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    Old 08-17-2014, 02:24 PM   #1
    sweetpea2014
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    Please help me understand MRI results

    CLINICAL HISTORY: scoliosis; daily numbness in bilateral upper extremities
    737.30 - Scoliosis (and kyphoscoliosis), idiopathic
    numbness in bilateral upper extremities

    COMPARISON:

    TECHNIQUE: MR CERVICAL SPINE WO CONTRAST, MR THORACIC SPINE WO CONTRAST,
    MR LUMBAR SPINE WO CONTRAST

    FINDINGS:

    CERVICAL SPINE: The vertebral body heights and disk spaces are maintained.
    Straightening of the normal cervical spine lordosis is likely related to
    position. There is no abnormal spinal cord signal. No acute abnormalities
    in the included paraspinal soft tissues or posterior fossa. No dysraphism
    or segmentation anomalies.

    Axial images:

    C2-C4: Scattered disk osteophyte complexes posteriorly without significant
    spinal canal or neuroforaminal stenosis.

    C4-C5: Posterior disk osteophyte complex which causes mild spinal canal
    stenosis. No significant neuroforaminal stenosis.

    C5-C6: Posterior disk osteophyte complex without significant spinal canal
    stenosis. There is mild left neuroforaminal stenosis. No right
    neuroforamina stenosis.

    C6-T1: No significant spinal canal or neuroforaminal stenosis.

    THORACIC SPINE:

    There is redemonstration of the S-shaped thoracolumbar scoliosis which is
    better delineated on the radiographs from 7/10/14. The vertebral body
    heights are fairly well maintained. There are no segmentation anomalies.
    There are areas of multilevel disk desiccation.

    Axial images:

    T1-T9: No significant spinal canal or neuroforaminal stenosis.

    T9-T10: There is left facet hypertrophy with mild to moderate
    neuroforaminal stenosis. No significant central canal or right
    neuroforaminal stenosis.

    T10-T11: There is left facet hypertrophy with mild lateral recess stenosis
    and moderate left neuroforaminal stenosis.

    T11-T12: Bilateral facet hypertrophy and mild right eccentric location of
    the spinal cord. There is mild left neuroforaminal stenosis. However, no
    significant spinal canal or right neuroforaminal stenosis.

    There is an eccentric location at multiple levels of the spinal cord
    within the thecal sac. However, there is no abnormal spinal cord signal.

    There are small bilateral pleural effusions.

    LUMBAR SPINE:

    Again, the left apex scoliosis is redemonstrated and better delineated on
    the radiographs from 7/10/14. The vertebral body heights are maintained.
    There is multilevel disk desiccation most notably at L4-L5 and T12-L2.
    There is no dysraphism or segmentation anomalies. There is an incidental
    fibrolipoma of the filum terminale with no cord tethering. Conus
    medullaris terminates normally at L1.

    There appears to be a small incompletely detailed cyst in the right
    kidney. No acute abnormalities in the included abdomen, pelvis or
    paraspinal soft tissues.

    Axial images:

    T12-L1: The spinal cord and nerve roots are located eccentrically within
    the right lateral recess/foramenal region where there is mild to moderate
    stenosis from facet hypertrophy. There is mild right neuroforaminal
    stenosis. No significant spinal canal stenosis.

    L1-L2: The nerve roots are located eccentrically within the right lateral
    recess which is moderately narrowed from a circumferential disk bulge and
    right facet hypertrophy. There is mild spinal canal stenosis and mild
    right neuroforaminal stenosis.

    L2-L3: Multiple nerve roots remain in the right lateral recess and there
    is mild spinal canal stenosis from a circumferential disk bulge and
    bilateral facet hypertrophy. No significant neuroforaminal stenosis.

    L3-L4: There is mild spinal canal stenosis from a mild disk bulge and
    facet hypertrophy. There is no significant spinal canal or neuroforaminal
    stenosis. However, the right exiting nerve exits inferiorly within the
    right neuroforaminal where there is minimal impingement.

    L4- L5: There is no significant spinal canal or neuroforaminal stenosis.
    However, the right exiting nerve exits inferiorly where there is moderate
    impingement.

    L5-S1: No significant spinal canal or neuroforaminal stenosis.

    IMPRESSION:

    If posterior hardware is being contemplated, close attention to multiple
    levels where the cord and nerve roots extend into the foramen and lateral
    recess is recommended.

    Redemonstration of the S-shaped thoracolumbar scoliosis which is better
    delineated on the radiographs from 7/10/14. No segmentation anomalies or
    dysraphism.

    There is eccentric location of the spinal cord and nerve roots at multiple
    levels most prominent in the upper lumbar spine where the distal spinal
    cord and nerve roots are located within the right lateral recess and
    partially extend into the neuroforamen at L1-L2.

    No abnormal spinal cord signal.

    No significant spinal canal or neuroforaminal stenosis in the cervical
    spine.

    Varying degrees of neural foraminal and spinal canal stenosis in the
    thoracic and lumbar spine as detailed above.

    Small bilateral pleural effusions.

     
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    Old 08-19-2014, 01:27 PM   #2
    teteri66
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    Re: Please help me understand MRI results

    Welcome to the board. Did you have all three MRIs done at the same time? That is a long time to lie still in a tube! What are your symptoms? I gather you have numbness in the upper extremities? Anything else going on?

    Without going into lengthy detail, the cervical area is not too bad. Most of the disc degeneration appears to be lower down. You will notice that there is spinal stenosis and neuro foraminal stenosis at several levels in the thoracic and lumbar spine. I will define those in case you are new to all this back talk.

    Stenosis means "narrowing". This occurs in two main locations in the spine...in the spinal canal and in the foramen (also sometimes called neural foramen ). The foramen are small openings at each vertebral level that allow spinal nerves to exit the spine and go out to other parts of the body...both these areas are passages for nerves. When the amount of space that is needed to allow the nerves to function normally is restricted or made smaller in diameter, the nerve ends up suffering. This nerve compression causes the type of pain that radiates
    out to an extremity, causing pain,tingling or numbness, in a finger or toe, hand or foot, etc. Each vertebral level of the spine contains a pair of nerves that innervate a particular area of the body. (You can search for a dermatome map online to see which nerve innervates which part).

    This stenosis can be caused by a disc herniation, an enlarged facet joint, etc. ...something that pushes out of its own space and causes narrowing in one of those two places....

    The report talks about the scoliosis that is present in the thoracic and lumbar areas, which I assume you are aware of. The biggest finding is that your spinal cord is not entirely where one would expect it to be. This would be a problem if you ever have a surgery that requires hardware. Instead of being contained within the spinal canal, there are places in the thoracic and lumbar spine where the nerves have moved into the foraminal area on the right side...and is something you should discuss with your doctor, as it is somewhat unusual. I do not know to what extent it may be causing some of your pain symptoms. Beyond that the foraminal and central canal stenosis found at various levels of the thoracic and lumbar spine is most likely responsible for your symptoms.

     
    Old 08-19-2014, 03:06 PM   #3
    sweetpea2014
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    Re: Please help me understand MRI results

    Hi thanks for responding. Yes I am aware that I have scoliosis since childhood. However I never experienced any pain from it up until about 10 years ago when I was in an accident. From there I was in several accidents. I started to develop life changing symptoms. First there was inflammation and pain. Then it started further downhill. I had to quit my fulltime job because anything I did too long bothered me. I was a teacher assistant of kindergarten and first grade. I was in excruciating pain daily. Now I have numbness in my extremities and tingling in my hands and feet. My feet and hand also get very tender. Just last month I developed knots on my forearms and then my hand were so tender and painful I couldn't open or hold anything. My feet get very tender underneath. Sitting, standing,bending, reaching too long causes extreme pain. I knew something else had to be happening with my spine besides the scoliosis. Bending over also causes shortness of breath. I wondered if maybe the pleural effusion may be the cause of that. Need more input.

     
    Old 08-19-2014, 05:58 PM   #4
    teteri66
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    Re: Please help me understand MRI results

    Shortness of breath is a symptom of pleural effusion.

    I hope you have a well trained, experienced spine specialist to make an accurate diagnosis and plan of treatment for you.

     
    The Following User Says Thank You to teteri66 For This Useful Post:
    sweetpea2014 (08-20-2014)
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