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  • cervical disc mri

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    Old 10-10-2016, 07:29 PM   #1
    ebb553
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    cervical disc mri

    Been watching this for years and recently developed all kinds of issues. Weakness both arms, intermittent pain down right arm into thumb, difficulty twisting/opening jars etc with both hands, vague shoulder pain. None of the pain and weakness is off the charts, but certainly noticeable. If I do PT (which N said may be an option), will it really help or am I just putting off the inevitable? (past Chiari 1 Malf surgery mentioned, which is no longer an issue)

    Findings:

    Suboccipital craniectomy with partial resection of dorsal C1 arch
    redemonstrated

    Mild reversal of cervical lordosis. Stable.. No abnormal intramedullary
    signal.. Visualized marrow within normal limits.

    C2/3: No significant abnormality.

    C3/4: Severe left facet joint degeneration stable. Moderate left neural
    foraminal narrowing. Small central extrusion stable..

    C4/5: Small grade 1 anterolisthesis. Severe left facet degeneration. No
    significant change..

    C5/6: Decreased disc space height. Large broad central extrusion/osteophyte
    complex. Moderate cord flattening. Ligamentum flavum hypertrophy. Moderate
    spinal stenosis. No abnormal intramedullary signal. Cord flattening has
    progressed.. Moderate bilateral neural foraminal narrowing, greater on the
    right...

    C6/7: Loss of disc space height. Endplate degenerative changes. Moderate
    left neural foraminal narrowing. Moderate broad based central
    extrusion/osteophyte complex. No significant change..

    C7/T1: No significant abnormality.


    IMPRESSION:

    Reversal cervical lordosis with severe degenerative changes worse at C5-6
    with large broad central extrusion/osteophyte complex causing moderate cord flattening which has progressed. Moderate spinal stenosis. No abnormal
    intramedullary signal.

    Stable postop changes craniocervical junction from Chiari impression..

     
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    Old 10-12-2016, 06:56 AM   #2
    teteri66
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    Re: cervical disc mri

    Welcome to the board. Sometimes insurance carriers require a course of physical therapy before they will OK surgery. Otherwise, with the amount of severe stenosis indicated on the MRI, I would guess more surgery is in your future.

    Most of the stenosis issues indicate that the foramina as mentioned above are almost completely blocked, making it difficult for the affected spinal nerves to exist and remain healthy...but apparently none of this is any worse than when the previous MRI was performed.

    The exception to this is at C5-6 where there was previous cord flattening and it has become more flattened. There is an extruding disc, meaning the disc material is coming out of the disc, causing the disc space to narrow. This degenerative process is causing some small bone spurs to grow on the adjoining vertebra ( disc osteophyte complex) which result in enlargement of the joint at this spinal segment. Since space is so limited in the neck, anything that gets bigger than it should be puts pressure on the nerves and, potentially on the spinal cord itself. This has the potential to be very harmful. If the spinal cord is compressed it can damage the cord itself, damaging the nerves contained within the cord. It can result in a disease called myelomalacia which causes the spinal cord to soften and can be very serious.

    Personally, when someone has severe stenosis, I don't see how PT can help...but I am not a doctor so perhaps just don't understand all the intricacies. It appears you have had these bulging discs for awhile, so I doubt at this point PT is going to help heal the discs!

     
    Old 10-13-2016, 02:32 PM   #3
    ebb553
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    Re: cervical disc mri

    thanks so much for your reply! I've made an appt with my NS (same guy who did chiari) just to get an updated opinion. Its hard to think about (another) surgery esp when the pain is not all that bad and the weakness if inconvenient, but not debilitating. I guess I'm just not sure what the implications of waiting may be, is my spine more vulnerable to falls, accidents, etc. and are there any nuances to this, of which I may not be aware. I'm def not in a big hurry to get surgery, Chiari was enough. But I also don't want to be irresponsible and short sighted. Thanks again!

     
    Old 10-13-2016, 05:54 PM   #4
    teteri66
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    Re: cervical disc mri

    Any time there is spinal cord involvement, it makes sense to see a spine surgeon for an accurate diagnosis and plan of treatment. I would think he would want to keep an eye on it to see if more compression is developing or if there are changes such as myelomalacia forming. Anything that compresses the spinal cord needs to be followed because the potential for permanent damage exists and is serious, leading to things like bladder or bowel problems, loss of muscle function, etc. even leading to paralysis.

    Your report doesn't indicate anything that serious...but As far as I am concerned, one can't be too careful when it comes to the spinal cord!

    When is your appointment?

     
    Old 10-13-2016, 06:02 PM   #5
    ebb553
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    Re: cervical disc mri

    I should back up and say I called to make an appt - the scheduler pulled my mri the neurologist ordered (all Duke system) and said he'll look at it and basically make a triage decision (immed, first avail, PA, or him) depending on his take on the mri. Those appts usually take a bit so I wouldn't be surprised if its not a mth out or longer, unless he sees something that warrants coming in sooner. I guess it worries me to see see words like "severe"..ha

     
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