 60's or 70's. Only been here 8 years. Previously lived in IL, WI, NJ and OH (Kent) but didn't have the level of spine problems that I have now. But I've always had big knee problems and I would definitely feel the difference when the weather changed.
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    Old 01-03-2010, 08:20 AM   #10
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    Re: Cervical Spine MRI RESULTS

    As I read your reply I thought of another question you may have some thoughts on. My neck is always cracking and popping. If I turn slightly to the left, right, front, or back, it pops. Any thoughts?

     
    Old 01-03-2010, 10:20 AM   #11
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    Re: Cervical Spine MRI RESULTS

    I can't say for sure but I can tell you that joint popping is often the result of air in the joint which is released by the pop. Or perhaps the degeneration in the discs and the bone spurs (osteophytes) are causing the cracking and popping as the neck is not working as biomechanically correct as it would in someone who did not have your symptoms and findings. You may want to ask that question in a new thread and see what other members have to add (since the question may get lost in this thread).
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    Old 01-03-2010, 03:19 PM   #12
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    Re: Cervical Spine MRI RESULTS

    Ahhh thank you so very much. I did take your advice and post my "ailments" to the Spinal Cord Disorder board. Just waiting to hear back, but I don't think anyone will be able to tell me anything more than you have. Now the painful part is just playing the waiting game. Especially with this weather!!

    Two years ago I fell down the stairs at my house and broke my left leg in at least 8 places. (the Dr stopped counting after 8) I broke both bones in the leg plus I had a break in the ankle. I now have a 4 or 5 inch metal plate on the outside of my leg and a metal plate on the inside of my leg that goes from my ankle to almost the middle of my leg plus 10 metal screws. I do know all that goes with surgery and the waiting game, but I just pray that if I do need surgery for my neck, the Dr will do it in the summer. The inability to walk for 8 weeks was made even worse by not being able to even step outside!! Talk about cabin fever~ It was the worst. I have since then gotten married and moved. We have a beautiful view and a walkaround porch easily accessible from the french doors in the bedroom.

    I just want to have at least a small portion of my life back.

    All of this blah, blah, blah about my "stuff".....I do want you to know I am praying for you and also for the Drs who will be performing your surgery. I pray for a speedy recovery. I pray you will feel better than you ever have!!~

     
    Old 01-05-2010, 10:10 PM   #13
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    Re: Cervical Spine MRI RESULTS

    [QUOTE=Tashaisinpain;4152593]Can anyone help me understand the results from my recent MRI?

    Impression: At C5-6, there is a small diffuse disk osteopyhyte complex indenting the sac and mildly narrowing the foramina, without central canal stenosis. The ventral surface of the cord is slightly deformed at this level, although CSF surround the cord. Elsewhere, there are more mild degenerative changes.

    Ok...I think the "diffuse disk osteophyte complex" is osteoarthritis, but what is the deformity to the cord?

    Any help would be greatly appreciated!!~~[/QUOTE]

    Impression of this means. indenting the sac Referring to the Thecal sac that surrounds the spinal cord. Hense cord deformity. HEY GOOD LUCK. i HAD CERVICAL DISECTOMY. Ain't fun i'll tell you. I think i am messed up for life.

     
    Old 01-06-2010, 08:37 AM   #14
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    Re: Cervical Spine MRI RESULTS

    hey broke up? just wanted to mention that this is ONLY the outside thecal sac that is 'deformed" and not the actual cord itself? the report stated that there IS CSF surrounding the area of the cord, therefore there is not actual cord contact at this point. as long as you have that CSF between the thecal(also called the dura) and that cord area THATS the clue right there. and thats a really good thing.

    tasha, i would have to agree again with what AZ told you was possibly causing your "sounds'? when you have bits of boney anything which is what the bone spurs are(calcifications/build up) believe me you can hear alot of crunching grinding and popping too from just moving the neck into certain posistions. as long as anything actually has 'joints' as the spinal column does(every single level has joints that allow for the movement of segments), you can always hear possible popping coming from them too. if there is a worn down area too where the discs are supposed to be, you can also get that grinding or scraping sound too. some days with all i have in my neck going on it sounds like a 'rice krispies' kinda day at times. i am sure AZ knows exactly what i am talking about unfortunetly. this just kind of comes with the territory for anyone with spinal issues, espescially with repeated surgeries. i have just been kind of reading along here since you have been getting some really excellent advice from AZ, but i AM still here for ya too hon. marcia
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    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 01-07-2010, 08:04 AM   #15
    Tashaisinpain
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    Re: Cervical Spine MRI RESULTS

    Thank you very much for you response!! I really appreciate all the input.
    I am new to all of this spinal lingo and still don't fully understand. I do understand the cord is not deformed yet, but my questions are: should I be worried? Based on the MRI results, how severe is this? What do Dr's usually do for my problems? I'm scared and still in pain. The worst part is waiting to get in to see the Dr.

     
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