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  • Help to understand the re-read of original MRI. Can someone explain?

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    Old 12-04-2007, 03:50 PM   #1
    skych
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    Help to understand the re-read of original MRI. Can someone explain?

    Hello everyone,

    My neurologist has said from the begining that I had nerves that were compressed at C 3-4, 4-5 and C-6. The original mri report did not say that and because it is a MVA that caused the pain etc. I had the attorney have the films reread.

    ORIGINAL READING:
    C2-3 Normal
    C3-4 Mild Bulging of the disc is noted which is slightly left sided. There is no foraminal or cord impingement.
    C4-5 Small broad based central disc protrusion is noted without neural impingement nor foraminal narrowing.
    C5-6 Small broad based central disc protrusion is noted without neural or foraminal impingement.
    C6-7 Normal
    T-1 Normal
    CONCLUSION:
    There is mild bulging a C#-4 through C5-6. No neural impingement. No cord contact.


    RE-READ
    Findings:
    The axial images do indicate unconvertebral joint arthropathy and neural foraminal encroachment which is mild to moderate left side at C3-4 and is moderate to sever left side at c4-5. Some associated facet arthropathy is identified, left greater than right, at both these levels. Some minimal asymmetric unconvertebral joint arthropathy is also identified at C5-6, although to a lesser degree than the other.

    CONCLUSION:
    Associated unconvertebral joint arthropathy leading to some asymmetric left-sided neural foraminal encroachment is identified and is most prominent at the C-45 neural foramina therby leading to potential left C5 compromise. Less severe changes on the left side at C3-4 and C5-6. Some associated asymmetric facet arthropathy is also noted, left greater than right.


    So what is unconvertebral joint arthropathy?
    What does the stuff about asymmetric mean?
    What does potential C5 compromise mean?

    Does that mean that my spinal cord is somewhat compromised at this time?
    So if I were to fall or get in another accident it could make that worse?
    Someone please help me to understand!!

    Chrissy

     
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    Old 12-04-2007, 06:27 PM   #2
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Arthritis

    When was the accident?

    Arthritis takes time to develop so it is not a good diagnosis if you are trying to use it in a law suit. They can say that it is pre-existing.

     
    Old 12-08-2007, 10:10 AM   #3
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    I understand about arthritis, but I have never had any trouble with my neck in my entire life.

    If you look at both of the reports there are some other things going on in there beside arthritis and/or DDD which everyone has to some extent.

    The things that I am most concerned about are the bulging discs and the neural foraminal encroachment which the neurologists believs is from the discs bulging.

    The other concern I have is the statment in the Re-read MRI that states that there is potential C5 compromise.

    Does potential C5 compromise mean that my spinal cord is at risk here?

    If that is the case then could it be made worse if I were to fall on the ice leftover from snow or to have another accident or sleep wrong? Scared!!!

    I wish some others would coment because I am a bit concerned.

    Thanks Christine

     
    Old 12-08-2007, 12:12 PM   #4
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Hi Chrissy, actually all the stuff going on in your neck is related to each other. This is long and I really hope you take time to read it and hopefully it will help put some of your fear to rest.

    You know how the disc is made up of material that acts like a cushion between the bones? When a disc has problems, it cannot provide adequate cushioning between the vertebrae. The bones start moving closer together. When the disc isn't is able to take the load that it usually did, the other joints of the spine take on extra load. Once this process starts, then cartilage starts to breakdown. Discs also have some cartilage. As the cartilage degenerates, the bone becomes exposed and an inflammatory reaction begins which starts the arthritis. So actually it is all related. Sometimes disc problems heal themselves and we don't even know they are there.

    When the bones get closer together, the neural foramen (in your case foramen, not the central spinal canal) can narrow. The foramen are the openings where the nerve roots exit the spinal cord (it forms like a little tunnel). Nerve roots are like branches off the tree (spinal cord). The nerve roots travel through the foramen to reach the rest of your body. There are two foramen between each pair of vertebrae, one on each side. The foramen can narrow from bone spurs or ridges growing inside that little tunnel, or by disc material pushing into the area.

    In the re-read they are pointing out that you have some on the right, but it is not the same as left. Your foramen is narrowed by disc material "encroaching" or pushing in that tunnel space.

    I am not a dr. but have personal experience -- because I have lots of nerve root problems myself . Although I know you are in very serious pain, they didn't use these words in your MRI read: C5 nerve root impingement, compression, radiculopathy. Nor did they say you have spinal cord compression or stenosis - that space is ok. The news is really better than you are thinking.

    By them using the word "compromise" I believe your foramen space is narrowed only by the disc pushing in there and your nerve root might be getting constant irritation or inflammation. That is probably why you get very short lived results from the nerve root injections. The irritation is so constant, even thought they put medicine in there, it continues to get irritated, meaning the inflammation doesn't get a chance to go down.

    My impression from this is that your general spinal cord is at not any more risk than the average person if they were to have an accident. However, any time that you have a spine issue you should be extra careful, who would want to cause more problems! More than that, if your foramen continues to narrow, you could start experiencing even worse pain conditions, numbness, tingling, etc. .

    Now that I have seen this MRI reread, I am wondering if you had ever tried gentle traction by PT? Because your disc is pushing in that space, very gentle traction might have helped this situation. But it can also irritate the nerves further if not done slowly.

    You probably are a candidate for minimally invasive surgery. Without really seeing the MRI etc we can only advise based on what you have here and compare it with our own experiences.

    Hang in there - you are doing fine.

    Last edited by PNo; 12-08-2007 at 12:22 PM.

     
    Old 12-09-2007, 02:04 AM   #5
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Chrissy Feelbad has said it all........I recall my spinal doctor telling me that a MRI is basically worthless and that a CT scan and Mylegram is really the only way to see nerve involvement. I suggest you get one of those. I also know that different radiologist read films differently. I remember my first MRI in 2004 showed cord involvement and my cord was 6.5mm. My Neurosurgeon said I had severe spinal cord compression. Unfortunately with workers comp nothing happens in a hurry. Also I had a bone spur and herniation centralized at C4/5 and it did happen in short order since I didn't have a bone spur at all several months before when I had a follow up MRI from my prior surgery issues. Anyhow, by the time I was ready for surgery (18mo later, also a baby later) that MRI report said nothing about cord compression even though you could clearly see it. My spinal cord looked like a flattend heart. That was rediculous. And unfortunately the MRI they looked at for my impairment rating. The idiot never got the ct scan results. All that said to tell you that you need to get a CT scan with a mylegram to really know what is going on. Your MRI doesn't sound all bad and like Feelbad said maybe a minimally invasive surgery will help you. Like a decompression or something of the nevers involved.

    Some people are just more sensitive then others. Pain is subjective to each of us. When the pain is so bad which from all your posts appears to be and that medication doesn't help you then you need to find a spinal surgeon who will really help you. Or in cases like mine you end up with atrophy and long term pain and lack of feeling until it is time. My MRI doesn't show a horrid nerve compression however, it does show I have moderate nerve involvement on C6/7. And have had it for over three years. Finally WC lost their denials and am going to have that fixed. Mine was from a mva also and a prior decompression on that site collapsed. My pain on the right side is not all that bad it is the weakness and atrophy and lack of feeling in the muscles that affect me.

    So go get a ct scan.

     
    Old 12-09-2007, 07:26 AM   #6
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Thanks so much for your thoughts,

    I do have a neuro surgeon that I go see again on Dec 14th. He is pretty good and many tell me he is one of the best around here. My firend who is a cardiologist told me that if he were in my shoes he would see this Doc.

    Anyhow, I thank you for your thoughts.

    I am really fed up with this stuff!!! YUCK!!!

    Backinthesaddle, I was on WC just prior to this accident for 3 years and yes, they do everything at a snails pace. I had 4 surgeries on my left arm.

    With that being said, I am sure that 3 years of dis-use of my entire left extremity weakened the surrounding muscels etc on that side of my body. The PT office I went to would pke fun at me because my left arm was so skinny from atrophy. At one time there was a 1 and 1/4 inch difference in the size of my right dominant arm and the injured left.

    No sooner am I realesed from all the doctors from WC do I have this accident.

    I was pushed right back into the cycle of pain and eventually back into PM.

    At this point the last time I saw the neurologist he said to try the transforaminal ESI and I have since done them with no results. He said that if they did not work I may want to consider the foraminotomy.

    So when I see him on the 14th I will let him know that if he thinks that is what we should do next than lets do it ASAP.

    The 14th is also the last day of my semester of school and I willnot have to return for the next semester until the end of January. So I think I have a goood opportunity to have it done with time to heal.

    Thanks again for the comments....

    Has anyone here ever had the foraminotomy?

    Chrissy

     
    Old 12-09-2007, 01:18 PM   #7
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    I haven't had a foraminoty but had been considering it at one point, instead I ended up with a more elaborate procedure to fix multiple problems. It is less invasive for sure. Were you the person with problems with anethesia? This procedure can be done with a local and it can also be done lapriscopically and done that way it doesn't entail overnight in hospital it can be outpatient. If not done with lap, it still isn't too difficult a recovery. Maybe helping you get back to your life!

     
    Old 12-09-2007, 05:37 PM   #8
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Thanks Neck-p

    I sure am tired of this!! I am working on dealing with the pain. I really work on surrender but the last 2 months have really broke me.

    So I am trying to learn more ways of dealing with the emotional stuff. Reaching out and telling others how I feel is one thing and because I am in recovery (12 step, but I do not abuse pain meds that is all monitored and I hate the darn things but they help) anyway, I am in consant contact with my 12 step sponaor working on my issues and coping mechanisms.

    I am ready for the surgery! This is way a minaimal surgery compared to an ACDF which my neuro already said I may need in the future because of the discs and because of the DDD. He said he thinks I will have good results from the foraminotomy.

    I do have issues with anesthesia, but not anything life threatening. I actaully would prefer to be knocked out and just stay in the hospital for 24-48 hours. Most of the things that the anesthesia does can be helped by not being dischared for 24-48 hours from the time I wake up.

    We will see what he says. I hope that he is satisfied with what I have tried because I just can not keep putting my life on HOLD. I am single and I will be 30 in about 10 days. I really gotta get to a place that I can work because I need to make some money to support myself untill I apply to the nursing program. I already have now put that off untill spring of 2009 because what is the point if I am physically unable to work and even now I am unable to sit in class for over an hour.
    Nursing school is full time school and they do not even like the students to work during their first year.

    I want to say thanks for the support because I am in some ways just having a hard time. I get scared about what path I am supposed to be on and if I will ever get to be a nurse. Of course I do the "what if" stuff as well.

    Any way chatting with others who understand is really the best. My 12 step sponsor and one of my other friends who is pregnant and was a nurse at one time, both have neck issues. The one who is preganant has had a disectomy and ACDF, so we are always talking about life.

    So thanks again and by the way if you go Xmas shopping don't forget your Pain meds. Today I was gone longer than I anticipated and I only had something for break through pain and it really did not help. By the time I got home I was at the 9 level of pain. My fault for not putting enough in my purse. Oh well it will pass. Live and learn.

    Thanks everyone....Christine

     
    Old 12-10-2007, 05:16 AM   #9
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Chrissy, what you have said on this post about being single & not being able to put your life on hold your schooling ect is exactly what you should say to the doc. You only have you to depend on & you have been through enough. Your future depends on getting some relief from all this pain, I know if I was a doc & someone put it to me like you did here I would understand that it is time to try to try surgery. As always you are in my thoughts & I hope all goes well for you, how nice it would be to go on with your life with out the pain holding you back. Already found out the hard way about the christmas shopping pain game. I am almost done & time shopping with taking my meds. always getting bumped into & that sends me into orbit, I swear this sling is like a red flag, I got bumped so hard the lady almost knocked me down & of course it would have been on the injured side.
    By the way going to see ortho surgeon the end of the month, been hearing lots of stories about MRIs not showing problems, so lets hope this guy is good. I daydream alot about what it feels like to not wake up with pain & all the things I could do. Getting worse have upped my meds & can't go with out the sling for long at all, Have learned to rest more & upping the meds have helped. Good luck to you & please let us know about the surgery issue.

     
    Old 12-10-2007, 06:19 AM   #10
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    Re: Help to understand the re-read of original MRI. Can someone explain?

    Thanks Sammy,

    I am always thinking of you to.

    Yes one of my biggest fears right now is to fall down on some patch of ice or for some person who is not paying attention to their driving to hit me.

    Yesterday I was on the way to a friends and some kids were tailgating me. As I was slowing to turn I watched in horror as they slammed on the brakes and came within inches of rearending me.

    I am so excited your finally going to see an ortho Surgeon. Hope that goes well.

    Thanks for posting and you keep us up to date on your ortho appointment and I will report what my docs say on Fri.

    This is the last week of school so I am really working hard at understanding the material.

    Chrissy

     
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