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    Old 07-20-2011, 02:54 AM   #1
    ralthiel1983
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    Bulging discs in cervical and lumbar spine

    Hello,

    I recently had a spine MRI done to check for possible causes of some neurological problems (neurogenic bladder, poor memory, headaches, poor balance).

    The MRI shows bulging discs at C2-3, C3-4 and C4-5 and L3-4, L4-5, L5-S1, possibly L2-3 that are putting pressure on and reducing width of the spinal cord. It does not appear the discs have herniated at this point.

    I haven't talked to my neurologist to get his interpretation yet, but I wanted to know how severe this is and what the possible treatment options are. I know surgery is an option, but I fear that would be pretty major and would have a long recovery. But I suppose if needed, then I should to prevent permanent nerve damage.

     
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    Old 07-20-2011, 05:30 AM   #2
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    Re: Bulging discs in cervical and lumbar spine

    I would get a consultation with a spine specialist, either a neurosurgeon or orthopedic spine surgeon, and either could really give you a better interpretation than even the neurologist can. You may need some type of surgery to relieve the pressure, but you really need the expertise of someone who deals with this all the time.
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    Old 07-20-2011, 05:33 AM   #3
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    Re: Bulging discs in cervical and lumbar spine

    I take it you have the radiologist's report on the MRI? If so, he should be using adjectives like "mild", "moderate" and "severe", which are very important. If your disks have not herniated but are still impinging on the cord, it sounds like you have a pretty narrow spinal canal (stenosis).

    Certainly something to take up with the neurologist, and soon, but it's probably best if you yourself understand every word of that report, as well.

     
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    Old 07-20-2011, 05:01 PM   #4
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    Re: Bulging discs in cervical and lumbar spine

    Thanks for the replies

    I will most certainly be discussing it with my neurologist next time I see him, should be early next week. I don't have the radiologist's report, I was just looking at the films. It's plainly obvious that my spinal cord is being compressed, even to me, with no medical background. My cervical spine seems to be most effected, and the compression can be plainly seen. The mri has a reference ruler in CM on each picture, and it appears that the 3 bulging cervical discs are reducing the spinal cord from average of about 20mm normal to around 13-15mm. I'll try to post a picture later if I can of the film. I'm going to call my neuro tomorrow and see if they have the radiologist's report yet and get their impressions. (the MRI place gives me the films to keep, and sends the report to the doctor). When I see the neuro, I'll get a copy of the reports for myself as well.

    It could be plausible that I have stenosis, but I can't comment on that for sure. I only can judge what I can plainly see on the mri. If surgery turns out to be neccessary, and I fear it will be, I will seek out a neurosurgeon.

    The mri also shows hints that I may have degenerative disc disease. The disks in the cervical and lumbar spine look fairly healthy, even though they are bulging, but I have a couple of discs in the thoracic spine that seem to be degenerated. Very flat, dark grey and thin. I'm 28, so probably a bit young to have problems like this, but certainly not impossible.

    Edit: Here is a picture of the MRI showing 3 saggital views of the spinal cord and the offending discs. (any sensitive info has been blurred out )
    http://i52.tinypic.com/j81els.jpg

    I measured the reduction in spinal cord widths as follows:
    C2-3: 5mm
    C3-4: 5mm
    C4-5: 7mm

    Last edited by ralthiel1983; 07-20-2011 at 07:20 PM.

     
    Old 07-20-2011, 07:24 PM   #5
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    Re: Bulging discs in cervical and lumbar spine

    ralthiel - I will give you my impression, although it goes without saying that I'm very much an amateur and no substitute for a neurologist or neurosurgeon.

    1. Most of the people here would LOVE to have MRI's that look like yours

    2. That's not your cord running down the middle. It is the spinal canal. 18-20mm is a good width for it. The dark thing in the middle is the spinal cord, and the white around that is spinal fluid.

    3. The disks don't look bulging to me. Certainly, I have seen a lot worse. Even if they were bulging, you have a lot of room to spare. Those of us with canal stenosis (narrowing) have no room to spare. For us, the white spinal fluid that is so abundant in your MRI cannot be detected at all at some levels.

    4. The disks also look pretty healthy, as they should in a 28-year-old. I don't see any disk collapse (ddd).

    5. The radiologist's report will either confirm or contradict what I'm saying. You REALLY should have a copy. You paid for it, after all.

    6. I didn't know anyone even got films any more. It's all on disk, and in a format that can be read by a special viewing software. This software will provide top-down slices that will be much more helpful. In particular, they will allow the radiologist to see if anything is impinging on the nerve roots, such as osteophytes.

    All in all, while I don't want your symptoms - which, I fear, have their cause ABOVE your cervical spine - I would gladly take your MRI. May all turn out the best for you!

    in edit: I see your edit, and you are now measuring the actual cord. Granted, it looks quite narrow, but I don't see any indentations, do you? I think it's better to use the top-down (sagittal?) slices to measure the cord.

    Last edited by WebDozer; 07-20-2011 at 07:38 PM.

     
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    Old 07-20-2011, 07:54 PM   #6
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    Re: Bulging discs in cervical and lumbar spine

    Thanks for the input

    Ahh, that makes a bit more sense. I had assumed that the whole area was the spinal cord, the darker portion being grey matter and the lighter portion being white matter. I do have some axial (slices) views, which I saw some oddities on, and assumed the could be related.

    Here they are:

    3d balanced sequence, axial
    the black streak in the first 6 or so pictures is a bit strange

    t2 fast spin echo, axial

    The images aren't the sharpest, the measurement scale in each image has the tick marks as 1cm.
    Attached Images
    File Type: jpg 1.jpg (105.0 KB, 3 views)
    File Type: jpg 2.jpg (102.0 KB, 2 views)

    Last edited by moderator2; 07-20-2011 at 08:17 PM. Reason: to show your pics as attachments

     
    Old 07-20-2011, 08:05 PM   #7
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    Re: Bulging discs in cervical and lumbar spine

    Well, those first six sure look different, but that could well be OK. The dark is the neural matter, and where the nerves pass out of the cord and toward your shoulders and arms I would expect the dark to break through the surrounding bone and spinal fluid.

    Any radiologist, neurologist or neurosurgeon will have no problem with it. Still, just so you feel better about the process, I would again urge you to get that radiologist's report. Whoever has it HAS to give you copy, even if they charge a few bucks for it.

     
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    Old 07-20-2011, 08:34 PM   #8
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    Re: Bulging discs in cervical and lumbar spine

    One other thing I wonder about, on the t2 weighted image that is axial, normally CSF would show up bright white, correct? But in those images, the area outside the spinal cord is mostly gray, but you can see a few bright white areas. Or is that just the way that the image was weighted?

    I'll get a copy of the report as soon as I can. Thanks for the input and helping me read these, I feel a bit better now. The spinal cord does seem to be a bit thin, but looks healthy. The discs that are slightly bulging are just pressing into the fluid a little, not hitting the cord at all. I've already had my brain checked and it was normal.

    Last edited by ralthiel1983; 07-20-2011 at 08:45 PM.

     
    Old 07-20-2011, 09:06 PM   #9
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    Re: Bulging discs in cervical and lumbar spine

    If it's a cervical MRI, they may not bother to do a good job on the T's.

    BTW, when I wrote this

    "Any radiologist, neurologist or neurosurgeon will have no problem with it. "

    I meant they will have no problem READING IT....

    Last edited by WebDozer; 07-20-2011 at 09:08 PM.

     
    Old 07-20-2011, 09:48 PM   #10
    ralthiel1983
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    Re: Bulging discs in cervical and lumbar spine

    I figured that was what you meant

    I'm going to call my doctor in the morning and find out if they have the reports yet, and also call the MRI place and request a copy of the report.

     
    Old 07-21-2011, 10:53 AM   #11
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    Re: Bulging discs in cervical and lumbar spine

    It should be easy to get the actual MRI report. Just call the facility and ask for the MRI report. Also, a neurologist is a place to start but to really discuss spinal pain it's important to see a spine surgeon specialist such as Orthopedic Spine Surgeon and/or Neurosurgeon (not neurologist). They don't only do surgery, but can review tests, symptoms and examination to provide a consultation.

    Also know that if you took 100 people off the street and gave them an MRI many would have disc bulges but would have absolutely no symptoms. So the doctor has to evaluate the testing (i.e. MRI) in relation to your symptoms.

    If you look for a spine dermatome chart you'll see where certain spine problems can appear in the body. Such as my cervical disc that caused numbness in my index finger.
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    Old 07-21-2011, 02:43 PM   #12
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    Re: Bulging discs in cervical and lumbar spine

    I'm going to be following up with my neurologist Tuesday morning, so I'll know more then. I asked over the phone what the report said, but the front desk person didn't want to say anything, which I thought was odd. When I had my brain MRI recently, they told me over the phone that it was normal when I called to make the followup appointment. Not sure what to make of that, could be the person I talked to just didn't feel qualified to try and interpret the report.

    I called the MRI place and requested the report, and they told me that they couldn't give it to me until I saw the doctor, and to ask him for a copy, and if the doctor wouldn't give me one, to let them know and they will. I thought that was odd too.

    I will get some additional pictures up soon to show, but looking at my lumbar spine it seems possible that the nerve bundle is being pinched by the disc at L4-L5 and L5-S1.

    I also have 2 discs in my thoracic spine that look entirely flat and dried out, suggesting degenerative disc disease there. I don't know how relevant that is to my current symptoms though.

    Last edited by ralthiel1983; 07-21-2011 at 03:22 PM.

     
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