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  • Help with the meaning/definitions of MRI Cervical Scan Report

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    Old 02-16-2016, 06:45 PM   #1
    NinjaNNN
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    Help with the meaning/definitions of MRI Cervical Scan Report

    Hello all, I am a new member here and have just had an MRI scan 2 days ago of my cervical spine. The scan was asked for by my GP because of the following symptons... I started having tingling/numbness in my pinkie/ring/middle fingers in my left hand 4 weeks ago and slowly getting worse. About 1 week ago my right hand's same fingers started feeling the same as well. I have no pain at the moment nor any other symptons, but the report below has me quite concerned.

    If anyone can please explain in everyday english/layman's terms what exactly the report below (in blue italics) is saying it would be greatly appreciated

    I am not asking for an interpretation/treatment explanation, just a translation for a non-medical person to understand and have little more insight into before I see my GP and physio.

    MRI CERVICAL SPINE
    CLINICAL DETAILS

    Paraesthesia 4th and 5th fingers on both hands for more than four weeks. Previous motorcycle injury falling on shoulder and
    back with broken collarbone.

    FINDINGS
    There is loss of the normal mid cervical lordosis. The vertebral body heights have been maintained, the bone marrow signal is
    normal and no focal osseous lesion is present. The craniocervical junction outlines normally.

    C2/3: The disc contour, signal and height are normal. No foraminal or canal stenosis is present.

    C3/4: There are bilateral uncovertebral disc-osteophyte complexes which cause mild narrowing of both neural exits, slightly
    worse on the right. There is minor canal narrowing flattening the anterior aspect of the spinal cord without significant cord
    deformity or intra-axial signal change.

    C4/5: There is anterior craniocaudal narrowing of the disc with bilateral uncovertebral and left paracentral disc-osteophyte
    complexes. Severe narrowing of the right C5 intervertebral neural foramen is present with mild narrowing of the left C5 neural
    exit. There is also narrowing of the spinal canal with indentation of the left anterior aspect of the spinal cord without definitive
    intra-axial signal change.

    C5/6: There is a central disc extrusion measuring up to 6mm nteroposteriorly x 8mm craniocaudally x 8mm transversely indenting the anterior aspect of the spinal cord with near complete effacement of the CSF surrounding the spinal cord at the level of the disc. In addition there are bilateral uncovertebral disc-osteophyte complexes, larger on the right causing moderate
    right and mild to moderate left C6 neural exit narrowing.

    C6/7: There is desiccation of the disc with bilateral uncovertebral disc-osteophyte complexes, larger and wider on the right causing moderate right and mild left C7 neural exit narrowing.

    C7/T1: No abnormality is present.

    COMMENT:
    1. Moderate canal narrowing at C5/6 with less severe spinal canal narrowing at C4/5 and C3/4.

    2. Severe right C5, moderate right C6 and right C7 and mild to moderate left C6 neural exit narrowing.

    Yours sincerely

     
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    Old 02-17-2016, 07:37 AM   #2
    teteri66
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    Re: Help with the meaning/definitions of MRI Cervical Scan Report

    Welcome to the board. I think I will explain some terms that will help you understand why your fingers are numb. As you can imagine, there is not a lot of extra space within the cervical spine. When anything extra develops or forms, or enlarges, it can create issues that put pressure on a spinal nerve or on the spinal canal itself. The "narrowing" you see referred to in the report is called stenosis...and it primarily occurs in two places: the central canal (where spinal cord is located) and the neural foramen. The foramina is an opening located at each vertebral segment where the spinal nerve exits the spine and goes out to innervate a specific part of the body. If the nerve is pressured or irritated due to this opening getting clogged up or narrowed, the result is pain, tingling or numbness. This can be felt right at the site of "pinching," or, it can be felt anywhere along the path of the spinal nerve that is being pinched.

    When the narrowing occurs in a foramina, it will affect a single nerve. When there is pressure on the spinal canal or spinal cord itself, it can cause pain anywhere below the level of the narrowing. If this compression is severe and not relieved, it can damage the cord itself which can have disastrous results including paralysis and development of myelomalacia, which is a softening of the cord.

    It is also helpful to know that radiologists use specific adjectives to help rate just "how bad" a particular finding is: minimal, mild, moderate and severe. Of course the spine specialist will pay no attention to the written report, but will look at the MRI and make his/her own assessments. Since the MRI is just one piece of the puzzle, the doctor will correlate the findings to what is found upon physical exam and a basic neurological exam.

    So, even though there are different issues causing the stenosis, all of which could be lumped into the category of degenerative disc disease, they all produce the same result (narrowing or stenosis.).

    You will see that under the Comments, it summarizes what is " wrong." #1 describes narrowing of the central canal, moderate at C5-6 with a bit less narrowing at C3-4 and C4-5. Probably none of this is severe enough to warrant surgery (but of course I am not a doctor, so I am merely guessing based on my own experience!)

    #2 describes the amount of stenosis that was found in the foramen at C5, C6 and C7.

     
    Old 02-17-2016, 04:52 PM   #3
    NinjaNNN
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    Re: Help with the meaning/definitions of MRI Cervical Scan Report

    Hello Teteri66

    Thank you very much for your explanations! Helps me to understand more of the report for sure

    I had an appointment with my local GP this morning. From the report and my current symptoms he thinks that the neck area may not be the cause and could be just the ulnar nerves in both elbows being compressed. His main reasoning is that I have no pain nor weakness in my hands, arms or upper back (at the moment) and the report indicating no issues with the C7/T1 disc, as the C8 nerve in between these vertebrates is what innervates sense/feeling in the ring and pinky fingers...

    I am still wary though, as the large disc extrusion at C5/6 seems like the most important issue and should be followed closely as per what the radiologist doctor who did the MRI told me. I will need to seek more professional medical opinions.

    Can you (or anyone else ) please clarify a bit more on this particular part?

    C5/6: There is a central disc extrusion measuring up to 6mm nteroposteriorly x 8mm craniocaudally x 8mm transversely indenting the anterior aspect of the spinal cord with near complete effacement of the CSF surrounding the spinal cord

    Last edited by NinjaNNN; 02-17-2016 at 04:54 PM.

     
    Old 02-18-2016, 09:32 AM   #4
    teteri66
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    Re: Help with the meaning/definitions of MRI Cervical Scan Report

    Of course the doctor is correct regarding the dermatomes. However our bodies are not all divided up as accurately as a diagram in a textbook and symptoms are not always 100% direct indicators of what and where something is going on.

    An extruded disc is one where disc material has come out of the disc. Follows is the measurement of this blob...8mm up and down by 6mm forward and backward? In this case it is pushing into the central canal with sufficient force that it is almost completely affecting the CSF ( cerebrospinal fluid--the liquid that surrounds and cushions the spinal cord in the central canal).

    The purpose of CSF is to protect and cushion the brain and spinal cord from trauma. It also carries nutrients to the nervous system tissue, brain and spine, and carries waste away from the brain.

    The danger is that without sufficient CSF, the nerves of the spinal cord cannot function optimally...which could have a deleterious effect on the central nervous system. It can result in a compression of the spinal cord at the affected level.

    Since to me this is a more serious possibility than a compressed ulnar nerve, I would make an appointment with a spine specialist for a proper evaluation and diagnosis. In the US this would be an orthopedic spine surgeon or neurosurgeon who limit their practice to the neck and back.

    Remember that when the spinal cord is compressed, symptoms can show up anywhere below the level of compression. From a C5-6 cord compression it is possible to have numb feet. The fact that you don't have pain, etc. as well isn't all that significant.

    I developed numbness in my toes years before I got around to developing symptoms that clearly indicated a lower lumbar spine issue. Doctors just thought I had a bit of neuropathy of unknown cause.

     
    Old 02-18-2016, 09:47 AM   #5
    teteri66
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    Re: Help with the meaning/definitions of MRI Cervical Scan Report

    I would add that I went through a year of misdiagnosis of my lower lumbar nerve compression because I did not have the most common symptoms...the fact that you are not showing weakness yet doesn't change the fact that there is a disc extrusion blocking CSF...

    I would get it checked out!

     
    Old 02-19-2016, 12:01 AM   #6
    NinjaNNN
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    Re: Help with the meaning/definitions of MRI Cervical Scan Report

    Hello Teteri66, thanks very much for your last reply and explanations, very helpful

    I will be seeing another doctor next week for a second opinion and also will see a physiotherapist to see if some conservative treatment may help with the extruded disc, as this is what the radiography doctor who did the MRI suggested.

    I agree with you on the importance of this C5/6 extrusion issue and the likely future complications on the spine. I will seek out a neurologist/neurosurgeon in the next few weeks also!

    I guess the strange thing is my limited symptoms which seems to be why both doctors so far cannot definitively pin point the cause of the numbness in my fingers. I have no issues of the lower body. The only we found additional is that these cervical disc issues and narrowing of the foramens are what probably has caused my stiff neck occurences over the past few years... I get stiff necks 3-4 times a year from exercise/sports and never really thought anything about it, thinking it was just a tweaked muscle from too much strain or a sudden sharp neck movement etc.

     
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