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  • MRI of the cervical spine

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    Old 10-07-2015, 11:44 AM   #1
    BenzWin
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    MRI of the cervical spine

    Recently had an MRI and the following are the findings,

    Degenerative changes are seen at the following levels:
    C2/C3: No central spinal canal or foraminal stenosis.
    C3/C4: Uncovertebral/facet hypertrophy results in mild bilateral foraminal stenosis. Minimal diffuse disc bulge without central spinal canal stenosis.
    C4/C5: Right uncovertebral/facet hypertrophy results in severe foraminal stenosis. Mild diffuse disc bulge without ventral cord contact or central spinal canal stenosis. No left foraminal stenosis
    C5/C6: Uncovertebral/facet hypertrophy, left greater than right, results in severe left and mild right foraminal stenosis. Mild diffuse disc bulge, eccentric to the left, results in left axillary recess stenosis.
    C6/C7: Diffuse disc bulge contacts the ventral cord without central spinal canal stenosis. Uncovertebral/facet hypertrophy, left greater than right, results in severe left and mild right foraminal stenosis.
    C7/T1: Minimal diffuse disc bulge. No central spinal canal or foraminal stenosis.

    IMPRESSION:

    Multilevel spondylotic changes with ventral cord contact at C6/C7, but without central spinal canal stenosis. Severe right C4/C5, left C5/C6 and left C6/C7 foraminal stenoses.

    Today is 7 Oct and I see a spine surgeon on 22 Oct. I am a very active 56 year white male who does yoga, core strenghtening, and upper body exercise everyday for 30-45 minutes. Basicly I am scared out of my mind and not sure what to expect when I see the doctor. Anyone with similiar findings?

     
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    Old 10-08-2015, 07:23 AM   #2
    teteri66
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    Re: MRI of the cervical spine

    Welcome to the board. First of all, try not to be frightened. The spine surgeon will recommend conservative treatments and surgery will always be a last resort! I feel it is important to go to a spine surgeon, who is the best educated, trained and experienced in the areas of the diseases and injuries to the back and neck, for an accurate diagnosis and plan for treatment. This will usually include referrals for physical therapy and perhaps pain management. The more you can learn about your issues, the less frightening it all will seem, plus you will understand what the doctor is telling you.

    First a little basic anatomy: the cervical spine includes the first seven vertebrae of the spine, which are separated and cushioned by the intervertebral discs. The discs are mostly "water" and as we age, they lose moisture and tend to flatten. This begins a cascading series of degenerative changes that result in further break down of the joints and ligaments that hold us together!

    There are two issues that occur commonly and cause us lots of discomfort....herniated or bulging discs and stenosis. Stenosis means "narrowing" and occurs primarily in two areas of the spine: the central canal, which when narrowed can squeeze the spinal cord, and in the foramen. The foramina is a little opening where the spinal nerve exits the central canal and goes out to the area of the body that it innervates. When something pushes into the canal or opening, it puts pressure on the nerve and can cause pain or symptoms like tingling or numbness. This can be felt right at the origin of the nerve or anywhere along the nerve's path. (This "path" is called a dermatome and you can look for a dermatome map online to indicate what area of the body is innervated by which spinal nerve.)

    Now to your specific issues....the MRI is just one piece of the diagnostic puzzle. Your spine doc will correlate the findings to what he/she finds on physical exam, a basic neurological exam and after listening to your description of symptoms and what impact they have on your daily life. Sometimes something looks bad on the MRI but in reality is not causing any pain. So the doctor's knowledge and experience is very important.

    There are signs of disc bulging at most levels, but the greatest issues are seen at C4-5 through C6-7 with varying degrees of stenosis. At C4-5 and C 5-6 you will see facet arthropathy listed. The facet joints are located at each vertebral level and link the vertebrae together. They are synovial joints that, along with the discs, allow us to bend and twist and have movement in the neck and back. They are subject to arthritic changes which cause them to enlarge and become stiff and painful. This arthropathy is resulting in foramina lol stenosis which is judged to be severe at C4-5 on the right side and at C5-6 and C6-7 on the left side. In addition the bulging disc at C6-7 is pushing into the central canal but it is not impacted the spinal cord at this time. I imagine the doctor may want to keep an eye on this as it becomes a more serious issue when the spinal cord is being compressed.

    You might want to read up on degenerative disc disease and spinal stenosis before your appointment and look at a good diagram of the spinal anatomy so you will be able to better understand the spine doctor when you have your appointment. I would also ease up on your exercise regiment a bit until you see the doctor as you wouldn't want to make the disc issues worse. What you are doing may be fine, but it could also be aggravating your issues, so you might want to wait for guidance from the doctor.

    Good luck and let us know how the appointment goes.

     
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    BenzWin (10-08-2015)
    Old 10-22-2015, 10:06 AM   #3
    BenzWin
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    Re: MRI of the cervical spine

    I had my consult with my ortho surgeon today and he asked me what I would like to be done, therapy, injections, surgury. I asked him what am I the best candidate for and he recommended therapy. I told him I have been taking 6-8 advil per day to manage pain and he said that is to much, take a max of 4 per day and expereiment with tylenol or asperin and see what works best to help with pain. That's it.

    I'm in the process of requesting a second opinion. I am by no means the smartest man in the world but it's almost like this guy didn't even look at the MRI.

     
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