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  • Please, Please help interpret MRI comments

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    Old 04-14-2015, 08:54 PM   #1
    jr03
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    Please, Please help interpret MRI comments

    Hello,

    My mother has been having some neck pain for a while now. She went to the doctor for quite some time now and the doctor finally decided to send her for an MRI of the Cervical Spine.

    I am very concerned of what this could mean, she is suppose to make an appointment with the neurologist but I am driving myself crazy over this, if anyone can please give me an idea of what this stuff means I would really, really appreciate it.

    Here are the comments:

    - There is normal signal of the marrow. There is no evidence of marrow infiltration. There are no intrinsic bony lessions or destructive changes. There is no compression fractures.
    - There is normal heigh and alignment of the vertebral bodies. There is a reversal of the normal curvature of the cervical spine compatible with the spasm.
    - There is loss of T2 Hyperintense signal of the disc involving all of the cervical disc levels. Anterior productive changes are noted at C4, C5, C6 and C7 levels. There is normal heigh of the discs spaces.
    - At the C2-C3 disc level there is a focal central disc herniation.
    - At the C3-C4 disc level there is a left paracentral posterior ostephyte bridging with the hypertrophy of the left uncinate process, which results in effacement of the left lateral recess and moderate-to-severe left neural foraminal stenosis and impingement of the left c4 exiting nerve root.
    - At the C4-C5 disc level there is no disc herniation or disc bulge, however there is hypertrophy of bilateral uncinate processes as well as hyperthrophy of bilateral facet joints, which results in moderate bilateral neural foraminal stenosis.
    - At the C5-C6 disc level there is 1.2 x 0.6 x 0.6 cm broad-based extruded disc herniation, which extends superiorly behind the inferior endplate of C5 and inferiorly behind the posterior endplate of C6 impinging upon anterior thecal sac.
    - At the C6-C7 disc level there is a 0.6 x 0.5 x 0.4 cm central disc herniation impinging upon the thecal sac
    - At the C7-T1 disc level there is normal signal as well as height of the disc without contour abnormalities, disc herniation, or disc bulge .
    - There is normal caliber as well as contour of the visualized spinal cord. The cervical medullary junction is unremarkable. There is no evidence of Arnold Chiari malformation. There is no epidural disease or paraspinal mass. The paraspinal soft tissues are unremarkable .

     
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    Old 04-15-2015, 08:38 AM   #2
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    Re: Please, Please help interpret MRI comments

    In essence, this report indicates your Mom has arthritis in her neck, with several deteriorated discs and herniated discs as well as bony spurs pressing on the nerve roots, which cause both neck and radiating arm pain. It is no wonder she is in pain, as her entire cervical spine is affected, and the nerve root irritation is causing spasm of the neck muscles. She should see a neurosurgeon, and consider getting these herniations fixed. In the meantime, muscle relaxants and anti-inflammatories might help some, along with pain meds if needed. Heat would help the spasm and probably feel good to her. Her PCP could help with the temporary things until the neurosurgery consult.

    Last edited by ladybud; 04-15-2015 at 08:39 AM. Reason: added

     
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    Old 04-15-2015, 11:14 AM   #3
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    Re: Please, Please help interpret MRI comments

    Thank you for taking the time to answer, it really means a lot. In your opinion is what she has dangerous ?

    She's in pain but not a ton, the general doctor suggested that she speak to the neurologist but avoid surgery as much as possible because 90% of his patients always end up worse.

    We are going on Monday to see the neurologist, but do you have any opinion on her not getting surgery and possibly trying to work it out with therapy?

     
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    Old 04-15-2015, 01:12 PM   #4
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    Re: Please, Please help interpret MRI comments

    I do not think she is in any danger at all. She has no pressure on the spinal cord itself, but the bony arthritic spurs and herniated discs are pressing on the nerves coming from the neck causing her pain. A lot depends on how old she is, how active, how much pain, and whether the pain is requiring narcotics to control. Certainly conservative measures can be tried first, but the disease process itself tends to worsen with time, so she may need surgery at some point-when the pain is not tolerable or she cannot function. Her situation is complex because of the extensive nature of many levels being involved, not just one or two. I had neck surgery and did quite well with it, but I had two levels involved. Your Mom should learn about all her options, and then choose depending on how badly this is impacting her life. Using narcotics long term creates a whole batch of new problems for people, so if she can get by with anti-inflammatories, PT like traction, muscle relaxants, she can buy some time with this. It tends to progress over months/years, not days or weeks. The situation is different if she has muscle weakness in an arm, which means the pressure on the nerve is severe and could result in nerve damage. That is a more urgent situation compared to pain only.

     
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    Old 04-15-2015, 02:09 PM   #5
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    Re: Please, Please help interpret MRI comments

    Ok once again I really appreciate you answering me and helping me put this into perspective.

    She is not in too much pain according to her, just some pain here and there and a little tingliness. She is 50 and she tries to go to the gym as much as she can, which I am telling her to hold off on for the time being, she mainly just swims, I am curious if this is a good or bad thing.

     
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    cervical spine, herniation, mri, neural, spine



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