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Help with reading MRI results of C-Spine PLEASE

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Old 05-29-2012, 04:07 PM   #1
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painintheneck5 HB User
Help with reading MRI results of C-Spine PLEASE

C4-5: Disc desiccation. Broad based right paracentral disc protrusion abuts the ventral epidural space and thecal sac with moderate resultant central canal stenosis. Neural foramina are patent without neural impingement. Mild facet arthropathy evident.

C5-6: right paracentral/right foraminal disc protrusion indents the ventral epidural space and cord with moderate central canal stenosis andAP canal diameter of 7.5 mm along the mild sagittal plane. Moderate right neural foraminal narrowing effaces the exiting C6 nerve roots. Left neural foramen patent mild facet arthropathy evident.

Dextroscoliosis measuring 11 degrees centered at C7 level evident.

Conclusion: Right paracentral/right foraminal disc protrusion C5-6 level with moderate central canal stenosis and right neural foraminal effacing the exiting C6 nerve root. Central disc protrusion with moderate central canal stenosis C4-5 level associated with 3mm of retrolisthesis.

Any help would be greatly appriciated. I have been refered to a neuron surgeon who in turn refered me to a doctor of Physical medicine. I have been dealing with the pain for a long time. I had back surgery in 2005 I had L5-S1 fused and a stimulator implanted. I was 31 when I had this surgery done.

I have a tens unit, take percocet and baclofen to try and just get through my day so I can take care of my 6 yo and 15 month old daughters.

Thanks for reading and if able to assist,

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Old 05-30-2012, 04:14 AM   #2
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pebblebeach2 HB Userpebblebeach2 HB Userpebblebeach2 HB Userpebblebeach2 HB Userpebblebeach2 HB User
Re: Help with reading MRI results of C-Spine PLEASE


The biggest thing for me that pops out is the "stenosis." Your post says there is "moderate" stenosis of the central canal and of the foramen.

As to the central canal, think of your spine as a straw. Thru the center of the straw all the nerves run the center. That is like your spine all the nerves are running down the center of your spine. The stenosis means that there is a "narrowing" of the canal and putting pressure on the nerves.

The "forament" stenosis refers to the following While the nerves run down the central canal of the spine, they also have exit points from the spine at various levels. Some of the nerves that exit in the neck area are nerves that go to the arms, to the hands and to the fingers. And the same would have in the lumbar area in that the nerves exit and go to various parts of the leg and foot.

So you have stenosis from your report of the central canal and from the exit points as well.

I know you said you are on medication. Are you getting symptoms such as radiating pain to the shoulders or weakness in the hands or fingers.

I have had stenosis in both the cervical and lumbar areas. In my case at least, the only way to resolve the issue was thru surgery. They needed to remove the pressure from the areas where it was getting narrow and putting pressure on the nerves.

Are you doing any type of physical therapy? What type of doctor are you treating with? Whoever you treat with I would recommend either an Orthpedist or Neurosurgeon that are specifically trained in dealing with "spine issues." Everything is so specialized these days.

Please let us know how you are doing. Good luck.

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Old 05-30-2012, 06:08 AM   #3
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Re: Help with reading MRI results of C-Spine PLEASE

Hi Missy....I'll add to what Pebblebeach said.

The 2 problems most of us have in our necks are nerve compression and spinal cord compression. As PB explained, the nerves peel off the cord at each vertebra and go out to the body....and this is where most of your pain comes from. The spinal nerves have pain receptors but the spinal cord, like the brain, doesn't. So you're feeling the compression of the nerves but compression of the cord shows up differently. Since your cord compression is at C5-6, it might give you clumsy hands that drop things or have trouble controlling the ability to write. And it can show up as numb toes, stiff/weak leg muscles, trouble walking such as your legs not wanting to move forward so you take baby steps or perhaps have to walk with your feet farther apart than normal to help with balance. It can even show up as a need to run to the bathroom as soon as you get the urge to urinate or have a bowel movement as you can't hold it anymore, or just the opposite, you can't go even when you know you have to. These are the symptoms the docs are watching for...but they never tell us.

I know from experience(2 cervical surgeries and 1 lumbar)that we all focus on the pain but to a spine surgeon, pain is irrelevant. Pain means the nerve is working and they don't operate for pain. But signs that a nerve is in danger of dying such as numbness, pins and needles, and tingling along with weakness in the affected muscles ...that needs attention. Even more important are the signs of a spinal cord in trouble(what I listed above).

Your canal diameter is down to 7.5mms and some docs might operate at that point but most will wait longer. The normal cord diameter is 11-12mms but we've had someone here who was down to 4mms without surgery and I didn't have surgery until I was down to 5-6mms. I had all those symptoms I listed for cord compression. In fact, my cord and my nerves were all so badly compressed that I had NO pain....I was becoming paralyzed from the neck down and didn't even know it. I thought I was getting better...not worse. No one had told me what to watch out for.

So I'd start keeping a journal of what you experience and when. You have some numbness in your fingers one day...write it down. Have trouble walking, write it down. Don't focus on the pain but on the other stuff.

The only way to fix a neck really is surgery. I don't advise anyone to use chiropractic care on the neck as there are 2 big arteries that go up into the brain from C6 to the skull. If you have a bone spur inside where the arteries are and you get an adjustment, that bone spur could trigger a potentially fatal stroke.

Work with the physiatrist for now(I have one too) and keep track of what is going on. If you stabilize and don't get worse, then you can stay surgery free but if you get worse, see the very best neurosurgeon you can get to, even if it means traveling out of the area. At your age, having the best spine doc you can get is so important as it could make the difference between a life of pain and a good life. This is one time where expertise makes all the difference in the world. There are more bad spine docs out there than good ones.

Any questions, please ask. That is why we are here.

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

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Old 05-30-2012, 08:30 AM   #4
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Re: Help with reading MRI results of C-Spine PLEASE

Missy... As Jenny said, you need to keep track of this. The reason is that you are already borderline for a C5-6 ACDF (diskectomy/fusion) and you are getting to the point where you may begin to suffer permanent cord damage. I'm sure that you and your docs do not want to rush into surgery (as the NS even referred you back DOWN the ladder to a physiatrist), but at the same time you don't want to wait too long.

Watch for loss of strength in right arm, and problems with right thumb and index finger. Look for right leg trouble and for right-side hyperreflexivity. (but don't look so hard that you generate your own symptoms, which is what I'd probably do)

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