It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Spinal Cord Disorders Message Board

  • MRI Cervical and Lumbar MRI explanation

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 12-26-2011, 07:50 PM   #1
    purplelcr
    Newbie
    (female)
     
    Join Date: Dec 2011
    Location: south carolina
    Posts: 6
    purplelcr HB User
    MRI Cervical and Lumbar MRI explanation

    I had a Cervical MRI that I would ask that someone translate for me. My histor is extensive as I have had chronic pain for the past 10 years since my last surgery in July 2001. 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. The neurologists also did an EMG and NCV study which he stated it revealed some nerve irritation or nerve involvement in my lower spine. I have had problems with bladder control, but it is not a daily problem. I did have a bladder sling problem in 2007 which the neurogist states the findings on the cervical and lumbar MRI are probably totally unrelated to my bladder issues. What exactly is meant by the lateral recess narrowing, and what is meant by uncoveterbral hypertrophy resulting in foraminal narrowing. Thanks to anyone who can help...

    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

     
    Sponsors Lightbulb
       
    Old 12-27-2011, 07:29 AM   #2
    WebDozer
    Inactive
    (female)
     
    Join Date: May 2011
    Location: So Cal
    Posts: 1,379
    WebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB User
    Re: MRI Cervical and Lumbar MRI explanation

    Uncovertebral joints - upward extensions of the lower cervical vertebrae that form joints with the vertebrae above them. For your purposes, think of them as bony bodies that grow alongside the vertebrae. When they are hypertrophied they have gotten too big, probably by laying on additional bone. They are thus expanding backward into the foramina.

    Foramina - at each level of the cervical and thoracic spine (except the C1-2 level), a nerve leaves the spinal cord on each side. For example, at the C4-5 level, the C5 nerve is heading off to the shoulder and arm, especially controlling the deltoid (back/top of shoulder) and biceps muscles. When the nerve leaves the cord it passes through an opening - "foramen" in Latin - where it is subject to being pinched by various disorders. The section of the nerve immediately after leaving the cord is call the "root", and a problem in this area is called "radiculopathy" (more Latin, meaning "root problem").

    Canal stenosis - behind your vertebrae is an opening called the spinal canal. Within that canal is a sheath of fiber called the "thecal sac", though which flows the cerebrospinal fluid (CSF). Suspended within the fluid is the nerve bundle called the spinal cord. "Stenosis" means narrowing, and it can happen when any part of the spinal structure intrudes into the canal. This might be a disk (as happened to you at C5-6), disk/osteophytes (bone spurs growing off the vertebrae), hypertrophied facet joints (coming from the sides) or hypertrophied ligaments coming from behind. Also, some people (like me) are just born with undersized spinal canals.

    Let's look at your two problematic cervical levels...

    C5-6, where you had the ACDF some years back. I'm a little surprised that your have an osteophyte (literally "bone growth") problem. I would have thought that the surgery would have removed the osteophytes growing off the back of your vertebrae and that, since that level is fused and no longer moves, there would be no cause for osteophyte re-growth. Guess I would be wrong. Still, it does not seem that there is any longer an immediate problem at that level. Unfortunately, the damage done at that level may well be permanent. Did you go a long time between first noticing symptoms and when you had the surgery done?

    C4-5, where you now seem to be developing a problem similar to the one at C5-6. The disk is forcing itself back into the canal, mostly on the right side, and simultaneously impinging on the foramen through which passes the C5 nerve root. The radiologist uses the adjective "severe", which is a flashing red light. Unfortunately, he only says the CANAL is being narrowed. Remember that you have the thecal sac inside the canal, the spinal fluid inside the sac, and the spinal cord inside the fluid.... so it's possible for considerable canal narrowing without the cord being affected. THIS IS SOMETHING YOU WANT TO CLEAR UP. He also said that you have "at least moderate" foraminal narrowing. "Moderate", in radiologist-speak, is one step below "severe", so saying something is "at least moderate" is another way of saying "possibly severe". ANOTHER THING YOU WANT TO CLEAR UP.

    If the C5 nerve is being affected, it should have a range of symptoms in the neck, shoulder and arm. When my C5 nerve was pinched, the first sign I had of that was when I could no longer lift a 12-pack of soda (deltoid muscle). I also couldn't "make a muscle" with my biceps. I would guess I lost 70% of the strength in those two muscles (until the problem was surgically fixed).

    I see your C4-5 problems possibly causing neck pain, plus a variety of shoulder/arm problems. If the cord is impacted, then anything below that level is fair game. Also, there are likely residual problems from C5-6 years ago. I cannot say whether or not your bladder problems might be related to the cervical cord narrowing. As Jenny has a more global understanding of these things, you would hope to hear from her.

    Last edited by WebDozer; 12-27-2011 at 07:38 AM.

     
    Old 12-27-2011, 07:50 AM   #3
    WebDozer
    Inactive
    (female)
     
    Join Date: May 2011
    Location: So Cal
    Posts: 1,379
    WebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB User
    Re: MRI Cervical and Lumbar MRI explanation

    Your lumbar is problematic only at L4-5, where the immediate concern would be the lateral recess encroachment by a protruding (herniated?) disk. "Lateral recess" encroachment is a new term for me, but at least at the cervical level I don't really see significant difference between that and foraminal encroachment. Since the radiologist mentions them together regarding L4-5, I suppose he's saying you may have a radiculopathy of the nerve heading into your left leg from that level.

    Overall, your report gives strong evidence of what might be causing problems in your LEFT leg and RIGHT arm. However, if you are having BILATERAL problems, that is of some concern, as it may indicate cord involvement.

    Talking to a neurosurgeon (or orthopedic spine surgeon) is the obvious next step. If I were you I would line up appointments with THREE docs, not just one. Sometimes these appointments take a while, and if you are faced with a long delay in getting second/third opinions you may decide to just go with whatever the first doc recommends, and that's not advisable.

    Last edited by WebDozer; 12-27-2011 at 08:43 AM.

     
    Old 12-27-2011, 08:42 AM   #4
    WebDozer
    Inactive
    (female)
     
    Join Date: May 2011
    Location: So Cal
    Posts: 1,379
    WebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB User
    Re: MRI Cervical and Lumbar MRI explanation

    purple... Still thinking about your situation, in particular about the ongoing problems after your first surgery. If I were in your shoes, I would be very much concerned that something didn't go right with the first surgery. That level of pain and continuing symptoms just seems like too much, unless, of course, you let the symptoms go for quite a long time before getting the surgery.

    One way or another, I'd want to find the best surgeon I can and bring the subject up with him. Needless to say, you do NOT want to be having this conversation with the guy who did the original surgery.

    It's not terribly unlikely that a surgeon will recommend a C4-5 ACDF for you, and I guess there's an outside chance that he'd agree to re-do C5-6 while he's at it.

    Last edited by WebDozer; 12-27-2011 at 08:45 AM.

     
    Old 12-27-2011, 06:27 PM   #5
    purplelcr
    Newbie
    (female)
     
    Join Date: Dec 2011
    Location: south carolina
    Posts: 6
    purplelcr HB User
    Re: MRI Cervical and Lumbar MRI explanation

    Thanks for your comments and concerns. You had asked if I had waited a long time before I had surgery when my symptoms began. Actually, My iniital neck pain begain in 1995, and i saw my MD'S on several occasions regarding the neck stiffness, and was assured that this was not related to my c spine, that it was only muscle. I had had given birth to premature twins in96 and they felt it was the lifting and all the activity included in caring for those twins,one who was dx with cerebral palsy, and also had a 4 yr old at the time also. I did not get concerned until the numbness and parasthesias begain in June 2001 and was finally sent for and MRI which revealed this large herniated disc which was placing severe pressure on the spinal cord. I felt like the surgery was my only choice with the spinal cord compression. Now I have shoulder blade pain, pain in right arm and left, and now due to the lumbar herniation, have pain when standing and at times pain down both legs. Beleive it or not, the most severe pain in my legs wake me up at night. I am currently taking MS contin for the chronic pain, and my neurologist has ordered a short term therapy of Lortab for the acute neck pain and the leg pain.. I feel like I am in a mess right now and dont like what my options may be. I do appreciate your concern. THANKS ALOT....

     
    Closed Thread




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 06:59 PM.





    2019 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!