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    Old 12-28-2011, 03:32 PM   #1
    Lolly808
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    My MRI results - Cervical Spine

    Hello!

    This is my first time posting. I need help understanding my MRI results.
    Here it is!

    The C2-3 and C3-4 discs are normal with no neural foraminal narrowing.

    At the C4-5 level there is disc desiccation, disc narrowing and prominence of the posterior disc endplate complex with effacement of CSF from around the cord and some ventral cord flattening. Mild left C4 neural foraminal narrowing.

    At C5-6 level there is disc desiccation and prominence of the disc endplate complex which effaces CSF from around the cord and causes some cord compression and distortion. Bilateral C5 neural foraminal narrowing.

    At C6-7 level there is disc desiccation of the disc endplate complex less severe than that seen at C4-5 and C5-6 with flattening of the ventral surface of the cord. Moderate left C7 neural foraminal narrowing.

    The C7 - T1 disc appears normal.

    Summary: Spinal stenosis due to spondylosis most marked at C4-5 but also present at C5-6 and C6-7. Moderate neural foraminal narrowing is seen on the left at C4 vertebral body and at the C4 vertebral body levels as well as bilaterally at aC5 & C6. Incidentally noted are multiple thyroid masses. Thyroid ultrasound might be considered in further evaluation.

    Lots of info! Any help would be appreciated.

    thanks!!!!!!!
    Laurel

     
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    Old 12-28-2011, 03:38 PM   #2
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    Re: My MRI results - Cervical Spine

    Some background.

    I have had terrible back and neck pain for about 15 years. My last x ray was in 2006 which showed severe arthritis. I am on Norco 3 - 4 times per day.

    I have been wanting new xrays as my pain is getting so much worse. Sometimes the meds just don't work. Finally my doc ordered the cervical MRI.

    Basically he told me it's bad. He said it will most likely get worse and all we can do is manage the pain. He did say fusion surgery later on could be an option.

    When I lie down, my arms fall asleep. Both of them, not always at the same time. They fall asleep all the way to my hands. I'ts like they are dead. Its hard to get them moving again.

    I have terrible pain in my neck and lower back. I am trying to get him to order thorasic and lumbar MRI's as well.

    I also have really weak quads. I walk on the weekends and can walk for 4+ miles. However, going up stairs is really difficult. I have no strength and it hurts!

    OK. That's just a little background. I really would like some help understanding what this all meansll!!!!

    thanks again!!!!!!!
    xoxoxoxox

    Last edited by Lolly808; 12-28-2011 at 03:40 PM.

     
    Old 12-28-2011, 06:18 PM   #3
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    Re: My MRI results - Cervical Spine

    <<Basically he told me it's bad. He said it will most likely get worse and all we can do is manage the pain. He did say fusion surgery later on could be an option.>>

    Huh? It's bad, it'll get worse, but we can only manage the pain??? Maybe your doc doesn't know there are about twenty kinds of surgery for problems like yours. Is he 100 years old?
    I think you really need to get another doc, probably two. Maybe the new guys will agree with your current doc, but you still need to see. Some docs are surgery-averse, more so than they ought to be.

    It's kind of hard to know what to make of all that cord flattening without getting measurements in mm (which many radiologists will include) or without seeing the images themselves. Also, the radiologist should have been more explicit about how bad the foraminal narrowing is. Still, based on the report, it's not all that unlikely that you would be better off with a three-level ACDF surgery (removing the three disks in question, replacing them with donor bone, and clamping the vertebrae together. You would lose some range-of-motion, maybe 30% (just a guess), but you'd keep enough to be able to drive, which is most important.

    Some caveats...

    - It's possible that your symptoms are not caused by your cervical spine problems. Lumbar and thoracic MRI's would be ordered by a doc who really wanted to get to the bottom of this. Of course, maybe there's a non-spinal cause for much of your symptoms.

    - Even if the symptoms are caused by the cord flattening or the foraminal narrowing, they might not improve all that much with the ACDF surgery. The surgery is really to keep things from getting worse, while improving existing symptoms is a hoped-for but not assumed outcome.

    Please keep in mind that I'm just a somewhat informed and more-than-somewhat opinionated amateur. Still, I really think you need a less passive doc...

     
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    Old 12-28-2011, 06:27 PM   #4
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    Re: My MRI results - Cervical Spine

    Hi Lolly(I have an aunt by that name)....I'm Jenny and one of the people here who tries to make MRI's understandable.

    First, let me start by talking about neck anatomy. Your spinal cord goes down through the middle of the vertebra and at each level, a pair of spinal nerves peels off the cord and goes out to the body through small holes called foramina. Since so many problem start with the disks that are in between the vertebrae, they focus the MRI study there. Depending on what and where the problem is, radiologists use the words, Minimal, Mild, Moderate and Severe to rate the amount of closing or compression or just a problem. You have a lot of Moderate problems so far but that is like saying out of a worst rating of 4, you are a 3.

    So, at C2-3 and C3-4, you are okay.

    C4-5....here you start with disk problems. Dessication means they are drying up and getting narrower. Disks are like jelly donuts in that they have a thick layer on the outside and a thinner slightly more liquid inside. As we age, they get drier and shrink and as a result, more fragile and likely to herniate(jelly inside pops out). Yours aren't herniated yet but they are drying up and when that happens, they can develop a hard jagged edge on them as if they are forming bone spurs....they are part of the joint so bone spurs can form on them. They call this a "complex" as it has both disk material and bone material. So this bad edge is bulging backwards into the canal and pressing on the membrane that surrounds the spinal cord(thecal sac) and just flattening the front side of the spinal cord. It is also big enough that it is "mildly" blocking the left foraminal hole where the nerve goes to the body. When I talk about bulging...we're talking about millimeters here.....1 or 2 mms. Maybe. Doesn't take much.

    C5-6.....basically the same thing as above but here the bulges are blocking both spinal nerve holes to a Moderate level.

    C6-7, same thing but not quite as bad. The cord is only "flattened...meaning they don't see it actually pressing into the cord. And only the left side foraminal hole is blocked to a Moderate level.

    C7-T1 ....normal.

    Now here is where the word Moderate comes in. Most doc's won't operate until you reach the Severe level of blockage or compression of the nerves. And they usually don't operate until you reach Moderate compression of the spinal cord....or compressed down to the point of your spinal cord going from 10-12mms down to 7-9mms. They don't give any measurement of your cord so maybe it isn't that compressed....they don't even use the words moderate or even mild. However, your spine surgeon might do a measurement and find it is that far compressed. I was down to under 6mms at several areas when I had my first surgery and severe at every level for the nerves. So for now, pain management is indicated but maybe not surgery.

    However, you should have the other areas MRI'd as your weak quad muscles of your legs may be from nerve or cord compression elsewhere. Rarely do you have problems in one area of the spine and not in others. Push for getting the rest of your spine done!

    We have many people here getting pain management for spine issues, waiting for the day they get bad enough to need surgery. How do you know you are ready....you stop hurting and get more and more numbness and your arms don't work right and/or you get problems and numbness in your legs from cord compression. That is when they go in as you have a certain number of people who will become paralyzed just from the surgery.....so they make sure you are close to that point anyhow. And it seems with necks, once they start operating, they just never stop. So you wait until you can't wait any longer.

    I'm sure others will come along and add their 2 cents and maybe even a different opinion as to where you stand. And we are here for any questions you have...and I bet you have many.

    Hugs.................Jenny(fused C3 to T1)

     
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    Old 12-29-2011, 02:41 PM   #5
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    Re: My MRI results - Cervical Spine

    Quote:
    Originally Posted by Lolly808 View Post
    Some background.

    I have had terrible back and neck pain for about 15 years. My last x ray was in 2006 which showed severe arthritis. I am on Norco 3 - 4 times per day.

    I have been wanting new xrays as my pain is getting so much worse. Sometimes the meds just don't work. Finally my doc ordered the cervical MRI.

    Basically he told me it's bad. He said it will most likely get worse and all we can do is manage the pain. He did say fusion surgery later on could be an option.

    When I lie down, my arms fall asleep. Both of them, not always at the same time. They fall asleep all the way to my hands. I'ts like they are dead. Its hard to get them moving again.

    I have terrible pain in my neck and lower back. I am trying to get him to order thorasic and lumbar MRI's as well.


    xoxoxoxox

    JMO but I think you need a new doctor.

     
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    Lolly808 (12-29-2011)
    Old 12-29-2011, 03:13 PM   #6
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    Re: My MRI results - Cervical Spine

    Thanks for the info everyone. Very very much appreciated and informative!

    I live on Maui and it is very difficult to find specialists here. I had CMC thumb joint arthroplasty 5 months ago due to arthritis. Had to fly to Oahu to have it done. Also had open heart surgery 2.5 years ago, same thing. Oahu!

    It's time to go to a specialist for sure.

    I don't know if you noticed, but in the summary it also says I have thyroid masses. He told me not to worry about it and to wait until after the 1st and he would order an ultrasound. I've been calling the office to get it done sooner and not getting any response. Very frustrating. The MRI was done in October.

    Again, thanks for responses, and if anyone else has input I would appreciate it greatly!

    :-))) Happy New Year!

     
    Old 12-29-2011, 04:48 PM   #7
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    Re: My MRI results - Cervical Spine

    Quote:
    Originally Posted by Lolly808 View Post
    Thanks for the info everyone. Very very much appreciated and informative!

    I live on Maui and it is very difficult to find specialists here. I had CMC thumb joint arthroplasty 5 months ago due to arthritis. Had to fly to Oahu to have it done. Also had open heart surgery 2.5 years ago, same thing. Oahu!

    It's time to go to a specialist for sure.

    I don't know if you noticed, but in the summary it also says I have thyroid masses. He told me not to worry about it and to wait until after the 1st and he would order an ultrasound. I've been calling the office to get it done sooner and not getting any response. Very frustrating. The MRI was done in October.

    Again, thanks for responses, and if anyone else has input I would appreciate it greatly!

    :-))) Happy New Year!
    If I had masses in my thyroid I'd be demanding that something be done now. I've learned this past year to be my own advocate because if you aren't you get screwed over quickly.

    I have the same problem with specialists. There are only 2 orthopedic groups and one neurology and both basically told me to get lost when I was looking for someone to treat my neck. I had to get a referral to a hospital's trauma/acute on call neurosurgeon to get any help.

    Now I am dealing with a possible torn meniscus but the ortho who saw me told me to get the neck surgery done first and then we'll work on the leg. I can walk on it to some degree so it's not a huge deal.

    But you have to be "pushy" when it comes to your healthcare. Your doctor seems to have a nonchalant attitude and that would bother me.

    Last edited by Administrator; 02-23-2012 at 11:27 PM.

     
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    Old 01-05-2012, 12:25 PM   #8
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    Re: My MRI results - Cervical Spine

    Soo hard to be pushy with this doc! I'm trying though!

    I just saw him yesterday. I asked for MRI's of the rest of my spine. He said there is no reason to do them. He said we already know they are going to be bad, so unless I am considering surgery in the near future, then there is no reason to get them. He said for now all we can do is pain management.

    He wants me to try taking 30 mg of Kadian every night, and to use the Norco 10's as BT meds. I said I would try it. I've had morhphine in the hospital and I didn't have any problems with it. I took one last night and got a little light headed, but not much. I still woke up in pain. Maybe it takes a while to get a steady level in my bloodstream.

    My labs were all very very good (cause I've been juicing!). My thyroid was on the low side of normal. He said its nothing to worry about. (says that a lot) He did order an ultrasound of my neck. Said multiple masses are better than one mass. More likely not to be cancerous with multiple masses. So that is January 20th.

    I think I can feel the mass in my throat when I lie down at night. Sometimes during the day. I don't know if it just my imagination now that I know they are there! I can get like that at night. After my open heart surgery I get anxiety at night when I go to bed. Its been 2.5 years, but I still have it. Hopefully if it is close to my throat, it will show on the ultrasound.

    He scheduled me to come back in 3 months. He did say if the Kadian doesn't agree with me, or doesnt provide relief, he could up the dosage, or we could try oxycontin, or ms contin. He suggested Opana as well, but I took that after the heart surgery and it did nothing for me.

    I swear, as I type this, I feel like my throat is constricted or something on that side. I'm sure nothing bad will happen in the two weeks till I get to the ultrasound. If it does, I can always call him if I feel its getting uncomfortable. He did mention that it is probably goiters and the only reason to remove them would be cosmetic or if they become uncomfortable. You can see it pretty prominently on the left side of my neck. Geez. I don't want any more surgery for a while!

    Has anyone taken Kadian? Any thoughts on it?

    Thanks again!!

    L.

     
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    Old 01-05-2012, 10:32 PM   #9
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    Re: My MRI results - Cervical Spine

    Lolly, I'm sorry but after reading your post I have to say if I was you I'd be looking for a new doctor ASAP. To tell you that you didn't need an MRI for your lower back because we already know it will be bad is just negligence on his part IMO.

    When I told you that you have to be your own advocate it comes from experience. I go to the local Community Health Center and my first doctor there was just like yours. She put me on Rinicort Aqua which is a steroid nose spray. If not used properly it can perforate the septum in your nose. Well, no one told me to make sure I didn't spray it towards that part so guess what? I now have a hole there. Before it happened I told her that I was getting nosebleeds and said that drug could cause it and holes in the nose. She said you only get holes in your nose from snorting coke.

    Then I had foot problems. When I told her I had severe pain in them she didn't even examine them-she just glanced at them with the shoes on and said I had high arches. I finally got tired of her and requested a new provider. This one examined my feet and then told me to go to some foot store and buy their special arches(she used them so they oughta work for my feet) After spending $70 on two pieces of crap that did nothing for me and waiting the 6 months like she said I was finally referred to a podiatrist. She examined me and said I had bone spurs on my feet. When I told her what the other two providers said she told me "that's why I'm the podiatrist". Those bone spurs are now gone.

    I spend hundreds of dollars on shoes and insoles and spent needless months in agony from those feet. Both providers were negligent IMO.

    It took my herniated discs though to make me become a demanding, pushy patient. I've had to deal with ER's treating me as if I were a drug seeker-one snotty nurse even had the nerve to ask me what I expected them to do for me when I came in during one of my flare ups. If I hadn't been pushy and demanding I wouldn't be having the surgery next week because the girls who are not doctors in the NS office gave me a hard time when I first called. That was when the new, pushy and demanding person took over-since the ER referred me they HAD to see me. Luckily the NS didn't share their "diagnosis". I'll be damned if I'm going to let anyone else treat me like crap again in the medical field.

    Your problems are a little more serious than my feet and nose so I really hope you listen and find someone else ASAP. Your health is too important to be entrusted to a doctor who has such a crappy attitude. It's time for you to become a pushy and demanding patient-it's not that hard once you take that first step.

     
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    Old 01-06-2012, 05:30 AM   #10
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    Re: My MRI results - Cervical Spine

    ""He said we already know they are going to be bad, so unless I am considering surgery in the near future, then there is no reason to get them.""

    That may be the single dumbest thing I have ever seen from a doc, unless, that is, you'd already told him you had no intention of getting surgery.

     
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    Old 01-06-2012, 12:00 PM   #11
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    Re: My MRI results - Cervical Spine

    I have had doctors say some dumb things to me, oh the bones are already fused together and that's a good thing because that is what they do in surgery, another one said oh I see a little arthritis but, it dosen't look too bad, I'll set up up for an injection, I never went back to that doctor, I never go back after they say something like that to me, its insulting, I will probably get another neuro because all this one does is prescribe me barrells of pills so she can get the bonus from pawning them off on unsuspecting patients, before I had my cervical fusion in 2002 I started to lose control of certain bodily functions, that is when you need to do something for sure , then it becomes an emergency ,a good radiologist should be able to tell from an mri if it is an emergency, if you see the word severe, I would be concerned and still get a second opinion, good luck !

     
    Old 01-06-2012, 02:22 PM   #12
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    Re: My MRI results - Cervical Spine

    Lolly,

    I had a mass on my thyroid 10 years ago. It was found during a routing exam, and was quite large. I was sent for an Ultrasound Immediately, and for a biopsy immediately after that. I was only 35 at the time. I was sent to an endocricologist as soon as the biopsy came back negative, and put on medication to prevent it from getting any larger. I took synthroid for 2 years, and it kept getting bigger. I could feel it getting bigger. It got to a point where I had laryngitis for over a month, and was choking on everything I ate. They finally had to do surgery to remove it. By the time they did, it was 4.5 cm in diameter, and there was another mass started on the other side of my thyroid. It was very noticeable....I used to tell everyone I looked like I had 2 necks.

    Don't let anyone tell you that you don't need that checked out. My thyroid levels always came back normal, but I had all the symptoms of hypothyroidism, and since the surgery, it has taken years, and a wonderful endocrinologist to get my levels to normal, where I actually feel like they are normal.

     
    Old 01-06-2012, 02:40 PM   #13
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    Re: My MRI results - Cervical Spine

    Quote:
    Originally Posted by Patec8ke View Post
    Lolly,

    I had a mass on my thyroid 10 years ago. It was found during a routing exam, and was quite large. I was sent for an Ultrasound Immediately, and for a biopsy immediately after that. I was only 35 at the time. I was sent to an endocricologist as soon as the biopsy came back negative, and put on medication to prevent it from getting any larger. I took synthroid for 2 years, and it kept getting bigger. I could feel it getting bigger. It got to a point where I had laryngitis for over a month, and was choking on everything I ate. They finally had to do surgery to remove it. By the time they did, it was 4.5 cm in diameter, and there was another mass started on the other side of my thyroid. It was very noticeable....I used to tell everyone I looked like I had 2 necks.

    Don't let anyone tell you that you don't need that checked out. My thyroid levels always came back normal, but I had all the symptoms of hypothyroidism, and since the surgery, it has taken years, and a wonderful endocrinologist to get my levels to normal, where I actually feel like they are normal.
    once you got the level to normal, did the doc take you off of the meds

    it was the choking that took me to the ER

    , I had a mild goiter back in the 80's and they put me on synthroid for a year
    and its been okay since

    happy to hear you got it resolved

     
    Old 01-06-2012, 03:37 PM   #14
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    Re: My MRI results - Cervical Spine

    I had my whole thyrod removed during the surgery, so I have to take medicine the rest of my life. I take synthroid and cytamel. The cytamel is T3...apparently my body doesn't convert the T4 to T3.

    I'm glad that yours cleared up...I wish mine would have. I hated having to go on pills that I would need the rest of my life.

     
    Old 01-06-2012, 04:37 PM   #15
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    Re: My MRI results - Cervical Spine

    Quote:
    Originally Posted by Patec8ke View Post
    I had my whole thyrod removed during the surgery, so I have to take medicine the rest of my life. I take synthroid and cytamel. The cytamel is T3...apparently my body doesn't convert the T4 to T3.

    I'm glad that yours cleared up...I wish mine would have. I hated having to go on pills that I would need the rest of my life.
    its a pretty grim reality, I will always have to take blood pressure , blood thinners meds so that I don't have another stroke, you seem very strong having went thru all of that , your story will help a lot of other people, have a good night !

     
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