It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Spinal Cord Disorders Message Board

Cervical MRI results are scary to me


Post New Thread   Closed Thread
LinkBack Thread Tools Search this Thread
Old 07-26-2013, 07:49 AM   #1
Lori680
Newbie
(female)
 
Join Date: Jul 2013
Location: Atlanta, Ga USA
Posts: 3
Lori680 HB User
Unhappy Cervical MRI results are scary to me

Hello. This is my first post. I have recently received an MRI and the results have left me a little scared. I was wondering if anyone could help to explain the results and if this means I should have to have surgery or not.

A little history... I am a 48 year old, overweight, female. I am in a corporate position and work full time. I was in a car accident in 1987 that left me with a bad case of whiplash. Years later I began have neck tightness and soreness, pain in my neck that would often be described as a "crick" in my neck where I coukldn't turn my neck. Over the years I became accustomed and eventually the pain would go away unless I did something to cause a strain. Recently (april 3, 2013) I slipped on the bathroom floor at work and had a significant fall. I fell to the left and hurt my left side of my neck, left shoulder, left hip and left knee. The shoulder was causing me the most discomfort. The doctor sent me to PT for the neck, shoulder and back (turns out what i thought was hip was actually low back just to the left of my spine).

The therapy seemed to help the shoulder. Low back still bothers me but is tolerable. The neck however doesn't seem to be healing. Since the fall I have 3 - 5 severe headaches a week. I also am experiencing significant numbing, needles all the way from both shoulders to my tips of my fingers at night while sleeping. I am woke up nightly and sometimes have to get out of bed to make it stop. I am also experiencing a charly horse type feeling in my left hand and it appears to cramp into a claw like shape where the thumb comes inward toward the palm.

I had an MRI and was given the results yesterday. I am now being referred to a neck specialist. My MRI states the following:

C2 - C4 is Mild disc height loss. Small disc osteophyte complex causes slight canal and mild neural foraminal narrowing.

C4 - C5: Severe disc height loss. Disc osteophyte complex and mild facet degenerative changes efface the anterior and posterior subarachnoid spaces. Canal is narrowed to 8 mm AP in midline. Moderate left and mild right neural foraminal narrowing.

C5-C6: Severe disc height loss. Disc osteophyte complex has a focal more prominent area just right of the midline that indents the cord causing the greatest canal stenosis. Focal area appears to be a combination of disc and osteophyte. Canal is narrowed to 6 mm. Moderate left and mild right neural foraminal narrowing.

C6-C7: Moderate disc height loss. Disc Osteophyte complex assymetric left causes mild canal as well as moderate left and mild right neural foraminal narrowing.

C7 - T1: Disc desiccation and slight disc space narrowing. No stenosis. Moderate left and mild right facet degenerative changes.

Sorry for the lengthy post. As you can imagine, the C4-C7 areas concern me the most. I hope somebody here can help me understand these terms in "everyday speak" versus "doctor speak". The ortho that I went to said he thought the neck guy would want to try injections first before a surgical intervention. Then he took me to the hall to show me my films and pointed to the narrowest part and said that the neck guy may actually want to go straight to surgery. Thoughts anyone??

Signed, Terrified in Atlanta

 
Sponsors Lightbulb
   
Old 07-27-2013, 07:22 AM   #2
WebDozer
Inactive
(female)
 
Join Date: May 2011
Location: So Cal
Posts: 1,382
WebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB User
Re: Cervical MRI results are scary to me

First, your radiologist is using standard minimal-mild-moderate-severe terminology.

minimal = I can just make it out

mild = clearly there, but not of concern

moderate = clearly there, and of borderline concern

severe = needs attention

Now, to concentrate on one level (C4-5)...

<< Severe disc height loss >>

The disc between the C4 and C5 vertebrae has been compressed. Some level of compression is to be expected with age, but "severe" would indicate he thinks it's worse than normal. The disk is probably dried out, and may have lost its soft internal filling. The height loss may not directly cause symptoms - other than making you shorter - but can indirectly exacerbate many other problems.

<< Disc osteophyte complex >>

You have osteophytes (bone spurs) growing off the vertebrae where they interface with the disk. These may grow backward into the spinal canal or laterally into the foramina. The disk itself may be bulging backward or extruding its inner filling (herniating). The radiologist indicates - for C5-6 - that he thinks it's both bone and disk that are pressing backward.

<< and mild facet degenerative changes >>

The facet "joints" are on the sides of the spinal cage. Yours probably also have bone overgrowth.

<< efface the anterior and posterior subarachnoid spaces >>

The cerebrospinal fluid that fills the spinal canal and surrounds the cord has been pushed away (effaced) from the cord. I believe the concern would be less that the flow of CSF has been cut off - very unlikely - as that the bone overgrowths have reached the cord.

<< Canal is narrowed to 8 mm AP in midline >>

The middle of the spinal canal - measured front to back - is 8mm. This is narrow, but not extremely so. I have read that canal narrowing may result in fewer symptoms if it occurs slowly over time. However, the 6mm dimension of the C5-6 level is of somewhat more concern.

<< Moderate left and mild right neural foraminal narrowing. >>

The foramina are the openings in the front corners of the spinal cage through which pass the spinal nerves after they branch off from the cord and head down into your shoulders, arms and hands.

It's possible that your symptoms are due to spinal cord compression, or to compression of nerves as they pass through the foramina (radiculopathy). Or to both. Any nerve compression can have a variety of symptoms anywhere DOWNSTREAM from the compression. So cord compression at C5-6 can affect both arms and also both legs. Left-side foraminal narrowing at C5-6 can affect only those parts of the left arm ennervated by the C6 nerve, which would include the triceps and thumbs.

Part of the problem with just reading the report is that a given word may have a range of meaning, both between radiologists and even for a single radiologist. The most important of these words is "moderate". If we were to rate severity on a 1-100 scale, your radiologist might be using "moderate" for both a 61 and an 80. Or, his "moderate" might be someone else's "severe". This is why it's important that the referred docs (surgeons or neurologists) study the images for themselves.

As for your specific symptoms, it's hard for me to trace them back to cervical spinal problems. For example, your most affected cervical region (C4-6) does not send nerves into your head. Maybe the headaches are the result of referred pain, or muscular tension, or something else entirely.

Also, cervical spinal problems tend to be one-sided, or at least lopsided. If you have the same symptoms going down to BOTH hands, it's certainly possible that compression of the cord at C5-6 is causing the symptoms, but it's also possible that there's a systemic problem (blood circulation, or something circulating in the blood). The fact that it happens while you're in bed is telling, but I don't know what it's saying. Lying down could exacerbate a circulatory problem, or it could put your neck in a position where the cord compression is increased.

It seems to me that the least likely explanation of the tingling going down to BOTH hands is foraminal narrowing (radiculopathy). That's because foraminal narrowing is usually one-sided/lopsided (as is the case with you). It's also because for ALL digits to be affected, all three levels from C5 to T1 must be problematic.

Whether or not surgery is suggested really depends on the doc. One might very well recommend a two-level ACDF - removing the C4-5 and C5-6 disks. As drastic as this sounds, it is far from the most extensive cervical spinal surgery, and it's considered pretty routine. In fact, for some surgeons it's their bread and butter (something to keep in mind if a surgeon seems perhaps overeager to suggest it).

On the other hand, various non-surgical approaches may be suggested.

I would recommend three things:

1. You get MULTIPLE opinions. I would want at least three.

2. Be careful not to get shunted into some approach because it fits a doc's agenda. This could be PT (some docs own PT practices) or injections or pain management. It could be unnecessary surgery.

3. Make haste, but deliberately.

Finally, you should know that I am only an amateur, though one with more personal experience than he'd like. My opinions and recommendations should only serve as background and should certainly be subordinated to those of professionals.

Last edited by WebDozer; 07-27-2013 at 07:31 AM.

 
Old 07-27-2013, 08:22 AM   #3
Lori680
Newbie
(female)
 
Join Date: Jul 2013
Location: Atlanta, Ga USA
Posts: 3
Lori680 HB User
Re: Cervical MRI results are scary to me

Good morning and thank you WD for your insight. I am still waiting for the approval from workers comp.

As for my symptoms, I guess I should be a bit more explanatory. The numbing in my arms at night has been going on for several years but only one or two nights a week. The majority of the numbing is on the left side. The right side has become more involved since my fall and specifically noticeable if I wake up on my right side. The charley horse cramp in my left hand only and was noticeable rarely, once or twice a month, and I always chalked it up to being on my side and leaning on my elbow. That has now increased as well. As for the headaches, I have been a migraine sufferer for years. As I am now post menopausal they seemed to lessen in frequency but since the fall have increased. Also, I have a noticeable knot, lump, area at the base of my neck. As I said, I am overweight so I blamed that on fat, however, it is more noticeable in the last two months and clearly cervical related... Hence losing an inch of my height. I also tend to stumble a lot for no reason and I drop things. My daughter calls me clumsy and the kids always laugh when I stumble out of nowhere. I have taken a couple of pretty nasty falls over the past year as well.

I am grateful to you and boards such as this. I am very afraid of surgery. I left the ortho feeling very nervous because he gave me specific limitations that freaked me out a little...

Not to look straight up towards the sky for long periods of time

Not to lift more than 20 lbs

Not to lift more than 10 pounds over my head as I am looking up (cuts out the holding my grand baby up in the air)

Cautioned me on driving and said that even a small fender bender, if hit in the right place, could cause paralysis.

No exercise with any kind of impact like aerobics or jogging

So if I have to have surgery, the one you noted, is it dangerous? Could I be left paralyzed? Would it stop the numbing? How long would I have to be out of work? How long before I could lift my grand baby again?

I am so sorry for all the questions... Just really nervous.

 
Old 07-27-2013, 03:00 PM   #4
WebDozer
Inactive
(female)
 
Join Date: May 2011
Location: So Cal
Posts: 1,382
WebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB UserWebDozer HB User
Re: Cervical MRI results are scary to me

I'm afraid I can't give you an answer regarding your arm symptoms. It's plausible that they are cervical-spinal in origin, and it's plausible that they are not. If you have an operation, you may find out.

Your "stumbling" would seem to be a red flag. Gait problems originating in the cervical spine indicate cord damage. I assume the ortho gave you a walking/gait test, though, as that's about the first thing they look for.

<< So if I have to have surgery, the one you noted, is it dangerous? >>

There's always danger in surgery, although less so with better surgeons and anesthesiologists. I wouldn't say that ACDF's are particularly dangerous, though. Blue Blurr just posted about his four-level ACDF, if you want to read something.

<< Could I be left paralyzed? >>

With the wrong surgeon, yes.

<< Would it stop the numbing? >>

The point is to stop the numbing from getting worse. Improvements in existing symptoms can be hoped for, though.

<< How long would I have to be out of work? >>

Two weeks?

<< How long before I could lift my grand baby again? >>

Two-four weeks?

 
The Following User Says Thank You to WebDozer For This Useful Post:
Lori680 (07-27-2013)
Old 07-30-2013, 10:34 AM   #5
nochange
Senior Veteran
(female)
 
Join Date: Jun 2008
Location: United States
Posts: 1,409
nochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB Usernochange HB User
Re: Cervical MRI results are scary to me

Hello. Who is this neck specialist? I would like to know.
Thanks

 
Old 07-30-2013, 11:01 AM   #6
Lori680
Newbie
(female)
 
Join Date: Jul 2013
Location: Atlanta, Ga USA
Posts: 3
Lori680 HB User
Re: Cervical MRI results are scary to me

I am waiting to get the referral from Workers Comp. Why do you ask?

 
Closed Thread

Tags
cervical spine pain, cervical stenosis, disc-osteophyte complex, narrowing, spondylosis



Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 07:14 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2017 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!