It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Back Problems Message Board

  • MRI---what does the report mean?

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 08-29-2001, 08:40 PM   #1
    Marsh
    Newbie
     
    Marsh's Avatar
     
    Join Date: Aug 2001
    Location: Clarkston, Wash, USA
    Posts: 4
    Marsh HB User
    MRI---what does the report mean?

    I can't see the Dr. until Sept 15. I am curious to know what all this means.
    "At C4-5, there is some central left paracentral small disc protrusion which indents the thecal sac and is just in contact with the anterior cord surface on the axial image #20. There is no cord displacement or narrowing of the canal. It appears to contact the cord slightly inferior to the take off of the ventral nerve root at this level. At 5-6, there is some broad based dorsal disc bulging which is eccentric into the left paracentral region again indenting the thecal sac but this is smaller and does not contact the anterior cord surface. There is some very minimal narrowing of the left sided neural foramen. No central stenosis. This is stable." Anyone know what it means and what might be done about it? Marsha

     
    Sponsors Lightbulb
       
    Old 08-29-2001, 10:40 PM   #2
    mommy222000
    Newbie
     
    mommy222000's Avatar
     
    Join Date: Aug 2001
    Location: Foxboro, MA USA
    Posts: 2
    mommy222000 HB User
    Re: MRI---what does the report mean?

    I am not a doctor, but I do have some medical background, plus what I have learned through my own back problems. It sounds like you have two different disks being effected. One is ruptured and the protruding portion is pressing against the nerve root. One is bulging, but not too severely. As far as treatment, I am not one to ask. I was told that surgery was the only treatment for a ruptured disk, but since I have had two surgeries I have been lead to believe that I may have had other options that should have been tried first. I wish that I could help you out more, but this is the best that I can do. Maybe someone else will be able to help some more.

    Kelly

     
    Old 08-31-2001, 08:27 PM   #3
    Prouzy
    Newbie
     
    Prouzy's Avatar
     
    Join Date: Aug 2001
    Posts: 6
    Prouzy HB User
    Re: MRI---what does the report mean?

    "At C4-5, there is some central left paracentral small disc protrusion which indents the thecal sac and is just in contact with the anterior cord surface on the axial image #20. There is no cord displacement or narrowing of the canal. It appears to contact the cord slightly inferior to the take off of the ventral nerve root at this level."

    The thecal sac is the lining or surrounding of the central nervous system, if you will. In the spinal column, it lines the canal, containing the fluid and the spinal cord it surrounds. So the thecal sac is not "tight" covering the cord but there is space between, of which is filled with fluid. This is why you can have disc protrusion on the thecal sac without compression of the cord and may produce no signs/symptoms. Several studies of asymptomatic people were done and found 30-60% had disc protrusion. So, the findings on the image studies MUST be correlated with your signs and symptoms. This is a flaw in several failed back surgeries. So there is no cord compression at this level, but some ventral nerve compromise, which may relate to your signs/symptoms?

    "At 5-6, there is some broad based dorsal disc bulging which is eccentric into the left paracentral region again indenting the thecal sac but this is smaller and does not contact the anterior cord surface. There is some very minimal narrowing of the left sided neural foramen. No central stenosis. This is stable."

    Basically the same explanation as in the previous. Again, there is no "cord" displacement. Do you have any signs/symptoms that correlate to these levels? Are they getting worse? Or do you have any problems with the lower part of the body? Why did you have an MRI? Obviously, a second opinion is warranted and sometime required when it comes to surgery. Don't let people scare you about manual therapy, just as surgery. Everyone is different. Actually, if you don't have progressive neurological signs, the direction of treatment should be geared towards noninvasive methods, such as manual methods. This actually follows the natural course disc problems. Many times, the problem can be from the inflammation involved in disc material in places where it doesn't belong, causing irritation to nerve roots.

    Don't get me wrong, can't diagnose from just a post, so surgery may not be ruled out yet, but by what you wrote about your report and if your symptoms are not progressive/severe, you may be more of a candidate for a course of noninvasive treatment.

    Hope this helped a little. Good luck.

    Prouzy

     
    Old 08-31-2001, 09:31 PM   #4
    Marsh
    Newbie
     
    Marsh's Avatar
     
    Join Date: Aug 2001
    Location: Clarkston, Wash, USA
    Posts: 4
    Marsh HB User
    Re: MRI---what does the report mean?

    Do you have a medical background? Just curious. What sent me to the Dr. for the MRI was the fact that I had whiplash last Oct. and I seemed to be getting worse instead of better for some time and started having new symtoms such as more days with headaches then without. I finally had to resort to taking Vioxx daily to control pain.
    From all the research I have done and talking to those who are knowlegdable, I have a feeling the Dr. will tell me I am not a candidate for surgery at this point.
    Do you know, does chiropractic/massage/traction just work to control symptoms and at some future point the bulge will become bad enough that surgery will be required? Or will these measure eventually cure the problem if I continue them?

     
    Old 09-01-2001, 12:11 PM   #5
    Prouzy
    Newbie
     
    Prouzy's Avatar
     
    Join Date: Aug 2001
    Posts: 6
    Prouzy HB User
    Re: MRI---what does the report mean?

    Marsh,

    Answer to first question, yes. First, the headaches: telling me that something is going on in your cervical spine, e.g. motor unit dysfunction somewhere. You did not mention arm or leg problems, so I am guessing you don't, and I will continue on that line of thinking. This would suggest there is no cord or nerve root problem, at least expressing itself. So the headaches can be several reasons from you neck to psychological(that does not mean you are crazy, but long term pain has an effect and can affect somatic and visceral function). So let's assume we are talking about a neck problem casuing this. Some of the more recent research shows that a migraine is part of a tension-migraine continuum(I'm not saying you have migraines or that is the only cause, but bear with me). In other words, a migraine can result from a severe or long standing tension problem, and a tension headache is from a somatic dysfunction like tight and/or dysfuctional muscles; trigger points can refer to the head, causing that same pattern; improper function of the upper cervical spine can cause some Greater Occipital Nerve and Lesser Occipital Nerve compression; suboccipital muscles. Do you have any point tenderness at the back part/base of the skull? So your increase in symptoms may be because your origninal problems from the whiplash may not have been resolved. Whiplash is a devastating injury in that it is not always easy to determine what the problem is and if you can't see it, how can you fix it??? Soft tissue(muscles, ligaments, tendons) are most affected in whiplash and are very difficult for some practitioners to work. You may not have had any pain for up to two weeks after the accident! This was originally labeled "Litagation Psychosis" because there was often a lawsuit involved. Well, guess what, it wasn't and the pain is real, as you can attest to.

    No you don't sound like a candidate for surgery. I believe that to be a good thing. And I also believe, without knowing everything about your case, that if you did have surgery right now, you may end up being worse or no change, because it doesn't sound like that MRI is helping to diagnose the problem you are describing(again, there may be some things I don't know and Dr may say you are). Worse because if that was not your problem, you just added some other side effects. Are you having any other neurological signs? The fact that the Vioxx is helping to control the pain, tells me that this sounds like a motor unit problem(joint, muscle that moves that joint, nerve that goes to that muscle and joint), at least in part.

    "Do you know, does chiropractic/massage/traction just work to control symptoms and at some future point the bulge will become bad enough that surgery will be required?"

    Well, it depends. Sometimes things can't be "fixed" so the controlling is a possibility, which is not a bad thing, much like the Vioxx, but without the side effects. Sometimes surgery is used, but that is also not without side effects. For example, spinal fusion makes two vertebrae into one. There is a reason our body is made with all of those individual segments, so there will be a change in biomechanics, causing some other problems, though they may be far less than the original. You will end in rehab following that surgery, and some will actually send you before surgery to help with recovery. Will the discs get worse if you use something like a manual therapy? Maybe, but it is most likely not because of the therapy but the course the disc was taking, and actually the goal of manual therapy is to control or remiss the problem(sort of regarding the second portion of your question). In reference to my previous post, could those have been there prior to your accident? You would only know that if you had an MRI done before that.

    "Or will these measure eventually cure the problem if I continue them?"

    So the goal is to use the least invasive treatment possible to minimize cost and maximize benefit. Have you been to rehab yet or tried any other manual therapies like chiropractic, massage therapy including craniosacral therapy, etc.? I hope you were refered for therapy after your accident, if warranted, because it is proven that the quickest way to recovery to get the patient involved in active care as soon as possible. The longer that is put off the longer the eventual recovery.

    Hope this was helpful. The questios I posed are for you to answer yourself, but if you decide, you can answer them here and maybe we can talk again.

    Good luck,
    Prouzy

     
    Old 09-01-2001, 02:45 PM   #6
    Marsh
    Newbie
     
    Marsh's Avatar
     
    Join Date: Aug 2001
    Location: Clarkston, Wash, USA
    Posts: 4
    Marsh HB User
    Re: MRI---what does the report mean?

    Perhaps I should go back and give you more detail. I actually began having muscle stiffness and loss of range of motion 2 years ago. Chiropractic didn't seem to help anything so I had an MRI April of 2000 which revealed
    1.) Degenerative disc disease and arthritis with posterior disc spur complex at C5-6. Not causing stenosis or nerve root impingement.
    2.) Small posterior bulging disc at C4-5.
    3.) High siganl lesion in the right lobe of the thyroid.
    I had had a whiplash 25 years prior to this. I ended up going through some tests and had surgery to remove half my thyroid in May.
    I was sent to physical therapy for the muscle stiffness and loss of ROM. Therapy helped me regain my ROM, but I continued to have flare ups of pain. The fact that I unknowingly broke my rib while coughing didn't help me progress very well in PT due to the extreme pain I was in with my rib. After my rib healed and I was starting to do better I reinjured it and so was sent for BMD and learned I have severe osteoporosis. So physical therapy shifted some....we continued the massage, but my excercises took a shift more towards wieght bearing excersises. I was finally doing much better with fewer flare ups. Then I got plantar faciatis in my feet from a combination of all the walking I was doing for the bone loss and the drugs I was taking for the bone loss....the drug (Fosomax) caused severe muscle cramping especially in my feet and legs and I believe that in combination with the walking did my feet in. I quit the Fosamax and got new shoes and sole inserts and in about two weeks I was able to walk again without problems. Then I was in a car accident and got the second whiplash which undid everything I worked so hard to gain in terms of my neck/shoulder soreness/stiffness. I had to abandon my wieght bearing excercises, went back to physical therapy and he worked with me on massage and manual stretching excercises for several weeks, then suggested I go see a chiropractor in addition to what he was doing. So I did. Things went along not really getting any better but not any worse until about January. One day in January I leaned my head forward to wash my hair in the shower when a sharp pain went up the right side of my neck and at that instand I lost all ROM in my neck and was in extreme pain. I believe I saw the chiropractor 4 or 5 times over the next 7 days and my physical therapist saw me three times. He started cervical traction in addition to the massage and manual stretching. My ROM improved but the pain did not. So I went to an MD who prescribed Vioxx for me. Since then I have struggled to get back to where I was. I have tried unsuccessfully numerous times to start my upper body excercises and try to do them consistent at just a fraction of the wieghts I had been using before the accident, now I am just trying to do the motions without the weights just to see if I can keep the muscles going and if I can keep from flaring up maybe add just ounces at a time. Anyway, we knocked off the traction at some point because I was really getting agrivated with spasms and my chiropractor thught maybe traction was agrivating me. Looking back, I think she was wrong. But anyway, long about late June I began having these headaches. Sometimes it was just sharp needle like pains that would strike suddenly on the right side of my head and be gone as fast as they came, but it would happen repeatedly for a while and then go away. Other times it was pain up the back of the neck and round the right side of my head. Sometimes it is just a dull ache that comes and is there for long periods of time and pain killers don't seem to touch it. Sometimes I get shooting pain up the back of the head and then I end up with a full blown headache and my neck gets stiff and I loose ROM. So the headache thing isn't always the same pattern. But since I started taking Vioxx daily (I was only taking it when I just wanted a pain break, cause I hate taking drugs) the headache thing has become much less bothersome. But yes, I do have tenderness or trigger points on the right side at the base of the skull. I also have trigger points on the tops of both shoulders. I routinely have knots in the muscles of my upper back/shoulders/neck that my physical therapist really has to work to smooth out for me. It is not uncommon if I look down, say to wipe something off my shirt, that when I lift my head back up I will get a big muscle spasm right between the should blades at the base of the neck. I have to pace myself doing any kind of housework, computer work, driving and take frequent breaks as it will cause me ache something fierce.
    Currently I am at physical therapy once a week doing traction, massage, manual stretching excercises and I see the chiropractor about three times a month. I take Viox daily. I walk at least 20 to 30 minutes a day at least 5 times a week and I just decided to try to get back into the upper body excercises again but without the weights....just doing the motions for now. I have been forced to cut way back on the chiropractic because my insurance will only pay for ten visits a year and I have used up my ten. So it gets to be expensive for us. I will continue physical therapy until my insurance figures out it is maintenace therapy. At that point they will cut me off and then I don't know what I will do. I know they will pay for surgery, but they won't continue to pay for this other stuff. But I don't want a surgery if it's not a pretty sure deal it will fix my troubles and I am not convinced it will at this point. It will be interesting to see what the neurosurgeon says on the 17th. Well now you have the whole story!

     
    Old 09-01-2001, 10:48 PM   #7
    Prouzy
    Newbie
     
    Prouzy's Avatar
     
    Join Date: Aug 2001
    Posts: 6
    Prouzy HB User
    Re: MRI---what does the report mean?

    Sounds like you have been through it, just a bit. So, first of all, the disc protrusions may have been there from before or a a result from the previous trauma or a combination. Yes, it will be interesting to see what the neurosurgeon reports. Funny(or not so funny) thing about how insurance dictates the coverage, based on what??? That is another forum all together, but anyway. It sounds like some things were working and you had an exacerbation from a couple of different episodes. You have "severe osteoporosis", how do you define that? How old are you? What do you do for work or what is your activity level for work? Sitting standing, etc.? Or are you a homeworker?

    yes traction tends to feel good, but not always a good treatment. If you are tractioning hypertonic muscles, not spastic, it tends to aggrevate them even more, aside from the relief you get from the traction. Probably short lived??

    Because of the complexity of your cervical spine injuries, you seem to have more than one cause of headaches or pain generators. It sounds to me you have taken some responsibility for your care-very important. Yes, a set back is very frustrating when it took so long to get there. Have you been having these problems for 25 years? I know some people don't like to take drugs at all, but sometimes it's a good option. Controlling the pain can be very importnant in the rehabilitation process and the side effects of Vioxx can be quite minimal. Dependong on your age, the thyroid problem may have had an effect on your osteoporosis, and meds should be prescribed appropriately.

    So what's next? Well, another course of rehab to get the mobility back would be a choice. If it were me, I would try and find someone who really deals in soft tissue and/or chronic dysfunction of the locomotor system, most likely a physiatrist, chiropractor, physiotherapist, neuromusculoskeletal therapist, etc. Also, have you seen a psychiatrist or psychologist? Certainly not because it's in your head, but because this type of pain, relapse from injury, etc is very taxing on the mental capacity, which we know can have an effect on the autonomic nervous system causing increased physical tension, etc. In other words, don't neglect the other components of health. Injury to one of these components, long standing, will affect all, at which time you need to address all.

    Hope I gave you some useful information.

    Prouzy

     
    Old 09-02-2001, 12:08 AM   #8
    Marsh
    Newbie
     
    Marsh's Avatar
     
    Join Date: Aug 2001
    Location: Clarkston, Wash, USA
    Posts: 4
    Marsh HB User
    Re: MRI---what does the report mean?

    Sure do appreciate the time and concern you seem to be showing me on the forum. Thankyou!
    I will answer the questions you asked me.

    "You have "severe osteoporosis", how do you define that? My bone density test at the hip was -3.00.

    How old are you? I just turned 43 last week.
    What do you do for work or what is your activity level for work? Sitting standing, etc.? Or are you a homeworker? I am a wife, mother of two ages 5 and 8 and I teach them at home. We have lived most of our 18 years of marriage in one story homes, but two years ago moved into a home that requires me to run up and down stairs many times a day. Since getting the osteoporosis dx I walk 20 to 30 a day at least 5 or more days of the week.

    "yes traction tends to feel good, but not always a good treatment. If you are tractioning hypertonic muscles, not spastic, it tends to aggrevate them even more, aside from the relief you get from the traction. Probably short lived??" Yes, it is short lived. How does one know if the muscles are hypertonic or spastic and what do those terms mean? I do think the traction has helped some with the headaches, however, but I still have the problems of the spasms that come and go. My symptoms seem to come and go and change places from day to day and sometimes hour to hour. It is very agrivating because it makes it hard to explain to those who are trying to help when symptoms keep shifting around like that.

    Have you been having these problems for 25 years? NO. Over the last 25 years I have had infrequent neck problems that have always completely resolved. I never had persistent chronic pain that would not resolve.

    "Dependong on your age, the thyroid problem may have had an effect on your osteoporosis, and meds should be prescribed appropriately."
    I take Armour Thyroid 60mg. daily.

    Also, have you seen a psychiatrist or psychologist?
    When I had the flare in Jan. I was in extreme pain when I went to see the Dr. who prescibed Vioxx. Since I cried in front of him due to the pain, he put me on antidepressants too. These did nothing for me except plunge me deeper into depression, so he switched antidepresssants on me and the next one nearly ruined me. A friend from church who happens to be a physchiatrist took me aside and talked at length with me about what was going on and he encouraged me to quit the antidepressants, which I did. After several weeks getting it out of my system I couldn't believe how much better I felt. But my doctor was insistent that he wanted me on something and bugged me to death and due to our disagreement on the issue he dropped me as his patient which was a big relief to me because I was ready to quit him. So, to make a long story short.....emotionally, mentally, and spiritually, I am dependent on the grace of God to get me through this. I am finding much comfort and encouragement and strength in the company of Christian friends and in my relationship with God. I realize that while I don't know what my future holds, I know Who holds my future and He has allowed me to be in circumstance place for a specific purpose, and I rest in His Sovereign control.

     
    Closed Thread




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is Off
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 10:15 PM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!