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  • Opinions on 2 different cervical MRI's

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    Old 01-04-2012, 03:06 PM   #1
    Patec8ke
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    Opinions on 2 different cervical MRI's

    Hi all,

    This is my first post. Actually it is my second time typing it, because something went wrong the first time. I have had 2 cervical mri's in the last year. The second one because my dr is sending me to a new NS, and he wanted a new mri. I'm not sure if the second one is worse, or if it is just worded differently. The first one reads:

    The craniocervical junction is unremarkable and the intrinsic cord signal is normal in appearance. Reversal of the lordotic curve apexes at c5.
    c1-c2m c2-c3, c3-c4 and c4-c5 are unremarkable.
    c5-c6: Disc dehydration is accompanied by mild to moderate loss of disc height and anterior vertebral body osteophyte formation. Type 1 anterior sterile endplate marrow signal alteration is compatible with a fibrovascular inflammatory response. Broad based disc herniation of the protrusion type indents the ventral aspect of the thecal sac with rightward ventral cord effacement and mild cord flattened contour alteration. concomitant aburment of the c6 right nerve root is also demonstrated. Luschka and facet joint degenerative arthropathy combined to produce mild bilateral foraminal canal narrowing.
    C6-c7: shallow broad based posterior subligamentous protrusion slightly indents the ventral aspect of the thecal sac without evidence of neural compression. Mild degenerative facet arthropathy is demonstrated without substantive foraminal stenosis.
    c7-t-4: unremarkable.

    Conclusion:
    1. Broad based disck protrusion involving c5-c6, resulting in right hemicord effacemengt. Coexisting luschka and facet joint degenerative arthropathy combined to produce mild biforaminal stenosis.
    2. shallow broad based noncompressive subligamentous protrusion involving c6-c7

    My new MRI reads:

    The cercical vertebral bodies are in anatomic alignment. There appear to be mild degenerative changes in the discs at c5-c6 and c6-c7. There is no evidence of any significant prevertebral soft tissue swelling. The craniocervical junction in intact. No significant signal abnormalities in the bone marrow.
    c2-c3 normal
    c3-c4 normal
    c4-c5 normal
    c5-c6 lefel reveals a moderate sized osteophytic ridge disc complex along the uncovertebral joint. This causes partial effacement of both of the ventral and dorsal subarachnoid CSF space. The AP diameter of the spinal canal measures 8mm. There is mild narrowing of the neuroforamina bilatterally.

    c6-c7 level reveals a small osteophytic ridge disc complex along the uncovertebreal joint. This is slightly asymmetric to the right. This causes partial effacement of both the ventral and dorsal subarachnoid CSF space. The AP diameter of the spinal canal measures approximately 9.5mm. Ther does appear to be mild narrowing of the right neural foramen.

    Impression: Ther eis evidence of moderate central spinal stenosis seen at c5-c6 and mild cental spinal stenosis seen at c6-c7 as described above.

    I have had bad neck pain for 3 years now. I was going to PT and chiro, and it was the chiro that ordered the first mri, after he got the results, he said he couldn't treat me anymore because he was afraid of making it worse. He sent me home with a tens unit, which doesn't really help much.

    My dr then sent me to a neurosurgeon who said I would be fine, and just needed an epidural. She said I would be fine after, and probably not have any more pain. I have since had an episural, facet joint injections, and a medial branch block with no relief at all. Since I started having the injections I now have tingling in my neck that radiates down into my right shoulder. I thought this was caused by the injections, but I haven't had one since May, and I'm still having the tingling. Last month I also started having that tingling on my right thigh. I have a hard time walking when this happens, but I'm not sure if its being caused by my neck.

    Sleep is very hard, as I can't find a comfortable position for my neck. I have been tried many different pillows. Some nights I have to sleep in my recliner.

    I know this is kind of long, but any feedback would be greatly appreciated.

    Thank you,
    Patty

     
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    Old 01-04-2012, 04:15 PM   #2
    WebDozer
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    Re: Opinions on 2 different cervical MRI's

    <<I have a hard time walking when this happens, but I'm not sure if its being caused by my neck. >>

    Do you have any other ideas as to what might be causing that?

    Do you have any symptoms in your fingers (probably right hand)? If so, which ones?

    Has anyone said anything about you having congenital spinal canal stenosis? That's when your spinal canal just isn't as big as it should be, so anything intruding into it (osteophytes, disks, etc) has a disproportionate effect. I'm asking because you don't seem to have anything really big that's wrong at C5-6, but you are still compressed down to 8mm.

     
    Old 01-04-2012, 04:36 PM   #3
    Patec8ke
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    Re: Opinions on 2 different cervical MRI's

    The only problem Im having in my hand is that it goes numb if I lay on my back. Like it is asleep. Feeling comes back if I get up, or roll over on my side.

    Nobody has said anything about congenital problems. I have an appt with the new NS on Jan 30th. I'm just hoping he won't tell me to have more injections, they are uncomfortable, and they don't help, not to mention the cost.

     
    Old 01-04-2012, 04:51 PM   #4
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    Re: Opinions on 2 different cervical MRI's

    Congenital spinal canal stenosis is not a problem in and of itself. It only matters when other things (usually age-related) start to intrude into the canal, and the spinal cord does not have as much free space as it should.

    I don't understand the hand problem. You would know if it's just circulation being cut off, because that feels different when it comes back. A damaged nerve would not give the same feeling. You say it happens when you are on your back... is your head propped up with a pillow, so that the cervical spine is tilted forward?

    You clearly have a problem at C5-6. It's interesting that radiologist #1 mentioned "Reversal of the lordotic curve apexes at c5." That means that the normal backward (lordotic) curve of the cervical spine is not as backward as it ought to be. This could put pressure on the spine at that level, particularly on the disk. It may also have something to do with your neck pain.

    While neither radiologist has called any of your problems "severe" (the next step up from "moderate"), I wonder if maybe yet another radiologist might do so. It is certainly possible that the compression of the spinal cord at C5-6 is causing pain and other symptoms. You have "abutment of the nerve root" at that level, too, which MIGHT have some effect on your right neck/shoulder/arm.

    This...

    "Type 1 anterior sterile endplate marrow signal alteration is compatible with a fibrovascular inflammatory response."

    also catches my eye. I wonder if it is related to the neck pain? Hopefully, someone else will come along and explain it...

    Last edited by WebDozer; 01-04-2012 at 04:53 PM.

     
    Old 01-04-2012, 05:57 PM   #5
    capatga
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    Re: Opinions on 2 different cervical MRI's

    Quote:
    Originally Posted by Patec8ke View Post
    Hi all,

    This is my first post. Actually it is my second time typing it, because something went wrong the first time. I have had 2 cervical mri's in the last year. The second one because my dr is sending me to a new NS, and he wanted a new mri. I'm not sure if the second one is worse, or if it is just worded differently. The first one reads:

    The craniocervical junction is unremarkable and the intrinsic cord signal is normal in appearance. Reversal of the lordotic curve apexes at c5.
    c1-c2m c2-c3, c3-c4 and c4-c5 are unremarkable.
    c5-c6: Disc dehydration is accompanied by mild to moderate loss of disc height and anterior vertebral body osteophyte formation. Type 1 anterior sterile endplate marrow signal alteration is compatible with a fibrovascular inflammatory response. Broad based disc herniation of the protrusion type indents the ventral aspect of the thecal sac with rightward ventral cord effacement and mild cord flattened contour alteration. concomitant aburment of the c6 right nerve root is also demonstrated. Luschka and facet joint degenerative arthropathy combined to produce mild bilateral foraminal canal narrowing.
    C6-c7: shallow broad based posterior subligamentous protrusion slightly indents the ventral aspect of the thecal sac without evidence of neural compression. Mild degenerative facet arthropathy is demonstrated without substantive foraminal stenosis.
    c7-t-4: unremarkable.

    Conclusion:
    1. Broad based disck protrusion involving c5-c6, resulting in right hemicord effacemengt. Coexisting luschka and facet joint degenerative arthropathy combined to produce mild biforaminal stenosis.
    2. shallow broad based noncompressive subligamentous protrusion involving c6-c7

    My new MRI reads:

    The cercical vertebral bodies are in anatomic alignment. There appear to be mild degenerative changes in the discs at c5-c6 and c6-c7. There is no evidence of any significant prevertebral soft tissue swelling. The craniocervical junction in intact. No significant signal abnormalities in the bone marrow.
    c2-c3 normal
    c3-c4 normal
    c4-c5 normal
    c5-c6 lefel reveals a moderate sized osteophytic ridge disc complex along the uncovertebral joint. This causes partial effacement of both of the ventral and dorsal subarachnoid CSF space. The AP diameter of the spinal canal measures 8mm. There is mild narrowing of the neuroforamina bilatterally.

    c6-c7 level reveals a small osteophytic ridge disc complex along the uncovertebreal joint. This is slightly asymmetric to the right. This causes partial effacement of both the ventral and dorsal subarachnoid CSF space. The AP diameter of the spinal canal measures approximately 9.5mm. Ther does appear to be mild narrowing of the right neural foramen.

    Impression: Ther eis evidence of moderate central spinal stenosis seen at c5-c6 and mild cental spinal stenosis seen at c6-c7 as described above.

    I have had bad neck pain for 3 years now. I was going to PT and chiro, and it was the chiro that ordered the first mri, after he got the results, he said he couldn't treat me anymore because he was afraid of making it worse. He sent me home with a tens unit, which doesn't really help much.

    My dr then sent me to a neurosurgeon who said I would be fine, and just needed an epidural. She said I would be fine after, and probably not have any more pain. I have since had an episural, facet joint injections, and a medial branch block with no relief at all. Since I started having the injections I now have tingling in my neck that radiates down into my right shoulder. I thought this was caused by the injections, but I haven't had one since May, and I'm still having the tingling. Last month I also started having that tingling on my right thigh. I have a hard time walking when this happens, but I'm not sure if its being caused by my neck.

    Sleep is very hard, as I can't find a comfortable position for my neck. I have been tried many different pillows. Some nights I have to sleep in my recliner.

    I know this is kind of long, but any feedback would be greatly appreciated.

    Thank you,
    Patty
    you might try a memory foam pillow , it helped me a lot , I have some of the same problems that you have and the pillow really helped me sleep, only about 20 bucks

     
    Old 01-04-2012, 06:08 PM   #6
    capatga
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    Re: Opinions on 2 different cervical MRI's

    Quote:
    Originally Posted by WebDozer View Post
    Congenital spinal canal stenosis is not a problem in and of itself. It only matters when other things (usually age-related) start to intrude into the canal, and the spinal cord does not have as much free space as it should.

    I don't understand the hand problem. You would know if it's just circulation being cut off, because that feels different when it comes back. A damaged nerve would not give the same feeling. You say it happens when you are on your back... is your head propped up with a pillow, so that the cervical spine is tilted forward?

    You clearly have a problem at C5-6. It's interesting that radiologist #1 mentioned "Reversal of the lordotic curve apexes at c5." That means that the normal backward (lordotic) curve of the cervical spine is not as backward as it ought to be. This could put pressure on the spine at that level, particularly on the disk. It may also have something to do with your neck pain.

    While neither radiologist has called any of your problems "severe" (the next step up from "moderate"), I wonder if maybe yet another radiologist might do so. It is certainly possible that the compression of the spinal cord at C5-6 is causing pain and other symptoms. You have "abutment of the nerve root" at that level, too, which MIGHT have some effect on your right neck/shoulder/arm.

    This...

    "Type 1 anterior sterile endplate marrow signal alteration is compatible with a fibrovascular inflammatory response."

    also catches my eye. I wonder if it is related to the neck pain? Hopefully, someone else will come along and explain it...
    I have a lot of these same problems but much worse, surgery is imminent for me, I wished my doctor (neuro) had explained my mri to me as well as you did in this post, she just pretty much said your have more stenosis above and below your previous surgery so you might want to talk to a surgeon,I will refer you to a couple

     
    Old 01-05-2012, 02:10 PM   #7
    Patec8ke
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    Re: Opinions on 2 different cervical MRI's

    I did try a memory foam pillow, but I hated it. I woke up so sore every day. I have tried them all. Right now I am sleeping on a water filled pillow I got at the chiropractors office. I still wake up in pain, but its a little better than the other pillows I have tried.

     
    Old 01-05-2012, 03:00 PM   #8
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    Re: Opinions on 2 different cervical MRI's

    Quote:
    Originally Posted by Patec8ke View Post
    I did try a memory foam pillow, but I hated it. I woke up so sore every day. I have tried them all. Right now I am sleeping on a water filled pillow I got at the chiropractors office. I still wake up in pain, but its a little better than the other pillows I have tried.
    You must have tried the wedgie kind. There are memory foam pillows that are shaped like regular ones. I have one and I sleep really good. You could also try the cervical pillows-they're more pricier though.

     
    Old 01-05-2012, 04:28 PM   #9
    capatga
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    Re: Opinions on 2 different cervical MRI's

    Yes ,the wedgie kinds are for under the knees , I take my memory foam pillow every where, one you break them in , they cradle your neck , I bought a memory foam mattress for my bed , and then I got a scrap piece for my recliner , right now my whole body is so sensitve to anything that has to touch it ,I can't imagine not having one

     
    Old 01-05-2012, 05:42 PM   #10
    Patec8ke
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    Re: Opinions on 2 different cervical MRI's

    I had a regular memory foam pillow. It was too firm for me. My son has a memory foam mattress, and I tried laying on it, and didn't like that either. I guess it is just personal preference. Thank you so much for the suggestion though.

     
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