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    Old 03-01-2012, 08:39 PM   #1
    sandra159
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    help with mri translation

    At C6-C7, there is disk desiccation with associated central and paramedian disk herniation or
    protrusion which focally effaces the anterior subarachnoid space and indents the ventral surface of
    the cord. Findings are visualized on images No. 13 and 14, series 5 as well as image 9, series 3.
    No cord signal abnormality. There is mild uncinate hypertrophy contributing to mild bilateral
    foraminal narrowing. The mid sagittal canal diameter is reduced to approximately 9mm.

    At C5-C6, there is disk degeneration with superimposed diffuse posteriorly projecting disk
    osteophyte complex which results in diffuse effacement of both ventral and dorsal subarachnoid
    spaces and diffuse effacement of the ventral surface of the cord. There is marked mid sagittal
    canal diameter reduction to approximately 8mm. In addition, there is facet and uncinate
    hypertrophy contributing to severe bilateral neural foraminal stenosis. There is no cord signal
    abnormality.

    At C4-C5, there is no evidence of disk herniation. Partial effacement of the anterior subarachnoid
    space is noted related to a congenitally small cervical spinal canal with mid sagittal canal diameter
    of approximately 10mm. There is no cord signal abnormality. No foraminal compromise.

    At C3-C4, no evidence of disk herniation or foraminal canal stenosis.

    At C2-C3, no disk herniation or foraminal canal stenosis.
    At C2-C3, no disk herniation or foraminal canal stenosis.

    At C1-C2, thickening of the tectorial membrane related to degenerative changes. Otherwise
    unremarkable craniocervical junction. No evidence of neural encroachment.

    There is patchy borderline T1 hypointense bone marrow signal noted which could be related to
    early red marrow reconversion. Clinical correlation is suggested.

    There is no evidence of gross ligamentous injury. There is no evidence of fracture. There is
    straightening of cervical lordosis. No prevertebral soft tissue swelling. Retrospinal soft tissues
    appear unremarkable.

    My doctor says epedural shots will not help my pain and surgury is a must any suggestions?

    Last edited by Administrator; 03-03-2012 at 08:10 PM.

     
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    Old 03-02-2012, 08:49 AM   #2
    jennybyc
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    Re: help with mri translation

    Your doc is probably right.

    What this says is that at C6-7, a herniated disk is hitting your spinal cord and has reduced it down to 9mms in width when the normal should be 11-12mms.

    However, what they see at C4-5, shows you were born with an abnormally narrow canal of 10mms to start with...another reason to have it fixed.

    And at C5-6, you have a bunch of bone spurs from arthritis that have reduced the cord down to 8mms.

    None of these may be the source of your pain but it says you are headed for paralysis if not addressed.

    The pain you have is from the compression of the nerves that go out to the body and at C5-6, the nerves are being compressed to a "severe" level which is the worst form.

    Where you see words like "uncinate" and "facet" hypertrophy, that refers to a form of arthritis where there is bone overgrowth on tiny joints that are part of the big vertebra. The facet joints are off the back of the vertebra and the uncinate joints are fibrous joints very close to the openings where the nerves come through. They stabilize our twisting movements.

    But the real problems are 2 fold...the compression of your spinal cord and the compression of the nerves art C5-6.

    Shots might help the compression of the nerves but the ONLY way to fix the cord compression is surgery.

    My neck was somewhat the same(only I was down to 5-6mms and it was all the levels)and I opted to have a new surgery called a laminoplasty. It re-builds the bone over the back of the cord, giving you double the room for the cord. During the same surgery, my doc opened up the holes for the nerves to eliminate that pain as well. And no fusion was involved. Another option would be going in from the front and doing a multi-level ACDF to remove the disks and fuse all the vertebrae. However, this does not fix the problem of the abnormally narrow canal at C4-5.

    Big problem is so few docs are doing the laminoplasty....new surgery in this country.

    What has your doc suggested if anything?

    hugs........Jenny

     
    Old 03-02-2012, 11:27 AM   #3
    sandra159
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    Re: help with mri translation

    Well the first surgeon told me that all I have is a little arthtitis, but I suffer so bad with numb arms, shooting pain unbearable muscle spasms in my neck and legs leaving me unable to walk. I have not worked in six months because of pain so I decided to get a second opinion and that doctor told me that he will send me in for an epidural, I go on Tuesday, He also put me on nuerontin 900 mg three times a day, meloxocam and up to four 7.5 vicodin a day to help with spasms and pain. The meds Keep me comfortable but I feel like crap and cannot function properly. He said next step will be spinal fusion which I am scared to death of. The funny thing is I never had any pain until I was in a car accident where I was hit in the back, the guy was going fifty and I was stopped and pushed into the car in front of me. My doctor said The accident has nothing to do with what is going on which I find hard to believe. Everything takes forever so I sit here just waiting. My MRI was never explained to me, Like you just did so I thank you for that. All I want to do is go back to work and be able to do normal things again like walk my dog pick up my grandbaby go down a flight of stairs without my leg giving out. My TDI ran out so now we are living off one income. If I do the surgery How long before I will be able to go back to work?

     
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    Old 03-02-2012, 02:01 PM   #4
    jennybyc
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    Re: help with mri translation

    The average recovery time is 3 months whether they do a fusion from the front or a re-build from the back.

    You don't post where you live but let me caution you that this one surgery that can be easily messed up....and a ton of docs are messing them up. We hear about them everyday here. You need to go the very best spine surgeon you can get. The cord is part of your brain and you want the best "brain" surgeon you can find. I prefer neurosurgeons who do ONLY spine surgery but some like ortho spine surgeons who only do spines.

    Wherever you are, consider going to the biggest university/medical school teaching hospital you can go to and see one of their top docs. Since they have to teach the next generation of doctors, they tend to be far more up to date on the newest surgeries. Seems to me, you'd be perfect for a laminoplasty...but I'm not a surgeon.

    Spine surgery is not the mine field it used to be but there are way too many docs making way too much money off of doing bad jobs.

    If we can help you find a good doc to see, we will.

    I'm sorry you hurt so badly...been there. My insurance insisted I HAD to try an epidural before they would approve surgery so do the 1 shot and if it doesn't help...then find a surgeon. This can be fixed.

    hugs...........Jenny

     
    Old 03-02-2012, 05:17 PM   #5
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    Re: help with mri translation

    My guess is that you are headed for a C5-6 + C6-7 fusion. Given your MRI report, I would certainly want to know how C7-T1 looks, too. It should have been on the report.

    I also think that a laminoplasty - WITH FORAMINOTOMIES - might be preferable, but not that many American surgeons seem to have been converted to that point of view.

    These, of course, are only the opinions of an interested amateur, and should not be used as anything other than inputs in a program of self-education and consultation with physicians.

     
    Old 03-02-2012, 08:49 PM   #6
    sandra159
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    Re: help with mri translation

    The doctors that I am getting have never even spoke about a laminoplastyn and Im not comfortable with the one I have. I live in RI and only about an hour from boston. I have to have the epidural also for insurance reasons, but feel this will only mask the pain just like the pills. I want this to go away so I want the best treatment I can get. My insurance will cover just about anything if I follow procedure. My new neuro told me to apply for SSI because he does not see me going back to work anytime soon, and I need to try the shots which takes a year because I need to get three and if that don't work surgery can lay me up from six months to a year. He also said what I have will keep getting worst as I get older even with the surgery.
    Since you have had the operation how has your life changed are you working? can you lift things? or are you still disabled? Do you take pain meds? I want to hear good things and look forward to getting better. any good doctors in my area that you can tell me about would help also. Thanks again so much, I just never thought I would be on one of these boards looking for help.

     
    Old 03-03-2012, 05:58 AM   #7
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    Re: help with mri translation

    << Since you have had the operation how has your life changed are you working? can you lift things? or are you still disabled? Do you take pain meds? >>

    If you are referring to my laminoplasty (c4-5-6), that was last June. I'm retired, but if I had been working my old desk job I would have been back to work in no more than three weeks. I took some low-level pain meds, like Aleve, for a couple of weeks. Took maybe six months to return to the level that I'd been at before my symptoms started showing up a year ago. I would emphasize that that's just in how I FELT. In the sense of what I could DO, I was back to "normal" in 3-4 months.

    I can lift heavy weights and do hard physical work and all the things I could do before.

    But I've always been in good physical condition, never smoked or drank, and I'm not overweight, all of which probably helps.

    Last edited by WebDozer; 03-03-2012 at 06:00 AM.

     
    Old 03-03-2012, 08:31 AM   #8
    jennybyc
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    Re: help with mri translation

    Sandra... my doc's name in Boston is Dr. Eric J. Woodard....he used to be the head of spine surgery at Brigham & Women's but is now at New England Baptist Hospital and a leading spine surgeon worldwide.

    You need to have your doc send a consultation request along with your MRI report(or even the CD of it) and if he thinks he can help you, the office will call with an appointment. If you need to get in soon(he has a 4-6 month waiting list for appointments)there are 2 others that he trained that work there...both are very nice...Dr. Chima Ohagbulam and Dr. Marcotte(forgot first name)...you'd bet in much faster with them.

    A lot of Dr. Woodard's practice is made up of people who's doc messed up and a lot of them come from Rhode Island for some reason. It's well worth the trip into the city. I drive in from western CT.

    I really can't compare my experience with yours as I re-injured my neck less than 3 months after my C3 to C6 laminoplasty but for that 3 months, I was working, no pain or numbness and it was great.

    Please talk to your primary doc or pain doc (but not your spine surgeon doc)about being referred to him. You can't just call and make an appointment...he wants to see your MRI first and then decide how fast you need to be seen. I was told it would be 4-6 months for an appointment and once he saw my MRI report, I was in his office in 3 weeks and in surgery in 4 weeks. If you are in need, he moves fast. If you want to see one of his associates, you'll get in even faster. He picks and chooses who he trains and these are the only 2 he has ever chosen to work with him....so they have to be very good.

    hugs...........Jenny

    Last edited by Administrator; 03-03-2012 at 08:08 PM.

     
    Old 03-03-2012, 10:09 AM   #9
    sandra159
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    Re: help with mri translation

    Thanks Jenny, I will talk to my primary care on Monday and ask her to send me cd to your surgeon or at least see what she can do in Boston and yes I have also heard alot about the mess ups in RI and the newport hospital. My daughter works for an ortho in boston and told me the same thing you did. I will let you know what happens, thanks again so much for the info....

     
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