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    Old 10-05-2015, 08:21 PM   #1
    mws952002
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    Help Understanding Cervical MRI

    Would appreciate assistance to understand in English. I think below report is just degenerative in nature, but I don't understand a lot of the terminology.
    Thx.

    TECHNIQUE: Sagittal T1, T2 and axial 3D GRE images of the cervical spine were acquired. A STIR sagittal sequence was also obtained.

    FINDINGS: There is reversal of cervical lordosis. There is anterolisthesis of C2 on C3 and stepwise retrolisthesis of C3 on C4 and C4 on C5 and C5 on C6. The vertebral bodies are within normal limits for height. Ventral, prevertebral osteophytes are present at several levels. There are endplate degenerative marrow signal changes present at several levels with Schmorl's nodes. The cervical discs are desiccated with variable degrees of mild to moderate loss of height. Cervical spinal cord is of normal caliber and signal.

    C2-3: There are facet degenerative changes. There is a posterior osteophyte-disc complex with uncinate hypertrophy. There is no significant foraminal narrowing. There is mild spinal canal narrowing.

    C3-4: There are facet degenerative changes. There is a posterior osteophyte-disc complex with uncinate hypertrophy. There is a superimposed central disc protrusion. There is moderate-severe spinal canal stenosis with deformity of the cervical cord. There is severe bilateral foraminal stenosis.

    C4-5: There are facet degenerative changes. There is a posterior osteophyte-disc complex with bilateral uncinate hypertrophy. Severe right and moderate left foraminal narrowing. There is moderate spinal canal compromise with flattening of the ventral cord.

    C5-6: There are facet degenerative changes. There is a posterior osteophyte-disc complex uncinate hypertrophy. There is mild-moderate spinal canal narrowing with deformity of the ventral cord. There is severe bilateral foraminal stenosis.

    C6-7: There are facet degenerative changes. There is a posterior osteophyte-disc complex uncinate hypertrophy. There may be a superimposed central disc protrusion. There is moderate-severe spinal canal narrowing with deformity of the cervical cord. There is severe bilateral foraminal narrowing.

    C7-T1: There are facet degenerative changes. There is a posterior osteophyte-disc complex with uncinate hypertrophy. There is mild left and no right foraminal narrowing. There is no significant spinal canal narrowing.

    IMPRESSION: There are multilevel degenerative changes as detailed above.
    ***Final Report***

     
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    Old 10-09-2015, 07:28 PM   #2
    teteri66
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    Re: Help Understanding Cervical MRI

    Sorry no one responded to you yet. Judging by this report, I suspect you are in a great deal of pain. I am just curious whether there was more to the "Impression" section of the report. If not, it is surprising.

    You have a lot going on in the cervical spine. The discs are in the process of drying out and some are beginning to lose height or flatten. There is a reversal of the normal curve of this part of the spine and there is spondylolisthesis occurring from C2 all the way down to C6. This is when the vertebra slips over the top of the adjacent vertebra. The report indicates that each segment steps out from the above segment but doesn't indicate to what extent. Spondylolisthesis can create instability.

    You actually have a great deal of stenosis at almost all levels. Stenosis, simply put, means narrowing. It happens primarily in two areas of the spine: the central canal (that in cases the spinal cord and cauda equine nerves) and the intervertebral foramen. The foramina is a small opening located at each vertebral level where a spi nal nerve passes out from the central canal to the area of the body it innervates. If the opening gets clogged or blocked, the result is an irritated or compressed nerve. This can happen from swelling tissue or something that encroaches on the opening like a herniated disc or an enlarged facet joint. If a spinal nerve is irritated, it usually results in some pain. When it is badly compressed, there are symptoms of tingling and numbness, and if a muscle is affected, there can be a loss of muscle mass or motion.

    "Facet degenerative change" indicates that there is some degeneration of the facet joints. The facets are synovial joints located at each vertebra that link the spine together and, along with the discs, are what allow the spine to bend and twist. Just like other synovial joints, they contain fluid and are subject to arthritic degeneration and change.

    In your report you will notice that at several levels there is degenerative disc disease which is resulting in some osteophytes, or little bone spur type growths that form along the disc. The facets are showing signs of arthritis, no doubt causing enlargement of the disc/facet joint which is causing moderate to severe narrowing in the foramen at multiple levels. An even more serious finding is that these changes are also pushing into the spinal canal and causing deformity of the spinal cord itself. This occurs from C 3 down to C7, to various degrees. This is a potentially serious finding and your spine specialist will need to keep an eye on this. Any time the spinal cord is impacted in any way, it can lead to permanent nerve damage. I do not mean to scare you, but to impress upon you that you need to be examined by a spine specialist, either an orthopedic spine surgeon or neurosurgeon, to determine the extent of this impact on the spinal cord and how it should be treated.

    Also, you should know that specific adjectives are used to describe the range of severity for a particular issue in the spine. They are: minimal, mild, moderate and severe. When you see that your foraminal stenosis is severe, that means that it doesn't have a lot more room to get worse! That means the foraminal opening is probably almost closed, and the spinal nerve is being compressed a lot.

    If you do not yet have a referral to a spine surgeon, you should get one soon. You need a specialist to examine you, look at the MRI and evaluate just what is going on and what you need to do about it to keep things from getting worse. I see you are in Chicago. There are some fine spine surgeons there.

    Good luck and let us know how you make out.

    Last edited by teteri66; 10-09-2015 at 07:31 PM.

     
    Old 10-10-2015, 01:38 AM   #3
    mws952002
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    Re: Help Understanding Cervical MRI

    Thank you for reply. There was no more to the impression. What I do know is that I got results quickly. My Dr called me in about 4 hours after I had MRI. I have appointment with neurosurgeon in a couple of weeks.
    My primary Dr thinks I won't want surgery. I just had the luck of the draw. My rheumatologist is the one that ordered MRI and referred me to neurosurgeon.
    Thx again for reply.

     
    Old 10-10-2015, 08:03 AM   #4
    teteri66
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    Re: Help Understanding Cervical MRI

    They responded quickly due to the cord compression. Do not be shocked if surgery is mentioned. Cannot tell from the report "how much" cord compression there is or how severe the foraminal stenosis is from the radiology report. Perhaps you will just need to watch it for now to be sure you do not develop myelomycia and the spondylolisthesis is not unstable.

    If surgery is recommended, be sure to get more than one opinion. The first referral is not always the best choice available to you, plus the hospital is very important, too.

     
    Old 10-10-2015, 09:46 AM   #5
    mws952002
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    Re: Help Understanding Cervical MRI

    Rheumy told me she had spoken with radiologist; I have severe narrowing. We'll see what neuro says. I will want second opinion if surgery is recommended. Thank you very much for insight!

    Last edited by mws952002; 10-10-2015 at 09:49 AM.

     
    Old 10-11-2015, 10:18 AM   #6
    teteri66
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    Re: Help Understanding Cervical MRI

    Everywhere you see the word "stenosis" in the report you can substitute the word "narrowing." Yes, you have it at many levels and at both the foramen and in the central canal, severely. Hope you can get in soon!

     
    Old 10-28-2015, 06:49 PM   #7
    mws952002
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    Re: Help Understanding Cervical MRI

    I thought I would provide an update. I saw neurosurgeon at Northwestern today. The disc degeneration and arthritis were almost non-issues. He zeroed in on MRI and compression. My nerve test indicated a problem and confirmed by MRI. The neuro test he gave reflected problem too. I did not do well walking, putting one foot in front of other. That and manual dexterity issues are impacted by compression. There are 2 areas that are in line for repair, both front and back. It can be repaired but the surgery would be tough. Would be at least a week in hospital, perhaps longer, and off work 6 weeks to 3 months. He would go in both front and rear of neck. He is ok with watching progression, with the caveat of any worsening of symptoms, call. They will get me in next day. I see him in 3 months with another MRI before. He had two concerns. First, I have an immune deficiency (CVID) and could be prone to surgical infection. He wants to talk to treating doctor. Second, if I were to have a hard fall, I could “be in trouble”. And, living in Chicago with winter approaching, lots of snow and ice, is a concern. Being a bit stunned, I didn’t think to ask, what does that mean. I am being optimistic, that it’s not that bad, just pains of growing older.

     
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