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  • Can someone translate this MRI report into "english" for me?

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    Old 12-21-2011, 04:18 PM   #1
    claude9039u
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    Can someone translate this MRI report into "english" for me?

    Here's the report I got on the MRI for my neck (cervical spine). I'd like to have it translated into terms I can understand. I understand a couple terms, but not all.

    Case 365 COMPLETE) MRI CERVICAL W/O CONTRAST (MRI Detailed) CPT:72141
    Reason for Study: 5 weeks of cervical spine pain and left
    arm/hand paresthesia

    Clinical History:
    r/o cervical disc disease or stenosis as cause of left UE
    paresthesia

    no preceding injury, onset was acute approx 5 weeks ago.

    Report Status: Verified Date Reported: DEC 21, 2011
    Date Verified: DEC 21, 2011
    Verifier E-Sig:

    Report:
    Exam: MRI of the cervical spine.

    Indication: Left arm paresthesia.

    Findings: Multiplanar noncontrast MR images of the cervical
    spinal were performed utilizing standard protocol including
    sagittal T, T2, STIR and axial T2-weighted sequences. No priors
    available for comparison.

    There is slight exaggeration of the normal cervical lordosis.
    Mild disc desiccation changes are apparent in the mid cervical
    spine. Vertebral body height is maintained. There is no acute
    compression fracture or findings to suggest discitis or
    osteomyelitis.

    C2/C3: Mild posterior disc osteophyte, the central canal is
    patent, neural foramen are patent.

    C3-C4: Posterior disc osteophyte, flattening of the anterior
    thecal sac, central canal is patent, uncovertebral hypertrophic
    changes are apparent resulting in mild bilateral neural foraminal
    narrowing.

    C4-C5: Patent central canal, uncovertebral hypertrophic changes,
    mild bilateral neural foraminal narrowing right greater than
    left.

    C5-C6: Focal central disc protrusion with effacement of the
    anterior thecal sac, there is CSF anterior to the cord. The
    neural foramen are patent.

    C6/C7: Posterior disc osteophyte and more focal central disc
    protrusion with effacement of the anterior thecal sac,
    uncovertebral hypertrophic changes are apparent, there is mild
    left-sided neural foraminal narrowing.

    C6/C7: Posterior disc osteophyte with left lateral spur,
    effacement of the anterior thecal sac, there is moderate to
    severe left-sided neural foraminal narrowing, correlate with a
    left C7 radiculopathy.

    Otherwise cord signal is grossly normal on this unenhanced study.
    No abnormal epidural collections or masses are appreciated.
    Paraspinal muscle signal intensity is normal. Limited sagittal
    images of the posterior fossa shows no herniation.



    Impression:


    1. Mild to moderate spondylitic changes as detailed above, most
    severe at the C5-C7 levels. 2. Overall marrow signal is grossly
    normal. Mild disc desiccation changes in the mid cervical spine.
    Cord signal is grossly normal on this unenhanced study.

    Primary Diagnostic Code: ABNORMALITY, ATTN. NEEDED

     
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    Old 12-25-2011, 06:13 PM   #2
    jennybyc
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    Re: Can someone translate this MRI report into "english" for me?

    Hi Claude....I'm Jenny and one of the people who attempts to make sense of the doctor talk on the MRI's. and I've had 2 major neck surgeries myself and may be facing a 3rd so I do this for myself too.

    the opening statement says the neck is okay as far as infection or breaks. Bones look okay but the disks are showing signs of drying out. but your neck has a slight problem with going inwards a little more than it should. It's called Lordosis when the neck bends inward toward the front of the body and yours is bent in more than normal.

    The top 2 vertebrae are C1 and 2 and they have no disk in between them. And since that is where they focus with the MRI, they drop down to the first disk between C2 and 3.

    C2-3....everything is okay except they can see an arthritic bone spur growing on the backside of the disk.

    C3-4...another arthritic bone spur on the disk but the disk is bulging and the bone spur is hitting the "thecal sac" which is the membrane that holds the spinal fluid in around the spinal cord. But it isn't hitting the cord itself(good news). At each vertebra, a pair of nerves peels off the cord and goes out to the body through small holes in the bone(foramina)and they can develop blockages either inside the spinal canal from those disks/bone spurs problems or on the outside the vertebra from arthritis of some of the tiny joints there. The vertebra is not just one joint. It has "protrusions" that form tiny joints with other "protrusions" above and below and these tiny joints help to stabilize the spine when we twist and bend on all sorts of positions. One of these protrusions/joints is the "uncovertebral" joints and the bone spurs from arthritis of these tiny joints has caused a "mild" blockage of the holes where your nerves exit to the arms.

    C4-5...no disk problems here but you do have the same problem with the uncovertebral joints with arthritis and the bone spurs are again hitting the nerves. They rate the amount of blockage/compression of the nerve, as mild but slightly worse on the right side. More about "mild" later.

    C5-6...you have a disk bulging right in the center back of the disk and it is hitting that "thecal sac" again but not enough to block out the spinal fluid...the can see fluid between the disk and the cord so no cord involvement. The holes on both sides are open as is the entire canal.

    C6-7...similar to above, the disk has a bone spur on it and it is hitting the sac but not the cord. Those joints on the outside of the vertebra have arthritic bone spurs hitting the nerves on the left side to a mild degree.

    C7-T1.....here is your problem. Again, you have a large bone spur on the disk but this time it's to the left(rather then center), hitting that thecal sac again(but not the cord) but it is big enough that it is compressing the nerves to your left arm at a moderate to severe level.

    Everything else looks good.

    Now on the "ratings". Radiologists rate the amount of compression on a nerve, or blockage of a hole of canal with the words Minimal, Mild, Moderate or Severe. You are all Mild until you get to the last area...C7-T1 where you have moderate to severe nerve compression /blockage. Most docs want to operate to relieve that severe compression as once you reach that level, you are at risk of having the nerve lose it's blood supply and die, leaving the muscles affected, paralyzed. for that nerve, it would mean paralysis of the C8 nerve that goes down the arm to the pinky and ring finger. You might feel pain or numbness all the way down and/or numbness in those 2 fingers. The triceps muscle would be affected and feel weak. You might feel a loss of sensation in the back of the arm....sound familiar?

    Has any surgery been suggested yet? Have you seen a spine surgeon yet?

    One thing we suggest here is that you always get the very best surgeon you can even if it means traveling to a big medical center.

    We're here for questions.

    take care.................Jenny

     
    Old 12-25-2011, 06:32 PM   #3
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    Re: Can someone translate this MRI report into "english" for me?

    Your report, as transcribed, is a little confusing. The C6-7 level is described twice. I guess Jenny assumed that the second paragraph was supposed to be C7-T1, which is probably what the radiologist meant. However, that paragraph also references the C7 nerve, which comes from the C6-7 level. So there's a contradiction there.

    If the problem really is with the C8 nerve (coming from the C7-T1 level), then it would affect the ring and pinky finger. If it's actually the C7 nerve (as transcribed), then it's the two middle fingers that w/b affected.

    At any rate, an operation called a "foraminotomy" could probably take off the bone spur that's affecting the nerve. This is a fairly simple and usually outpatient operation with little recovery period.

    However, a foraminotomy would not do anything about the disk protrusions that are effacing the spinal fluid. These probably do not need to be fixed yet, but are a problem in the making, and at some time may require either that the disks be removed via an ACDF procedure, or that the spinal canal be opened up via a laminoplasty surgery.

    For now, though, I would want to know if a simple foraminotomy would be the way to go. If the first surgeon recommends an ACDF, get at least two more opinions!

    Last edited by WebDozer; 12-25-2011 at 06:35 PM.

     
    Old 12-25-2011, 07:53 PM   #4
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    Re: Can someone translate this MRI report into "english" for me?

    A posterior foraminotomy can be difficult. Going through muscle causes more post op pain, in my experience, than an anterior approach. So I'd only choose a foraminotomy if there were no other treatment choices such as Epidural Injections, etc.
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    Old 12-25-2011, 08:06 PM   #5
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    Re: Can someone translate this MRI report into "english" for me?

    I can only speak for the foraminotomy which I had (at C5). I was out of the hospital within hours of the surgery. General anesthesia was used, although I understand that foraminotomies are now being done without it. Muscles need not be cut, or even damaged, as it's an endoscopic procedure and the muscles can just be moved aside. I never even bothered to fill my pain med prescription, and the recovery period was negligible compared to other surgeries.

    I'm sure it depends on how many (and which) levels are done, and the skill of the surgeon. Also, I suspect that they're getting better this surgery all the time.

     
    Old 12-25-2011, 08:21 PM   #6
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    Re: Can someone translate this MRI report into "english" for me?

    I stayed in the hospital one night and had significant muscle pain from the foraminotomy which has lingered. I had a foraminotomy at multiple levels and shoring up of my C5-C6-C7 fusion, thus a bit more invasive.
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    Old 12-26-2011, 09:11 AM   #7
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    Re: Can someone translate this MRI report into "english" for me?

    Thanks Web....didn't even notice it was listed as C6-7 twice....I just assumed it was C7-T1. Too much partying over the weekend to see straight last night! And now I find out that my 4 year old granddaughter.....who was lavishing kisses on everyone, has strep. Welcome to 2012!

    So is it C6-7 twice or C7-T1 that I described????

     
    Old 12-26-2011, 06:25 PM   #8
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    Re: Can someone translate this MRI report into "english" for me?

    I have a Cervical MRI that I would ask that someone translate for me also I had a very large herniated disc 10 years ago at level c5c6, and I expected to be painfree immediately post op. For my experience, that did not happen. I have had chronic pain ever since the fusion. The main reason for the fusion was to decompress the spinal cord as the herniation was causing compression on the spinal cord. I have had arm pain, numbness on and off since the initial surgery. I have been through many injections, attempted a spinal cord stimulator. I am currently taking strong pain medications and have now developed some bladder symptoms. I have been having new neck symptoms, which included neck higher up in the neck, and the bladder symptoms. I was referred to a neurologists for an eval to see if the bladder was being caused by some spinal problem. Here is the following MRI of my Cspine and lumbar MRI. Could someone look at it and describe what is the foramin narrowing, etc means.

    MRI OF C SPINE -NO CONTRAST

    History-Myelopathy, MS(ruled out)

    Findings-The spinal cord shows normal contour and signal. There is an anterior fixation plate and screw device seen at the c5c6 levels, with resulting artifact obscuring some detail. There is no obvious malalignment or marrow signal alteration. No soft tissue abnormalities are seen outside the spine. At c2 the spinal canal and neural foramina are well preserved.

    c3-4 there is a minimal groad protrusion and unconvertebral hypertrophy resulting in only mild foramnal narrowing and no significant canal stenosis.

    c4c5 a large broad based central disc and osteophyte protrusion is seen mostly prominent to the right of midline, resulting in fairly severe canal stenosis on that side and at least moderate foramainal narrowing.

    at the fused c5c6 fused level, there is a broad disc/osteophyte protrusion with only mild canal stenosis.

    at the c6c7 level, a minimal central protrusion abuts the anterior surface of the cord, but there is so sigificant overall canal or foraminal encroachment.

    The other visualized levels are unremarkable.

    IMPRESSION: 1.No cord signal abnormality
    2.The domnant finding is a large central and right paramedium protrusion at c4c5 with fairly seere resulting stenosis and lateral recess encroachment.

    ------------------------------------------------------------------------

    Lumbar spine MRI

    Findings: Please see previous cervical MRI report regarding postoperative changing and canal compromose of c4/c5 and c5c6. The scout images reveal no significant canal narrowing or cord abnormality at the thoracic level.

    The distal cord and conus are normal. Vertebral stature and alignment are normal, and there is no significant focal marrow signal abnormalities. No paraspinous soft tissue lesions are seen.

    at L5-S1, There is minmal facet hypertrophy, but the spinal canal and neural formanina are well preserved.

    At L4-5, there is a large broad based central disc protrusion, centered slightly to the left of the midline. This results in no significant canal stenosis, but fairly severe lateral recess and moderae foraminal encroachment on the left side. There is minmal lateral recess narrrowing to the right of midine as well.

    The other visualized levels unremarkable.

    Impression: Large disc protrusion at L4-L5 with resultant fairly severe left sided recess compromise and moderate foramnal encroachemnt on the loeft. No significant canal stenosis.


    My plan is to see a neurosurgeon to review my scans and see if injections will relieve symptoms caused by these findings, but my concern is I have chronic pain in my neck and now new problems. It is hard to distinguish the new acute pain from the chronic since it radiates to both sided of my neck as well. I am terrified of the spinal cord compression problem happening again. I wake up in the am with bilateral arm and bilateral leg pain. I dont know which problem should be addressed first ... Thanks..... Purplelcr

     
    Old 12-26-2011, 06:33 PM   #9
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    Re: Can someone translate this MRI report into "english" for me?

    purple.... can you cut-and-paste that into a new thread before we continue? The moderators prefer that we not "hijack" a thread that someone else has started...

     
    Old 12-26-2011, 08:13 PM   #10
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    Re: Can someone translate this MRI report into "english" for me?

    I have copied and pasted my post into a new thread. I apologize. I am new to this site and this was an error on my part. thanks.

     
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