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Neck MRI what does all this mean? Surgery


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Old 12-23-2015, 08:49 AM   #1
Tmynhier2
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Neck MRI what does all this mean? Surgery

I get very bad head aches at night and in day.

AGE: 50 years DOB: 6/18/1965 GENDER: Female

PROCEDURE: MRI CERVICAL SPINE WO CONTRAST, 12/22/2015 9:51 AM
ACCESSION NUMBER(S): YUM15003059521
LOCATION: SSYUDIMA

CLINICAL INDICATION: Neck pain with headaches and occasional
extension into the upper extremities.

COMPARISON: Plain films of the cervical spine 12-14-2015.

TECHNIQUE: Images were obtained at 1.5 Tesla GE MRI. The
following sequences were obtained. Sagittal T1, T2 and inversion
recovery. Axial T2.

FINDINGS:

ALIGNMENT: Spinal alignment is anatomic. The bony spinal canal is
well-maintained.

CORD: There is mild deformity of the cord at the C5-C6 level. The
remainder of the imaged cord and neural structures in the
posterior fossa display normal anatomy and signal
characteristics.

DISCS: There is disc desiccation. There is mild loss of disc
height at multiple levels. There is mild to moderate disc bulging
at the C4-C5 and C5-C6 levels. Mild disc bulging at several
levels.

VERTEBRAL BODIES: The vertebral body heights are well-maintained.
The vertebral bodies display normal signal characteristics. There
is an 8 mm hemangioma in the T3 vertebral body.

AXIAL IMAGES:

C2/C3: There is no disc bulge, spinal canal stenosis or neural
foraminal narrowing.

C3/C4: There is no disc bulge, spinal canal stenosis or neural
foraminal narrowing.

C4/C5: There is mild to moderate spinal canal stenosis secondary
to a broad-based disc bulge. The CSF spaces anterior and
posterior to the cord are obliterated. The cord displays normal
anatomy and signal. There is mild neural foraminal narrowing.

C5/C6: There is moderate spinal canal stenosis secondary to a
broad-based disc bulge. The CSF spaces anterior and posterior to
the cord are completely obliterated. There is flattening of the
cord without abnormal signal. There appears to be moderate to
severe narrowing of the right neural foramina and moderate
narrowing of the left neural foramina.

C6/C7: There is no significant disc bulge, spinal canal stenosis
or neural foraminal narrowing.

C7/T1: There is no disc bulge, spinal canal stenosis or neural
foraminal narrowing.

ADJACENT STRUCTURES: The adjacent bony and soft tissue structures
display no abnormalities.



Impression
IMPRESSION:


1. At the C5-C6 level there is moderate spinal canal stenosis
secondary to a broad-based disc bulge. The CSF spaces anterior
and posterior to the cord are completely obliterated. There is
flattening of the cord without abnormal signal. There appears to
be moderate to severe narrowing of the right neural foramina and
moderate narrowing of the left neural foramina.
2. At the C4-C5 level there is mild to moderate spinal canal
stenosis secondary to a broad-based disc bulge. The CSF spaces
anterior and posterior to the cord are obliterated. The cord
displays normal anatomy and signal. There is mild neural
foraminal narrowing.

 
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Old 12-24-2015, 02:06 AM   #2
MSNik
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Re: Neck MRI what does all this mean? Surgery

I am not a doctor and you should wait to hear from you doctor on this- but honestly, it appears to be good news!
Mild Stenosis, which is a narrowing of the spinal column, is normal as we age. I have it on my MRIs too. You do not appear to have any disc problems, which is what would be more worrysome. Mild to Moderate disc buldging is also something that can happen at any time for any reason. If it was severe, it would possibly mean problems, as severe buldging can push against the spinal column causing pain and even tingling...mild buldging, usually means nothing. You could possibly benefit from Physical Therapy if you are having pain, it might help you align things and get some comfort....

I dont think you have anything to worry about, but again, do not take my opinon as a medical one, as it is not.

Relax! Have a good holiday. And, follow up with your doctor.
If there was anything serious going on, your doctor would call you, as MRIs are read within a day of them being taken.

MSNik
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Old 12-30-2015, 07:58 AM   #3
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Re: Neck MRI what does all this mean? Surgery

Welcome to the board. If your headaches persist and if someone other than a spine specialist is treating you, I would suggest you consult with a fellowship-trained orthopedic spine surgeon or a neurosurgeon for an accurate diagnosis.

It is important to note that the MRI is just one piece of the diagnostic puzzle. It needs to be correlated with a physical exam, a basic neurological exam and the patient's description of her symptoms and how they impact daily living. There are many instances where a disc bulge looks horrendous on MRI but in reality is having no impact, and, conversely, a small bulge may be causing many symptoms and a great deal of pain. These changes can be missed by the radiologist who writes the report and by the internist/PCP/family physician.

Do you get any pain or tingling or odd sensations at the base of your neck or across the top of shoulders, running down the arm into the thumb?

You might want to read up on "degenerative disc disease" to get an idea of what happens to elements of the spine as we age, often from normal day-to-day living. The discs are like cushions that separate the bones (vertebrae) of the spine and, along with the facet joints, are what allow us to bend and twist and have movement in the spinal column. They are comprised of something like 90% moisture, but have no blood vessels running through them to replenish lost moisture. They receive nutrients from the endplates of adjoining vertebrae...which as the spine ages turns out to not be very efficient! As a result you see "disc dessication" ...which means the disc is drying out. As this happens, the disc tends to flatten, which causes the disc space to narrow. It is this process that you have beginning to happen at several cervical levels.

It is not causing issues at most of these levels, except for C4-5 and C5-6, where there are the most changes. At C5-6 the disc is bulging, extending beyond the disc space and pushing into the central spinal canal. The spinal cord is protected by spinal fluid which encompasses the cord. When that fluid is displaced by something pushing into it, in this case, the bulging disc, it creates a situation that at least bears watching by a spine specialist. This is one cause of stenosis, which means a narrowing.

Spinal Stenosis occurs primarily in two areas of the spine: the central canal and the neuromoramen...which are openings located at each vertebral level where the spinal nerves exit the spine and go out to innervate a specific part of the body. These areas can become blocked or narrowed when something pushes into it, such as a bulging disc, arthritis that causes little bone spurs, calcifications, inflammation, etc.

You will note that there is stenosis mentioned in both locations at both C4-5 and C5-6. At this point it would be useful to note that radiologists use specific adjectives that serve as a means of suggesting "how bad" a particular issue is...minimal, mild, moderate and severe. Any time you see the last two words on a report, it often means that this issue may require further investigation. Severe stenosis usually alerts the doctor to the fact that there is going to be nerve compression.

So...at C4-5 there is a disc bulge that is sufficiently large that it is taking away the space that the cerebral spinal fluid (CSF) normally occupies around the spinal cord. At this level, it is not impacting the cord itself. There is also a small amount of narrowing in the neuroforamen...probably not enough to be causing problems at this point.

One level down at C5-6 the same issues are present, but at this level there is more pressure on the spinal canal. The CSF is displaced by the bulging disc and it is causing the spinal cord to be flattened...but not flattened so much that the cord would be considered diseases. The tissue itself appears normal. (On the report it reads "There is flattening of the cord without abnormal signal." Signal refers to the image itself on MRI. The image that the MRI creates looks black, white, and all shades of grey. These variations in shade is called "signal." High signal appears white, and low signal is a dark shade. The radiologist and spine specialist use these signal characteristics to determine if the appearance is normal or abnormal.) Yours is OK!

At C5-6 the stenosis on the right foramina is judged to be moderate to severe...meaning the nerves as they go through this opening are being irritated or "pinched" and on the left side, the foraminal stenosis is moderate.

Otherwise things look normal. I would suggest a visit to the ortho spine or neuro surgeon is in order. This doesn't mean you need surgery, just that you need an accurate diagnosis and plan for treatment from a spine specialist.

 
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Old 12-03-2016, 01:41 PM   #4
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Re: Neck MRI what does all this mean? Surgery

Did you ever follow up with a surgeon?

 
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