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  • Help with MRI reading, what does this mean?

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    Old 11-05-2014, 09:11 AM   #1
    fitzget1
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    Help with MRI reading, what does this mean?

    It is stated:
    C2-4 - Broad based left paracentral disc herniation with posterior osteophyte/uncovertebral joint arthropathy. Effacement left anterior lateral aspect thecal sac and remodeling left anterior margin cervical cord. mild bilateral neural foraminal narrowing.
    C4-5 - Broad based paracentral disc protrusion with mild inferior migration. Posterior osteophyete/uncovertebral joint arthropathy. Effacement anterior aspect thecal sac, remodeling anterior margin cervical cord and AP diameter canal narrowing 0.7 cm. moderate bilateral neural foraminal narrowing.
    C5-6 - Board based left paracentral disc protrusion with posterior osteophyte/uncovertebral joint arthropathy. effacemetn anterior aspect thecal sac, remodeling anterior margin cervical cord and AP diameter canal narrowing 0.8 cm. Moderate bilateral neural foraminal narrowing.

     
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    Old 11-12-2014, 03:10 PM   #2
    ChuckStr
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    Re: Help with MRI reading, what does this mean?

    Was it C2-C4 or C3-C4? They usually do it by pairs of vertebra, I'll assume it's C3-C4.

    C3-C4 - The disk between these two vertebra is popping out and pushing into the space for the spinal cord. In addition you have arthritic bone spurs developing on the vertebrae where they meet to form an exit for the nerve roots. These things are pushing into the spinal canal as well. Together they are pushing enough to touch (efface) the outside sac of the spinal cord and change the distance between the outside of that sac and the cord itself. These are also pushing mildly into the area for the nerve roots to exit at this level. This sounds bad, but would need to be correlated with symptoms to understand if there is any clinical significance.

    C4-C5 - Basically the same as C3-C4 except that the nerve exit holes are being constricted moderately. This is on a scale minimal, mild, moderate, severe. In addition, you see the exact canal measurement which is 7mm. This indicates a pretty severe stenosis (narrowing) of the spinal canal. Most sources indicate 10mm as the threshold for stenosis. There is some human variation but the cord itself on average is around 7 - 7.5 mm at that level so there may be some constriction of the cord although the radiologist doesn't mention it.

    C5-C6 - nearly identical to C4-C5 except diameter of canal is a little less restricted at 8mm.

    The moderate nerve root canal (neural foraminal) stenosis at C4-C6 could be causing symptoms of radiculopathy. Pain, tingling, numbness etc from your neck down into your shoulders/arms. This may be accompanied by weakness.

    The spinal cord canal compression at C4-C6 could also be causing symptoms of myelopathy. These include hand coordination problems, gait issues, a feeling of "walking through sand" or not knowing where your feet are in space, and possible bladder and bowel problems in addition to symptoms associated with radiculopathy such as numbness and weakness. It may also be causing no symptoms. In many cases, there needs to be 30% compression of the spinal cord in order to have myelopathy symptoms.

    I think it is worth seeing a spine specialist (neuro or ortho surgeon with special fellowship training and a specialty in spines only). They will be able to help correlate your symptoms with your diagnostic tests including the MRI. If you post your symptoms we can potentially help further while you wait for your appointment.

    My MRI results are very similar to yours. Your results at C3/4 map to mine at C6/7 exactly. If you swap yours at C4/5 and C5/6 they are almost the same as mine at those levels although, I do have worse neural foraminal narrowing and my AP diameter is better than yours (1.0 at C4/5 and .9 at C5/6). For me, this ended up causing severe left arm and shoulder pain followed by fairly significant weakness and even some muscle loss. That has since healed pretty well with conservative measures but I'm now having pretty severe pain in my right arm and shoulder. For comparison, I saw 5 spine specialists and got a range of opinions from "no surgery" to "surgery now". The consensus was to wait on surgery, have PT and follow up regularly or if myelopathy symptoms showed significantly. So, far 8 months after this I'm doing ok but like I said I'm in some significant pain now.

    Good luck and let us know how you get on...

     
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    teteri66 (11-13-2014)
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