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    Old 03-23-2017, 01:40 PM   #1
    nopainpls
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    MRI Report Questions

    There are several items stated on my MRI report. I got this report because I have been having right side radiculopathy from neck to arms and wrist.

    Neuro-Surgeon says I don't need surgery, just keep doing therapy and take medication. Suggested to epidural inject, which I have already taken twice. I have not seen much help.

    Here the two lines:

    At c5-c6: left paracentral extending up to 3 mm posteriorly with minor cord indentation on left. Central Canal Stenosis is appreciated, AP diameter of the thecal sac in the midline is 6.5 mm. Left greater than right. Uncovertebral and facet hypotrophy with moderate left and mild right neural foraminal narrowing.

    At C7-C8: 2 mm disc ostephyte complex with borderline central canal stenosis;AP diameter of the thecal sac in the midline is 7.5 mm, no neural foraminal stenosis.

    Can someone explain this to me in plain English? I am particular concerned about "AP diameter of the thecal sac in the midline is 6.5 mm". Some people says that's too narrow, and some people say that's normal and depends on the size of a person. It is narrow, but based on the MRI picture, I don't think overall size is more than 8 when I look at C7-T1 and C2 - C4.

     
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    Old 03-24-2017, 08:06 AM   #2
    teteri66
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    Re: MRI Report Questions

    Welcome to the board.

    The part of the report you copied would make more sense if your radiculopathy were felt on the right side.

    As you suggested there are issues at C5-6 and C7-8 that are causing the thecal sac to be reduced in diameter....first, "stenosis" is a term that means narrowing. It can occur mainly in two locations in the spine...in the central canal and in the neural foramina, which are openings located at each vertebra level that allows a spinal nerve to exit the spine to go out to the area of the body it innervates.

    When something that shouldn't be there...like a disc herniation, bone spur, enlarged facet joint, etc., forms, it takes up space that is needed by the adjacent nerve to function normally. The result is nerve irritation or compression...which results in pain locally or anywhere down the path of that particular nerve.

    When this impacts the spinal canal, it can be additionally damaging if it comes in contact with or puts pressure on the spinal cord. Anything that pressures the spinal cord has the potential to cause spinal cord disease and needs to be monitoring by either an orthopedic spine surgeon or a neurosurgeon.

    Anything that pushes into the spinal canal, narrowing its diameter, can be damaging if it puts pressure on the spinal cord. This too should be checked periodically to determine if it is getting worse.

    If I were in your position, I would be getting at least one more opinion on the extent of the cord compression and options for treatment. The diameter of the spinal canal would be of concern for me. If you look at just about any online source, it will say that the average diameter of the spinal cord is 10mm and doctors routinely consider any spinal canal smaller than about 12-14mm to be stenotic. The size may vary slightly from person to person...but not a big amount. I don't believe anyone would consider a measurement of 6.5mm to be anything but compromised.

     
    Old 03-24-2017, 04:41 PM   #3
    nopainpls
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    Re: MRI Report Questions

    Thank you!

    I wanted to mention that I have no numbness, NCS and EMG tests show no sign of weakness, all nerves are acting normally. I have not lost any strength.. Only radiculopathy coming from C6-C7 area per EMG test. May be, that's why neurosurgeon did not recommend surgery at this time.

    Someone was suggesting me amniotic allograft ijection.. insurance does not pay, costs around $500. Not sure how well it works - I don't mind paying if it works, relieves pain and avoids surgery in a long run. I would love to see anyone's response!!

     
    Old 03-25-2017, 12:04 PM   #4
    teteri66
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    Re: MRI Report Questions

    This is why a MRI is just one piece of the diagnostic puzzle. It must be correlated with what is found on physical exam, a basic neurological exam and after to listening how the symptoms affect the person's daily living. Since there is no cord compression and you have few symptoms, there isn't much to worry about -- at least at this point. It may be that you were born with a spinal canal that is just more narrow than average.

    Keep in mind that the person who suggested the amniotic allograft injections to you, unless it is your spine specialist, doesn't know what your specific issues are. I would advise being extremely cautious when it comes to spinal injections, even epidural steroid injections. Side effects of all types of spinal injections seem to be minimized and lay people tend to assume they are safe....one should be skeptical and proceed with caution...particularly when it involves injecting into the space around the spinal cord.

    There have been a number of clinics popping up around the country offering various stem cell injections for a variety of ailments. At this point there is a lot of hype and little fact-based outcome to what the injections accomplish. What was sold to orthopedic doctors as amniotic stem cell fluid turned out to not have a single live stem cell when tested.

    The issues you are having, like stenosis and osteophyte complex, which are a result of the process of degenerative disc disease will not be ameliorated by any type of stem cell therapy. It might heal the bulging disc, but it will not remove bone spurs from the facet joints, or widen your spinal canal.

     
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