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    Old 02-08-2008, 06:38 AM   #1
    shaun472
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    Can someone help me understand my MRI?

    Can someone please help me to understand my MRI results? I`m 35, normally very active. I had a minor fall over 2 months ago and have recieved epidural steroid injections and trigger spot injections. Nothing has helped. One doctor suggest physical therapy, the other told me it would only make things worse.

    Findings: There is straightening of lordortic curvature of the cervical spine. There is no prevertebral soft tissue swelling. Brainstem and cerebellum are in tact. Vertebral body heights are well maintained. There is no intrathecal or intraaxial abnormality.

    C2-C3- Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

    C3-C4- Mild endplate DJD, Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

    C4-C5-Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or formaminal stenosis.

    C5-C6-Prominent left paracentral HNP with moderate impression on the left ventral cord. The HNP is associated with intervertebral disc space narrowing and advanced uncovertebral endplate degenerative changes extending into left foramen. No evidence of cord edema. Moderate left lateral recess stenosis. Superimposed mild facet DJD.

    C6-C7- Small central HNP with minimal impression on ventrical thecal sac. Mild facet arthropathy. Mild endplate spondylosis. No significant canal or foraminal stenosis.

    C7-T1- Mild endplate DJD. Mild facet disease. No prominent focal HNP or disc bulge. No significant canal or foraminal stenosis.

    Impression:

    1. Prominent left paracentral HNP of C5-C6 with moderate left lateral recess stenosis and mild impression on the left ventral cord. With associated advanced chronic uncovertebral endplate degenerative changes, further reducing the caliber of the left foramen. No evidence of cord edema
    2. Small central HNP of C6-C7 with no significant canal or formaminal stenosis.

     
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    Old 02-08-2008, 04:42 PM   #2
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    Re: Can someone help me understand my MRI?

    Hi -there are some things that may have been caused by that simple fall, but there are also some things there that I would think aren't just 2 months old. Lots of these arthritic changes are very common and don't usually cause symptoms for majority of people until we are older.

    You might have some problems from an old injury, car wreck, playing sports or just plain aging. Two months seems like a very short amount of time for these things listed here to appear and I would think these processes were already started before your fall:
    -advanced uncovertebral endplate degenerative changes
    -Mild endplate DJD (degenerative joint disease) - this is like arthritic bone spurring and changes.
    -Mild facet disease (facet joints are synovial joints. Each joint is surrounded by connective tissue and produces a fluid to lubricate the joint. The joint surfaces are coated with cartilage to allow joints to glide smoothly against each other. These start breaking down and stiffening.

    The herniations (HNP) could have been caused from your fall. Or could have been there and made worse. Herniation of the nucleus pulposus occurs when the gel-like substance of the disc breaks through outer surface - your discs are like shock absorbers. the material breaks through . It is also touching other stuff in your canal and causing narrowing. you have some of this stuff pressing on your spinal cord and also pushing in to the space called the foramens which are these canals where the nerve roots come off the spinal cord to your body parts. Think like a tree trunk with branches.

    When there isn't good spinal fluid flow because of narrowing, the ESIs might not help as much.

    I read that about 80-90% of patients with a herniated disc will respond to conservative treatment. Herniated discs can gradually reabsorb. Because this is one of your big problems, if it were me I would be trying all conservative therapy offered. I would go slow with PT, but definitely would do it.

    I would guess C5-7 are causing the problems. Is this where you had the epidurals? I would also doubt trigger points are going to have any long lasting value since the root of the problem is still there. There are some less invasive procedures to deal with HNPs. But I would definitely be trying everything else but surgery. I think this reabsorption process can take 6 months or longer. To help it you really need to restrict activities, no lifting anything over 10 lbs, rest and take care of your self.

    What else did the dr.s recommend for you?

     
    Old 02-08-2008, 08:42 PM   #3
    mcda
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    Re: Can someone help me understand my MRI?

    Shaun, I read your post on the "back problems" board...Physical therapy actually worsened my condition from Degenerative Disc Disease, which has recently spread to my cervical spine area. The internal medicine doctor told me before he re-located that I should also stay away from a chiropractor. I was wondering if you had any x-rays done before your MRI? If so, what did the x-rays show? I am curious because I have only had two x-rays on my cervical spine done but have had x-rays and a MRI done on my lumbar spine (which has abnormalities, due to the DDD). What type of pain are you in? Thanks, in advance.

     
    Old 02-09-2008, 11:13 AM   #4
    shaun472
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    Re: Can someone help me understand my MRI?

    Hi, I hope you have better luck than I have had so far, but to answer you questions- I first had an x-ray in my primary care phycians clinic because of the pain I was experiencing after a fall, which according to him appeared ok. I went another 2 weeks dealing with pain at the base of my head, down my neck w/stiffness, burning between my shoulder blades, sharp pain in my shoulder that radiates down my arm w/numbness and sometimes tingling in my hand and fingers. Its just been unbearable, so I went in for my MRI thats when I found out what was going on. How long have you been dealing with this? I`m also curious what part of my pain is related to DDD? My doctor didn`t recomend that I see a chiropractor either. I`m not sure what to do about physical therapy,on one hand It would help w/my herniated disc, but just like you said, it would probably make the DDD symptoms worse. Its a little frustrating!! If I can find a doctor I trust then maybe things will get better for me. I`m seeing a new doctor soon and hoping he will the right doctor for me. If you could offer any advice, I would really appreciate it. Thanks-Shaun

     
    Old 02-09-2008, 11:32 AM   #5
    shaun472
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    Re: Can someone help me understand my MRI?

    Thanks for taking the time to explain my MRI. You`ve managed to do a much better job than the 2 specialist I`ve seen so far. I didn`t think it would be so hard to find a good doctor but I`m still searching. Everything you said makes sense, I did have a terrible motorcycle accident when I was 14 w/head trauma.I am very active so I`ve probably injured it even further. The doctor did tell me I was a little young for the damage that was there.Neither one of the doctors I`ve seen offered a lot of options, just to take it easy for a while and take the meds they prescribed. I`m just not much for sitting around doing nothing. This is so painful, and I feel like I should be something to help myself. I`ve seen no improvement so far. Other than taking it easy, do you have any other suggestions to ease the pain? Thanks so much for your help. Shaun

     
    Old 02-09-2008, 12:57 PM   #6
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    Re: Can someone help me understand my MRI?

    Shaun, I'm so sorry to hear that you are still in pain, with no improvement. Have you heard of River Valley Musculoskeletal Center in Fort Smith...That is where I go. You can search for it on the web. My regular physician just prescribed me Soma, a muscle relaxer during my last visit to try to relieve the severe pain from the muscle spasms in my neck and head. She was also hoping it would relieve the severe headaches that I was having. Do you take anything for your condition? If so, what do you take? I hope you are having a "pain-free" weekend.

     
    Old 02-09-2008, 01:12 PM   #7
    ladybumblebee
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    Re: Can someone help me understand my MRI?

    Hi Shaun,

    I have very similar issues but have had 4 surgeries now and am 34. I would give alternate heat and cold patches a go. baths can help. don't go near a chiropractor as they can make it far far worse.

    rest and pain meds is the best you can do. Be honest with your doc and push to get something to take the pain away. Tens machines can also be very helpful at reducing pain but I would really be looking for a plan from my doc as a priority. Hope you feel better soon

    Ellie

     
    Old 02-11-2008, 09:12 AM   #8
    shaun472
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    Re: Can someone help me understand my MRI?

    Ellie, Thanks for the advice. I need all the help I can get. I haven`t tried the Tens machine yet, but I think I will bring that up at my next visit. I`ve done some research on it and lots of people have experienced benefits from it. Its worth a try. Thanks. Shaun

     
    Old 02-11-2008, 09:21 AM   #9
    shaun472
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    Re: Can someone help me understand my MRI?

    Thanks for the info for the center in Fort Smith. I`ve decided to take a more aggressive aproach in my treatment. Until now, I`ve just gone wherever they would refer me. That has gotten me nowhere. I`m glad to talk to someone who is familar with the area where I live. I will definately look into it. I sympathize with you on the headaches, I also suffer from them-THEY ARE AWFUL!! If you find anything that works please let me know.Thanks again,Shaun

     
    Old 02-11-2008, 09:45 AM   #10
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    Re: Can someone help me understand my MRI?

    The thing is it is the rest and taking care that helps that resolve and not get worse. the meds, like ibuprofen or NSAIDS? Injections don't usually help this kind of stuff to much. You could talk to PT about some very very very light traction or stretching. e-stim therapy, ultrasound and maybe tens unit while you wait. This might be enough to allow the disc to shrink back a bit giving you a little relief while you wait. But go slow with that kind of thing, You will know right away whether to continue or not. Otherwise your choice is to start looking for a doctor that does the minimally invasive surgery to pull out the herniated part. Look for Cervical Endoscopic Discectomy as a start. Know that once you start down any type of surgery route, you might be setting yourself up for more because of all your issues.

     
    Old 02-11-2008, 11:30 AM   #11
    shaun472
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    Re: Can someone help me understand my MRI?

    Its so scarey to even think about any kind of surgery on my back. I hear all of horror stories but it seems as though I`m running out of options. In your oppinion, how long would you wait before you would consider surgery? I keep thinking(or-hoping) it will improve over time, on the other hand, I just want to feel normal again. I`m starting to realize I may not be able to run again, and that was a big part of my life. I can come to grips with that, but it seems that everything I really enjoy involves physical activity. I can`t even go walking without being uncomfortable. I`m trying to stay possitive, but some days its hard. I know that alot of people are far worse than me and my heart goes ou to them. Thanks for responding, it really helps. Shaun

     
    Old 02-11-2008, 07:54 PM   #12
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    Re: Can someone help me understand my MRI?

    Hi again, yep I bet everyone on this board has felt like you do at one time or another. There are millions of people who do improve without surgical measures.

    These problems require patience and time. I know if feels like a long time already, but I bet you have been active and not resting. This is a blip on the map of your life, so do take the time to allow your body to try to take care of this on its own. Take one solid month of real rest. Do not lift, do not do your normal sports activities and if you walk do very light walking at a slower pace. Watch your posture. I hope you have a sedentary type job and don't do physical labor in your work.

    Ask your doctor for another round of oral steroids, if you can take ibuprofen take it and you need at least 800mg every 6 hours I think they said, you could check w/dr. on this. I am not a doctor, what I do know is they usually tell people in your situation to do about 6 months of conservative treatment before considering something like surgery. After having multiple surgeries where I had no choice, you have a choice with your condition. Do not rush into a quick fix - because there isn't a quick fix. You have a degernative neck along with this issue and making the wrong move too early might trigger that process to speed up.

    In the interim you could try finding a neurosurgeon in your area that does the minimally invasive type surgeries and get their opinion on your case.

    PS this is one of those things that you just don't "push through the pain", you really need to rest.

    Last edited by PNo; 02-11-2008 at 07:56 PM.

     
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