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  • Does my MRI result support my doctor's diagnosis?

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    Old 08-15-2016, 08:17 AM   #1
    pianoart
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    Does my MRI result support my doctor's diagnosis?

    Hi, I'm new here and happy to see how much help is given to people having trouble understanding their MRI result -- because I am one too. After accidentally lifting something way, way too heavy, I was diagnosed by my family doctor with herniated disc, probably at C6-7. My symptoms were some pain in the lower neck and very bad nerve pain all the way down my right arm to outside fingertips, plus tingling/numbness. Physical therapy is finally starting to help. My doctor ordered an MRI, called me with the result, and said it is not a herniated disc but instead is arthritis with "mild" nerve impingement.

    I'm now reading a copy of the MRI results. I'm confused, and an extra phone call to my doc didn't clear up my confusion.

    To save space I won't include the result at every level except to say mild spondylotic changes are present as well as posterior facet disease. (I'm age 66.)

    However, the MRI report at two levels makes me wonder, and I'm typing them verbatim:

    "At the C5-6 level, there are moderate spondylotic changes, slightly eccentric towards the right, where mixed hard and soft disc material abuts and mildly deforms the ventral surface of the cervical spinal cord. There is osseous foraminal encroachment right worse than left at this level, in part due to posterior facet disease."
    AND
    "At the C7-T1 level, there are also spondylotic changes, eccentric towards the right, with prominent abnormal material projecting into the right neural foramen. There is marked encroachment on the region of the exiting right C8 nerve root sleeve, likely secondary to combination of spur and disc. Left neural foramen is patent."

    First, does this sound only like arthritis, with no disc herniation?
    Second, if so, how can arthritis happen as a result of the lifting accident I had? Thank you so much for any information you can give me.

     
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    Old 08-20-2016, 07:43 AM   #2
    teteri66
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    Re: Does my MRI result support my doctor's diagnosis?

    Welcome to the board. I'm sorry I didn't see your post sooner. You are correct to be skeptical. Do you know if your doctor looked at the MRI or is just relying on the radiology report for his information?

    In either case, I think you would benefit from a consultation with a spine specialist. This could be either a fellowship-trained orthopedic SPINE surgeon or a neurosurgeon. Whichever specialty you pick, be sure the doctor limits his/her practice to issues of the back and neck. One of these two specialists is the best place to go for an accurate diagnosis and plan of treatment.

    In the case of spinal arthritis or what is referred to casually as "arthritis" often causes the same issues as a disc herniation or protrusion...which is that some body part enlarges in size, takes up more room than it should and ends up "pinching" or compressing a spinal nerve. Sometimes the result is just localized pain, but if it is in the facet joints, it results in the formation of osteophyte growth and joint enlargement, which puts pressure on the foramina and causes nerve compression. The foramina are small openings located at each vertebral level. The spinal nerve associated with that vertebral level has to pass through this opening as it exits the spine and goes out to the area of the body it innervates. If that opening is blocked (due to disc herniation, facet arthropathy, etc.) the nerve ends up becoming irritated or compressed, which results in pain at that site or anywhere along the path of the nerve, and results in pain, tingling or numbness, depending on the extent of the compression. This process is referred to as stenosis and can occur in the central spinal canal or the foramen.

    Now...to your report....first, there are specific adjectives used in describing just to what extent something is impacted..or "how bad" something is. They are minimal, mild, moderate and severe. Generally speaking, if something is minimal or mild, a doctor will say everything looks OK. Moderate usually requires paying attention to and severe often means it is pretty bad and might require surgery. These are a subjective judgment by the radiologist but it lets the doctor know where to begin looking for an issue.

    My guess is that when you lifted the item, a disc protruded. I must say I have never seen a report that says "mixed hard and soft disc material" and I am not sure exactly what is meant by it. But, in any case this disc material is coming out from the disc and is pushing into the front or ventral side of the spinal cord. (This is a finding I would want to explore further as it is not just pushing against the spinal canal, but into the cord itself.) (This is enough to be a pain generator.)

    At this level the facet joints have enlarged and are pushing into that foraminal space I described above, right side more than left.

    At the disc space between C7 and C8, a similar thing is going on...and again I don't know what is meant by "prominent abnormal material" but I think it means that disc material is coming out of the disc and pushing into the foraminal space on the right side...and it is noticeably pushing into the C8 spinal nerve. The exiting C8 nerve is also being impacted by the disc and bone spurs. Is this "abnormal material" disc material or could it be some sort of cyst or ?? I would want a spine specialist to check it out further. At this level, the foramen on the left side is open...no problem.

    You can look online for a "dermatome map" to see which areas of the body are impacted by which spinal nerve.

    Let us know how you are doing! Good luck, and no more heavy lifting! I should add that your issues are not serious and do not require immediate attention, but if I were you, I would go to a spine specialist.

    Last edited by teteri66; 08-20-2016 at 07:52 AM.

     
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