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    Old 04-02-2012, 11:50 AM   #1
    rednckmom
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    Question Can anyone help me understand my MRI results?

    Hi,
    I am new to this board. I am a 32yr old sahm to five children. I have been having pain, numbness, pins & needles, and muscle spasms in my left shoulder, down to the finger tips on my left hand since mid Dec 2011. I haven't been able to take care of my children without help. I had a MRI of my cervical spine on 2-29-2012.

    Curvature: There is reversal of the normal lordosis.c.

    C2-C3: Posterior facet/uncinate hypertrophy associated with hardened disc results in oderate narrowing of the left C2-C3 neuroforaminal canal.

    C5-C6: Central broad-based disc protrusion with a greater left-sided component effaces the anterior aspect of the thecal sac and left lateral recess and is associated with flattening of the cervical cord and mild narrowing of the right C5-C6 neural foraminal canal.

    C6-C7: Central broad-based disc protrusion results in effacement of the anterior aspect of the thecal sac and flattening of the cervical cord. Neural foraminal canals are patent.

    Impression:

    1. Moderate spinal stenosis secondary to disc disease. At the C5-C6 level there is mild narrowing of the right neural foraminal canal.

    2. Left C2-C3 neuroforaminal canal narrowing secondary to posterior facet/uncinate hypertrophy associated with hardened disc.


    If anyone could help explain all of this dr talk, that would be great.
    Thanks in advance!

     
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    Old 04-02-2012, 02:29 PM   #2
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    Re: Can anyone help me understand my MRI results?

    Your MRI does not seem all that bad, although it would look better on a 50-year-old than on a 32-year-old. Some tools for deciphering:

    1. The usual adjective progression employed is minimal/mild/moderate/severe, with severe being the one the surgeons pay attention to.

    2. Lordosis means backward bend (while rising), which is normal for the cervical spine. Radiologists talk of "straightening" and "reversal" of the normal lordosis. "Reversal" sounds worse to me, but you'd probably have to ask the radiologist to be sure. Do you have trouble holding your head upright?

    3. Hypertrophy of bony structures like the uncinates and facets means excess bone being laid on, or, colloquially, "bone spurs". He seems to think these are caused by, or influenced by, the disk between your C2 and C3 vertebrae hardening and probably thinning. This, also, could be either cause of, or result of, loss of lordosis. The C2-C3 neuroforaminal canal (or just "foramina") is where your C3 nerve leaves the spinal cord and heads off to your left shoulder and arm. If the C3 nerve is being squeezed at its root ("radiculopathy"), this could affect the left shoulder, but I think it would have less effect on the arm and hand. It's the C6, C7 and C8 nerves that mostly affect the hand.

    4. At C5-6, you have a disk bulging (more on left than right), which is pushing into the spinal canal. The thecal sac is the membrane running down the canal which contains the spinal fluid and within that the spinal cord. "Effacing" means that the disk bulge has pushed away the fluid and is directly impinging on the spinal cord. "Flattening" of the cord isn't so bad (at least not when you've seen MRI's like mine) but, who knows, this may actually be the cause of your problems. Do you have ANY symptoms in your left leg? If so, it could indicate that there's too much pressure on the cord.

    This is the first time I've seen a radiologist refer to a problem with the "left lateral recess". I'm not sure why he doesn't just call it the "left foramen" or "left neuroforaminal canal", as he does elsewhere. Seems like a distinction w/o a difference. He doesn't say how BAD the situation there is, but this is another problem that could explain your left arm symptoms.

    5. At C6-7 you also have some effect on your cord. Your foramina, however, are "patent" (open) which is a good thing.

    OK, since everything I say is coming from a slightly-self-educated amateur, and should only be used as an aid in following up with competent medical professionals (how do you like my Legalese?), let's just say that you need to have a good chat with a spine surgeon (better, two or three spine surgeons), particularly about the cord flattening and that left lateral recess, how they may relate to your symptoms, and what might be done about it. Most likely, the docs will prescribe everything short of surgery, for now, but the surgery of choice for your situation would likely be an ACDF, where the C5-6 disk (and maybe C6-7) would be removed and the vertebrae then held together with a titanium clamp.

    Good luck...

    Last edited by WebDozer; 04-02-2012 at 02:32 PM.

     
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    Old 04-02-2012, 04:35 PM   #3
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    Re: Can anyone help me understand my MRI results?

    Thank you for using a form of english that I actually understand! I have seen one spine doctor. He is a nonsurgical doctor. The first appt with him, he pretty much told me I needed surgery. I had been sent to him to get steroid injections. My primary dr sent me to him, telling me that I just had a pinched nerve and that the spine dr would do the injections for me. I explained this to the spine dr and he said that although he thought surgery was inevitable, he'd do an injection to see if it could buy me some time. The injection helped the pain go away, but now at 18 days after the injection the pain is coming back. I am waiting on an appt with a surgeon for a consult about whether or not surgery would help. The spine doctor has made me scared to move very much because of the spinal stenosis. His words to me at the last appt. was to lay low for now. I have five kids ranging in ages from 8 yrs down to 10 mths old, I can't just lay low! So I am really at a loss as what to do.

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    Old 04-02-2012, 04:49 PM   #4
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    Re: Can anyone help me understand my MRI results?

    If I just read your MRI report, without also reading your symptoms, I would say it's entirely possible that you are asymptomatic. However, since you are NOT asymptomatic, that puts the MRI report in a whole new light. Did the radiologist downplay the severity of the structural problems? Or maybe what LOOKS relatively innocuous on the MRI is NOT, in fact, innocuous at all.

    For what it's worth, I have had two surgeons tell me they don't even bother to read the radiologists' reports, they just go straight to the images themselves.

    Anyway, I'm glad you are getting so many different looks at this. I'd suggest a visit to a second surgeon, after you see the first. The problem is that doctors, unfortunately, have their own prejudices and also their own shortcomings, and you need to get the odds in your favor by getting multiple opinions, and even asking them - if they disagree with one another - to refute what the other has said. That's what I did with my latest surgery (saw three docs with three opinions) and I think it came out for the best.

    Last edited by WebDozer; 04-02-2012 at 04:49 PM.

     
    Old 04-02-2012, 08:16 PM   #5
    rednckmom
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    Re: Can anyone help me understand my MRI results?

    My husband and I have already discussed making sure I get a 2nd opinion. He is pretty scared for me and doesn't want me to have a surgery unless there is just no other way. Plus where we are living right now, we really don't have any one that can help me after the surgery. He will not be able to take any time off from work.

    I have noticed that over the past week, I have been having headaches. I am used to having headaches, I used to have migraines for weeks at a time while I was in highschool. They went away in my early twenties and I only have them when I am really stressed out now-a-days. So I don't know the exact cause of these that I am having now.

    Thanks for talking to me!

     
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