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  • Does this mean surgery?

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    Old 07-10-2016, 07:03 AM   #1
    Madi139
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    Does this mean surgery?

    Details
    Study Result

    INDICATION: Cervicalgia.

    TECHNIQUE: Multisequence, multiplanar MRI of the cervical spine
    was performed on a 3 Tesla magnet without contrast. Obtained
    sequences include: Sagittal T1, sagittal T2, sagittal STIR, axial
    T2, and T2 medic axial.

    COMPARISON: None.

    FINDINGS: Visualized portions of the posterior fossa are
    unremarkable. The bone marrow and cord signal are unremarkable.
    There are no masses in the central canal or paraspinal region.
    Prevertebral soft tissues and atlanto-dens interval are within
    normal limits. The craniocervical junction is within normal
    limits. Straightening of the normal cervical lordosis. The
    intervertebral disc spaces are maintained.

    Specific findings are seen at the following levels:

    C2-C3: Small sized central disc osteophyte complex. No neural
    foraminal narrowing or spinal stenosis.

    C3-C4: Mild bilateral uncovertebral hypertrophy. Mild left
    neural foraminal narrowing. No spinal stenosis.

    C4-C5: Moderate sized diffuse disc osteophyte complex. Bilateral
    uncovertebral hypertrophy, left greater than right. Mild left
    neural foraminal narrowing. Effacement of the ventral CSF with
    mild spinal stenosis.

    C5-C6: Moderate sized left paracentral disc osteophyte complex.
    Mild bilateral uncovertebral joint hypertrophy. Mild left neural
    foraminal narrowing. Indentation of the left ventral hemicord
    with mild spinal stenosis.

    C6-C7: Minimal left paracentral disc osteophyte complex. Mild
    left greater than right uncovertebral joint hypertrophy. No
    neural foraminal narrowing or spinal stenosis.

    C7-T1: No significant discogenic pathology. No neural foraminal
    narrowing or spinal stenosis.

    IMPRESSION:
    Cervical degenerative disc disease most pronounced at C4-C5 and
    C5-C6. At C4-C5 a moderate-size disc osteophyte complex
    contributes to mild spinal stenosis. At C5-C6 a small left
    paracentral disc osteophyte complex causes indentation of the
    left ventral hemicord with mild spinal stenosis.

     
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    Old 07-11-2016, 07:15 AM   #2
    teteri66
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    Re: Does this mean surgery?

    Welcome to the board. As you read, please remember two things. We members are not doctors, and, that the MRI is just one piece of the diagnostic puzzle. The spine specialist, either a fellowship-trained orthopedic spine surgeon or neurosurgeon, will correlate the results of the imaging with what is found upon physical exam and basic neurological exam. That being said, if this were my MRI, I would think that my issues could be treated with conservative modalities, and that surgery would not be necessary. I base this on the fact that there is no central canal compression and the spinal cord is not impacted.

    First, let's look at a few terms. The spinal cord is surrounded by and protected by a series of bones called vertebrae that are stacked one on top of the next. Separating the bones are spongy discs which serve to provide movement, cushioning, protection, and a place to attach ligaments. As the spine begins to degenerate due to daily wear and tear, aging, or injury, it is not unusual to develop disc osteophytes complex. This is when more than one disc develops small bone spurs called osteophytes, which is the body's attempt to lay down more bone in an attempt to stabilize the spine by limiting mobility and to reinforce structural integrity of the spinal column. This only becomes a problem when these bone spurs take up too much room and begin to put pressure on a spinal nerve or the spinal cord itself. This neural compression is responsible for many of the symptoms such as radiating pain, tingling and numbness.

    While you don't have specific nerve compression, the MRI reveals that there is a little degenerative disc disease (DDD) in most cervical levels...worse at C4-5 and C5-6.
    At C4-5 the bone spurs are sufficiently large that they are beginning to push into the central canal and both foramen, causing stenosis. This is a "narrowing" of an opening where spinal nerves pass ...in this case, rated to be mild (on a scale that uses the words minimal, mild, moderate and severe to judge severity of an issue).

    At both these levels, the disc osteophyte complex is judged to be moderate and is large enough that it is pushing into the central canal. At this point it isn't enough that it is impacting the spinal cord, but if the osteophytes would continue to grow, I suppose at some point in the future, this could become a problem.

    If you read carefully, you will note that most of the issues are located on the left side. Does this correspond with the symptoms you are feeling?

    One other term mentioned is "unconvertebal joint hyper trophy." These are little bone spurs that develop in these small joints that run from C3-7. This degenerative process often occurs as a part of DDD.

    Most likely your symptoms can be treated through a course of physical therapy, medications and perhaps a series of epidural steroid injections.

    Hope you get some treatment soon.

     
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