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  • Cervical MRI results

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    Old 07-25-2016, 07:28 PM   #1
    Clwalker
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    Cervical MRI results

    I am a 51 year old man who had a ACDF at C4-5 and C5-6 in October of 2013 after several years of suffering with neck pain. Initially things were great and I was relatively pain free. The neck pain began to return after about 3 months so I had a repeat MRI in June of 2014. My pain management doctor said I had some bone spurs along with other issues so I went back to managing the pain with meds (Hydrocodone 10 mg-3 times per day) and injections. I recently had a rhizotomy at C4-7 which provided no relief. My pain is now worse than ever and I am worried about what may happen next. I welcome any and all advice. Here are the MRI results:

    C2-C3: Minor disc osteophyte complex and mild to moderate left and minor right facetosteoarthritis are identified without stenosis.

    C3-C4: Trace grade 1 retrolisthesis, disc osteophyte complex, uncovertebral joint overgrowth and minor facet hypertrophy contribute to borderline right foraminal stenosis. Spinal canal remains patent.

    C4-C5: Operative level. Pre-existing left uncovertebral joint overgrowth and/or osseous fusion mass contribute to moderate left foraminal stenosis. Spinal canal and right neural foramen are widely patent.

    C5-C6: Operative level. Left eccentric and foraminal osseous fusion mass and/or pre existing left eccentric disc osteophyte complex and uncovertebral joint overgrowth contribute to moderate left foraminal stenosis. Spinal canal and right neural foramen are widely patent.

    C6-C7: Disc osteophyte complex and uncovertebral joint overgrowth contribute to moderate, left greater than right foraminal stenoses without significant spinal canal compromise.

    C7-T1: Minor disc osteophyte complex and uncovertebral joint overgrowth contribute to mild left foraminal stenosis.

    Impression:

    -Status post ACDF C4-5 and C5-6. Osseous fusion mass and/or pre existing degenerative change contribute to left foraminal stenosis at the operative levels.

    -Non-fusion levels demonstrate multilevel, multi factorial cervical spondylosis with foraminal stenosis most advanced at C6-C7.

    Thanks for your help.

     
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    Old 07-27-2016, 09:35 AM   #2
    teteri66
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    Re: Cervical MRI results

    Are your pain and symptoms mostly on the left side?

     
    Old 07-27-2016, 03:23 PM   #3
    Clwalker
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    Re: Cervical MRI results

    Yes-primarily on the left. Since the surgery I have had some sporadic pain on the right side but the left is definitely worse.

     
    Old 07-27-2016, 05:05 PM   #4
    teteri66
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    Re: Cervical MRI results

    Well, the MRI supports that! First let me state that the hardware from a fusion complicates the clarity of the imaging...so you need to take that into account.

    It appears there is some bone growth at the fused segments that is causing the foramina on the left side to narrow...this process of narrowing is referred to as "stenosis." The foramen is an opening where the spinal nerve exits the spine to get out to the part of the body it innervates. When it becomes clogged ( like with extraneous disc material from a herniated disc, bone spurs, scar tissue, etc.) there is no longer as much room for the nerve, and, as a result, the nerve gets "pinched" or compressed. This pain can be felt right at that localized spot or anywhere along the path of that particular nerve....in the case of C4, 5 and 6, the pain could be felt in the neck, shoulder, and down the arm into the thumb.

    At these levels the right foramina and central canal are open as they should be.

    At C6-7 there is also overgrowth pushing into the foramina...it is worse on the left side but there is also some on the right side....causing moderate stenosis. (Words used for the ranking are: minimal, mild, moderate and stenosis.)

    And finally, there is a small amount of foraminal stenosis on the left side at that last cervical vertebra...C7-T1.

    Hope this helps you to understand a bit better the report. Will you be going back to your spine surgeon?

    Last edited by teteri66; 07-27-2016 at 05:06 PM.

     
    Old 07-27-2016, 06:12 PM   #5
    Clwalker
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    Re: Cervical MRI results

    Thank you for the detailed response. It is good to know that the MRI does support the pain I have been feeling.

    To be honest, I am not sure what I am going to do next. A second surgery scares me and with issues at several different levels I am worried about the results. I think I may stick with my Pain Management doc for awhile longer and then consider seeing a spine surgeon again. Although I really liked the doctor who did my first surgery I think I may look at other options this time around.

    Thank you for your help.

     
    Old 07-29-2016, 05:11 AM   #6
    teteri66
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    Re: Cervical MRI results

    That makes sense. There is no guarantee that surgery would lessen the pain and can bring about new issues. From the report it doesn't appear there is any cord compression and serious nerve compression, so if you can manage the pain without more surgery, it is worth waiting.

     
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