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  • Myelopathy & MRI meaning? help please in Ky.!

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    Old 08-12-2006, 01:33 PM   #1
    ronginwalker
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    Myelopathy & MRI meaning? help please in Ky.!

    Hi, I'm brand new to this and hope I do it right! I have never posted anywhere on the internet before. I am hoping someone will be kind enough to advise me. I have been having neck pain, (burning, shocks) and also weakness in my arms and legs with partial numbness for a couple of years. I recently had an MRI and am hoping someone can help me decifer it and am hoping to talk to someone with similar problems. The neurologist I went to has referred me to a neurosurgeon in Nashville, saying if I don't have surgery I could end up paralized and that I have myelopathy, whatever that is, and need surgery. I don't know if this is true or maybe that he was just trying to get me to see someone about my problem. I did tell him I have been putting off going to any doctor cause I don't have the time to be down for any reason. I am 43, a mother and grandmother and former law enforcement and very busy! The real reason I even went to a dr. was because I have problems holding things without dropping them and it is getting aggrivating especially when painting my house or cooking. Anyway here are a couple of lines of my MRI that my doctor had underlined:
    "At the C4-C5 level there is a mild broad based posterior ostephyte/protrusion complex with mild impingement on the ventral thecal sac. The neural foramina are widely patent. At the C5-C6 & C6-C7 levels there are broad based posterior central herniations. There is significant impingement on the ventral spinal cord with compression. The neural foramina are patent at this level. At the C6-C7 level there is also a large posterior broad based central herniation with moderate impingement on the ventral thecal sac. The neural foramina are patent at this level." I hope I have not gone on too long for someone to respond! I almost feel stupid even leaving a post when so many people are way worse off than me. I am just curious about the meaning of the MRI and am wondering if I should go to the neurosurgeon and have surgery like my neurologist said or if I should continue adapting like I have been doing for a couple of years now. Thanks in advance to anyone who took the time to listen to my long winded post and takes the time to reply!

     
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    Old 08-12-2006, 01:53 PM   #2
    ThoreauFan
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Quote:
    Originally Posted by ronginwalker
    I almost feel stupid even leaving a post when so many people are way worse off than me.
    You shouldn't feel that way at all. You have raised some very serious issues.

    It is probably time to get out a pad of paper and pen. You may want to begin writing down the many questions passing through your mind. Your physicians will be in the best position to provide answers in your particular case.

    It sounds as if your physician indicated that you have herniated disc(s) pressing on areas of your spinal cord, resulting is certain symptoms. Did your physician perform any tests on your legs; reflexes; walking; shaking your legs?

    Whether or not you need surgery isn't for me to say.

    But do NOT ignore your condition. It can get much, much worse.
    __________________
    "Use your health, even to the point of wearing it out. That is what it is for." George Bernard Shaw

    Last edited by ThoreauFan; 08-12-2006 at 02:01 PM.

     
    Old 08-12-2006, 06:20 PM   #3
    ronginwalker
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Thanks for the reply! Yes, my neurologist performed all kinds of tests. He said my reflexs were hyper (whatever that means), I was walking with a wide gait and I tested positive for Babinski's syndrome and another one which I forgot the name of. He said he was very worried and wanted me to have surgery right away. I guess I'm not that phased yet cause I've been living like this for a couple of years and its just now getting worse. I just adapt to the new weird symptoms. Maybe if I understood my MRI, I would be in a more urgent mode to get something done. I am also procrastinating because I don't like the sound of having an anterior cervical corpectomy which is what my neurologist said was needed. It sounds like something that would have me out of commission for a few days. If you or anyone out there has had one please let me know what its like and how long it takes to recover. I would really appreciate it! Thanks again for taking the time to write back!

     
    Old 08-13-2006, 12:17 AM   #4
    ThoreauFan
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    I guess I shouldn't worry about shaking you up.

    It sounds as if your Dr. has really put it all out there.

    I also slowly developed myriad bizarre symptoms over roughly a two year period. One day, during an annual check up, I mentioned the increasing problems with my hands (dropping things) to a Dr. I am now five plus months removed from a C5-C7 ACDF. A corpectomy was discussed, but, ultimately, some areas were deemed to be asymptomatic and not treated.

    Caveat: The MRI is only one piece of the puzzle and this is a peer support community. Radiologists' interpretations and use of terminology can vary. I would hope that you have had a chance to see the MRI and have the significance of the results explained to you. Here's a brief translation:

    The neural foramina are small bone canals. Your nerve roots branch out from the spinal cord and exit to the body via these canals. These areas appear to be in great shape, based on the report.

    C4-C5 indicates that a bone spur is pressing up against the outer sac of your spinal cord.

    The spinal cord is bathed in cereberospinal fluid, which fills the thecal sac.

    C5-C7 indicates multiple areas of disc herniation and, more importantly, the disc material appears to be compressing your spinal cord at these levels. "Myelopathy" is injury to the spinal cord tracts. This is very serious.

    The hyper-reflexive response and Babinski's sign are present because certain nerve signals are currently not traveling up your spinal cord to your brain. Normally, your brain will assess a stimulus and modulate your body's reponse by sending an appropriate message back down your spinal cord. Without the modulation of an appropriate response, the reflexes respond hyperactively. You may discover that your calf muscles appear especially well-toned. This is because the muscles are inappropriately contracting. Some of us had (have) involuntary spasms of the arms/legs. Virtually anything below the level of injury can be affected, which is why it can become a very, very grave situation if ignored.

    Based on what you have described, you are facing some very serious issues.

    I would encourage you to seek out various medical opinions.
    __________________
    "Use your health, even to the point of wearing it out. That is what it is for." George Bernard Shaw

    Last edited by ThoreauFan; 08-13-2006 at 02:55 AM.

     
    Old 08-13-2006, 07:50 AM   #5
    ronginwalker
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Dear ThoureauFan, thank you again for taking the time to reply! I honestly didn't expect anyone at all to write me back but I have to admit I was hoping really hard! Your last note REALLY helped alot!! It helped explain alot to me! You are right about not shaking me up! I could get the worst news in the world from a doctor and I would just want a plan to fix it or manage it. I don't shake up when it comes to me. The only time I do is if it involves my kids or grandkids. Thats the real reason I don't want to do the surgery cause I know I will be down a bit and can't do my regular routine. I do have an appointment this Friday, August 18th, with a neurosurgeon in Nashville to discuss my having surgery. By the way, you hit the nail on the head when you said I would have well developed calf muscles! They are so hard & so tense that they hurt alot! I take one flexeril at bedtime to relax my muscles which really helpsme be able to sleep. I used to think my leg pain & walking funny at times were just some kind of early arthritis and never dreamed it was because of my neck! The toes on my feet go numb from time to time and also parts of my arms and fingers. My right leg and right arm are very weak although my muscles are hard which I find weird! Could you take the time and tell me more about your symptoms and your surgery and recovery time? It sounds like what I have is so similar to yours! Also if I didn't have surgery could it get better on its own or would it get worse? Thanks! Ginger

     
    Old 08-13-2006, 09:53 AM   #6
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Quote:
    Originally Posted by ronginwalker
    Thanks for the reply! Yes, my neurologist performed all kinds of tests. He said my reflexs were hyper (whatever that means), I was walking with a wide gait and I tested positive for Babinski's syndrome and another one which I forgot the name of. He said he was very worried and wanted me to have surgery right away. I guess I'm not that phased yet cause I've been living like this for a couple of years and its just now getting worse. I just adapt to the new weird symptoms. Maybe if I understood my MRI, I would be in a more urgent mode to get something done. I am also procrastinating because I don't like the sound of having an anterior cervical corpectomy which is what my neurologist said was needed. It sounds like something that would have me out of commission for a few days. If you or anyone out there has had one please let me know what its like and how long it takes to recover. I would really appreciate it! Thanks again for taking the time to write back!

    I'm glad that you found this website. You will find a lot of support, and understanding. I really understand and know what you mean when you said, that you just adapt to new weird symptoms, because I have been doing that for 3 years now. I believe in self healing, and I have tried everything, and anything to get rid of this pain, but unfortunately it's still here. I'm scared of surgery, and make excuses not to have it, and I also can't stand to be out of commission for a while or even to have to lay around in bed more than 2 days.

    But....I am to the point where I cannot take it anymore, and if I do not have surgery then I will have permanent nerve damage, and I really will not be able to do the things that I enjoy doing anymore. Please get some help soon! I have spinal stenosis, which means that there is pressure on my spinal cord, but I do not have damage yet. My surgery is on the 22nd of this month, and I am glad.

    Through reading all of these posts I have learned a lot, and just by reading ThoreauFan's post I just realized that I have been dropping things a lot, and just blamed it on being a kluts. I don't think it will get better on it's own! Believe me I've been waiting for 3 years. Keep us posted.

    ~Annette

     
    Old 08-13-2006, 03:54 PM   #7
    ronginwalker
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Dear Annette, thank you for also replying to my post! It's nice to talk to people that have similar symptoms! You sound alot like me as far as I put off everything when it comes to myself as long as possible. I don't want my family & children to think I am weak or whiny being I am only 43. Besides I did go to my neurologist 2 years ago for these same problems only they weren't as severe and the first neurosurgeon he sent me to in Hopkinsville, Ky. (not Nashville where I am going Friday) told me that I was too young to (41 then) to have a compressed spinal cord & that the MRI must be wrong. So I said okay & didn't go back till 2 weeks ago when my neurologist said I was to go asap to Nashville & he couldn't believe what the neurosurgeon near my hometown told me. Now I have trouble holding things or even raising my right arm up and my right leg is getting to where it is heavy and half numb too. I feel like I am dragging it when I walk. It is more irritating than anything else because I keep having to change how I do my normal chores. Do you have areas on your body that are totally numb? I have some spots between my neck and shoulder that I can't feel at all. Otherwise the numbness comes and goes in my arms & legs. I have to say the numb leg that I am dragging around for the past few days is the most aggrivating! It is hard to stand up in a chair to clean things or pack groceries in. I am hoping it will go away like the other weird things do from time to time. Well, I hope your doctor will be able to help you and thanks for writing. Please keep me informed on your symptoms and please tell me what your diagnosis is and what they are gonna do to help you. Thanks to you and ThoureauFan for writing. You have been so kind! Ginger

     
    Old 08-13-2006, 05:15 PM   #8
    ThoreauFan
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    I had bone growths compressing my cord at C4-C6; C4 was not treated (narrowed to 11mm); C5 was narrowed to 9mm, and; the growth at C6 displaced my cord, reducing it to 7mm. The foraminal areas at C6 had bone growths compressing the nerve roots and bilateral foraminotomys were performed, along with the C5-C7 ACDF (plate, screws, and BMP).

    I also have foraminal problems at C8. That nerve runs to my little finger and was left untreated. The thumb and index finger are considered the biggies in terms of function, though. Surgeons really don't like to delve down near the thoracic area.

    My case was considered to have been caught early, according to my Dr.s. I adjusted to my symptoms and wrote it off to aging. I had big problems with my hands, especially in the morning; opening meds; taking pills; fine motor skills. I broke a number of plates & dishes. I would inadvertently knock items over while trying to pick them up. Coordinating my fingers to type correctly became an issue. I was constantly bumping into doorways. My walk became clumsy.

    I forget the term, but there is a spinal cord tract that tells your brain where your limbs are in space without a visual cue. Apparently, this was the tract responsible for most of my problems.

    My pain was rarely excrutiating. I didn't even report pain as a symptom, although I was taking the full dose of ibuprofen for about a year and a half. I had all sorts of odd pains, particularly if I remained in a specific position for awhile. It was difficult to get out of a car after a long drive, up off the couch, out of bed, and I would wobble when dressing myself. A sneeze was excrutiating - pain bolting out from my neck to the tips of my fingers. I could feel when the foraminal areas were pinching the nerve roots. That's pain. Ouch!

    I had all sorts of strange spasms and fasticulations. Leg whips in bed would leave my wife with bruises. I named one of the spasms the "Marionette Twitch," (I know, I am NOT your average bear). I would be laying on the couch and - HELLO - both my left arm and left leg would jerk up into the air.

    I don't know if your condition can get better on its own. The symptoms you mention are very, very serious. In my case, paralysis was a real concern. Those bone growths were likely to continue causing damage. I was happy to trade the outcome of my surgery for the alternative. But no two cases are the same, believe me.

    I was up and around pretty quickly.

    Recovery is difficult to write about in general terms because so many individual factors are at play. I guess it depends upon what exactly the surgeon is going to do and what type of neurological impairments are present. Individual expectations and the ability to cope play important roles as well. And there can be an devastating emotional boomerang.

    It can be a long, frustrating process.

    I would begin compiling a long list of questions. Each case truly is unique.
    __________________
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    Last edited by ThoreauFan; 08-13-2006 at 11:19 PM.

     
    Old 08-14-2006, 10:45 AM   #9
    ronginwalker
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Dear ThoureauFan, reading your last post was like looking in a mirror. Your symptoms are almost exactly like mine and my neurologist did tell me he was worried if I didn't see the neurosurgeon and have surgery I would end up paralyzed. At first I thought he was just saying that to scare me into following up on my appointment but after hearing of your symptoms I guess he meant it. I guess I just keep telling myself if I wait long enough it will go away. But to be honest its slowly gotten worse, not the pain cause there rarely is any except for the stinging & burning sensations, but the numbness. I have one more question till I see the neurosurgeon Friday. I left out one line on my MRI that I don't understand. It says " also at the C5-C6 there is a posterior disc complex with right uncovertebral hypertrophy causing mild canal stenosis with minimal deformity of the cord ventrally. There is also severe right neural foraminal narrowing." Do you are anyone know what this means and can put it in laymans terms? I would really appreciate it! I do appreciate you writing me back especially your last post. I guess its time for me to get to business and get this taken care of! Thanks so much! Ginger

     
    Old 08-14-2006, 11:10 AM   #10
    dennisgb
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Ginger,

    The problems you have will not get better on there own.

    You need to be ready to ask this surgeon on Friday as many questions as you can. Also, prepare yourself to have the surgery. You will want to get this taken care of, as putting it off could cause you real problems.

    Dennis

     
    Old 08-14-2006, 11:57 AM   #11
    humantunigfork
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Ginger....You have to take this seriously...Listen to Dennis & Thoreau...they have been through it and know the ups and downs of the spinal sagas that plague many of us...As mentioned earlier what is most problematic is your cord compression...this is causing what is called "cord signal change" as Thoreau has alluded to...This cord signal change is not likely to be remedied until you have a surgery to relieve the compression...I too, have had severe cord compression and had an ACDF w/hardware (plating) on the C5-C6 7 weeks ago...I still have numbness in my left hand and L'hermitte's sign (the shocking sensation up and down your spine and through the hands when you lean your head forward)...But many of my neurological signs have improved...I have regained strength in my right arm and my gait has improved significantly...If you read my previous posts you will recognize that I expected to improve rather rapidly after my surgery and that was not the case...I didn't understand the significance of my spinal cord injury...If your cord compression is severe enough...your surgeon might not give you an option...Do as much as you can to learn these terms and go into your meeting prepared to ask as many questions as you can...you have to be your best advocate...Good luck..HTF

     
    Old 08-15-2006, 07:48 AM   #12
    ronginwalker
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    I want to say a thank you to Dennis, Humantuningfork, Annette, & of course ThoreauFan. Thank you all for taking the time out to send me a post! I do appreciate it. I'm not scared at all about surgery or my condition.I was just very uninformed but you all have helped tremendously! I will be going in Friday with lots of questions as you all suggested and I will do whatever has to be done. He is supposed to be the top rated neurosurgeon at St. Thomas hospital in Nashville so I am glad of that. In the meantime, my neurologist here has called me in a Medrol packet to help strengthen my spine till I get there and I only take Advil throughout the day and one flexeril at night so I can relax my muscles enough to sleep. Dennis, what kind of surgery did you have and how are you doing now? Annette, what kind of surgery do you have planned for the 22nd? Also please post as soon as you can afterwards so I can see how you are doing. I will be praying for you! Humantuningfork, do you notice improvement daily and do you have to wear a neckbrace or halo? Thanks you guys! You've been great! It's so nice to talk to people who have been in the same boat! Sometimes family members tend to think there's nothing really wrong with you since they can't see a wound! Ginger P.S.>>I do have one more question for anyone that might know what it means (I hate to sound completely naive when I go to the neurosurgeon) what does "severe right neural foraminal narrowing" mean? Thanks!

     
    Old 08-15-2006, 05:29 PM   #13
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    Quote:
    Originally Posted by ronginwalker
    Sometimes family members tend to think there's nothing really wrong with you since they can't see a wound!
    This is very difficult to manage. I do believe it can be challenging for friends and loved ones to see us as anything but in perfect health. Remember, it's scary for them also. I believe they can go into denial for their own sake.

    Quote:
    Originally Posted by ronginwalker
    I do have one more question for anyone that might know what it means (I hate to sound completely naive when I go to the neurosurgeon) what does "severe right neural foraminal narrowing" mean? Thanks!
    This refers to a spinal nerve root canal. A pair of nerve roots - one sensory and one motor - vent from your spinal cord beneath each vertebra and exit to the body via these canals. The narrowing can refer to disc material or bone growths compressing a nerve root. It's very common.
    __________________
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    Old 08-16-2006, 10:01 AM   #14
    dennisgb
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    I had ACDF on levels C5-6 and C6-7 with donor bone, plate and BMP on June 30th 2004. I am pain free and doing things I couldn't do for a number of years with DDD, bone spurs and all the other fun stuff that goes on in there.

    "severe right neural foraminal narrowing" was answered pretty well by ThoreauFan, but I would add, that these nerve passages also can close up due to congenital/hereditary conditions In my case they were small to begin with, so once the aging problems entered in, they closed up. Also added to this was spurring, some of which decided that pressing right on the nerves was the best thing to do.

    The nerves that come out of these spaces in the vertibrae, go to all different places in the body. The ones most common to the discussion here are the ones that make arms numb and ache, fingers numb, shoulders and chest hurt and ache, and these seem to be the most commonly problematic. These are the ones I had fixed.

    Last edited by dennisgb; 08-16-2006 at 10:02 AM.

     
    Old 08-16-2006, 11:44 AM   #15
    humantunigfork
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    Re: Myelopathy & MRI meaning? help please in Ky.!

    ginger...I never had a halo...and only wore a soft collar for about 10 days and then a little longer when I began to drive again...I wouldn't say I see improvement everyday...I think a good bit of the neurological improvement I don't tend to notice that much at all... I am fixated with my left hand numbness/heaviness which still persists...feels best in the morning right when I wake up...However I was able to play a little guitar the other day albeit a little clumbsily...I couldn't do that 4 weeks ago...So maybe it has improved...It feels variable but is always numb-like...Good days and bad days...particularly with my L'hermitte's sign...I'm only 7 1/2 weeks out...so I am hoping to get where T-row and DG are now...As far as other folks go...I feel you on the "you look fine" tip...They can't see the shocks running through your body or the unsure step you just took...and if I have one more person ask me how my back is doing I'm going to go Tom Cruise on somebody...for some reason people think every spine injury is a back injury...I would have rather it been my back...the cervical spine is a hard concept for people to get their minds around for some reason...but let me tell you one thing I've learned is that controls the whole motor show right there...good luck...HTF

     
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