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



Spinal Cord Disorders Message Board

  • MRI results

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 12-01-2014, 01:50 PM   #1
    ksprings3
    Newbie
    (female)
     
    Join Date: Sep 2011
    Location: Vidor,TX
    Posts: 7
    ksprings3 HB User
    MRI results

    I have had quite a bit of pain for several years such as headaches, neck and shoulder pain and the list goes on. Can you help with my MRI results? Impression: There is no acute osseous lesion and the paraspinal structures are normal. A broad based disc herniation at c5-6 compresses the thecal sac, causing moderate compromise of the spinal canal and moderately severe, compromise of both neural foramina. Although there is significant compression of the thecal sac, the spinal cord remains normal in signal at this level. There is no other disc herniation throughout the cervical region and no other compromise of the spinal canal or neural foramina is seen. No other abnormalities are noted. Thank you all

     
    Sponsors Lightbulb
       
    Old 12-02-2014, 12:40 PM   #2
    ChuckStr
    Veteran
    (male)
     
    Join Date: Apr 2014
    Location: seattle wa USA
    Posts: 406
    ChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB User
    Re: MRI results

    You have 7 cervical vertebrae c1 (roughly at the base of your skull) through c7 (roughly at the area between your neck and shoulders). Each pair of vertebrae have a spongy disk between them to provide cushioning and space for the spinal cord and nerve roots while allowing the neck to move.

    C5/C6 - The disk has bulged enough to protrude into the space for the spinal cord and nerve roots. The resulting narrowing of these spaces is called "stenosis" and is graded on a scale of minimal, mild, moderate, severe. In your case, the narrowing is moderate of the spinal cord area and moderately severe for the nerve root areas. There is a tough sac surrounding the spinal cord containing cerebral spinal fluid that protects the cord. The radiologist notes that the herniated disk is pushing into this sac in this area.

    This could definitely be causing pain like you describe. The most likely mechanism for this, given your MRI, is that the C6 nerve roots are being compressed by the herniation. This could cause neck pain and headaches as well as radiating pain/numbness etc down into your arms and even into your thumb.

    If you don't already have one, I would suggest getting under the care of a spine specialist. That is a neuro or ortho surgeon with special training in spines that has a spine issue dedicated practice. Those Drs will be able to correlate your symptoms and your diagnostics like the MRI and suggest a good treatment plan. I will say that if the pain is occurring as I described that is known as radiculopathy. That normally clears up with conservative measures such as PT, traction, steroid injections etc.

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

     
    Old 12-02-2014, 03:41 PM   #3
    ksprings3
    Newbie
    (female)
     
    Join Date: Sep 2011
    Location: Vidor,TX
    Posts: 7
    ksprings3 HB User
    Re: MRI results

    Thank you so much for your detailed reply. I do have an appointment with the neurologist on the 10th. I have actually seen him before for the same problem but my MRI at that time was only mild which was a couple years ago.

     
    The Following User Says Thank You to ksprings3 For This Useful Post:
    teteri66 (12-03-2014)
    Old 12-02-2014, 06:18 PM   #4
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,198
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: MRI results

    A neurologist studies the diseases of the nerves. You might want to see a spine specialist -- either a fellowship-trained orthopedic spine surgeon or a neurosurgeon to get an accurate diagnosis and plan of treatment. Neurologists are useful when you need testing such as EMG ....but do not have the further education in the neck and back that is needed for the best diagnosis.

     
    Old 12-02-2014, 09:01 PM   #5
    ksprings3
    Newbie
    (female)
     
    Join Date: Sep 2011
    Location: Vidor,TX
    Posts: 7
    ksprings3 HB User
    Re: MRI results

    Really? A neurologist is the one that did my mom's neck surgery for pretty much the same thing about 7 years ago.

     
    Old 12-03-2014, 05:29 AM   #6
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,198
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: MRI results

    He must also be a neurosurgeon. Neurologists, as a specialty, do not have training in surgery.

     
    Old 12-03-2014, 03:53 PM   #7
    ChuckStr
    Veteran
    (male)
     
    Join Date: Apr 2014
    Location: seattle wa USA
    Posts: 406
    ChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB User
    Re: MRI results

    Yeah, neurologists are not surgeons although there is nothing stopping a neurologist from getting a surgery credential as well and being a neurosurgeon (other than the 3 years it would take). And even being a neurosurgeon doesn't mean you are a spine specialist. Spine specialists, whether neurosurgeons or orthopedic surgeons get an additional 1-2 years of fellowship training focusing only on the spine. Also, they will generally limit their practice to spine issues thus they are uniquely qualified to diagnose and treat diseases of the spine.

    I personally would not want a spine surgeon who does mostly, for example, shunts for hydrocephalus doing my spine surgery although I guess I would prefer that to an ortho surgeon who does mostly carpal tunnel

    That said, I've had an interesting experience where I have developed fasciculations (muscle twitches) in my calves mostly. My main treating spine specialist is an orthopedic surgeon with specialty spine training. My issues are mainly in my cervical spine and when a lumbar MRI didn't find any particular issues that could be causing the fasiculations, he referred me to a neurologist. The neurologist did an EMG which found damage in my left arm but nothing in my legs so the they are both trying to treat the cervical spine issues. Luckily they sort of agree on the plan so coordinating isn't too bad.

     
    Old 12-03-2014, 05:07 PM   #8
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,198
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: MRI results

    I don't mean to get picky but lots of neurosurgeons do not have fellowship training in spine surgery. They learn spine and brain surgery during their residencies. Sometimes the specialty develops as a result of doing many more brain surgeries than spine, or vice versa.

    When they do choose to specialize in the neck and back, some do go on to do a fellowship in spine surgery, but this is a fairly new development. At least until recently, many neurosurgeons considered brain surgery superior to spine surgery and had a definite preference for it. Newly trained neurosurgeons found themselves having to do the spine surgeries because the senior doctors in a practice or hospital did all the brain surgeries...the old "pecking order" thing....

    Currently a neurosurgical residency is seven years, with a possibility of "specializing" in a specific area of neurosurgery after the fifth year.

     
    Old 12-03-2014, 09:17 PM   #9
    ChuckStr
    Veteran
    (male)
     
    Join Date: Apr 2014
    Location: seattle wa USA
    Posts: 406
    ChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB User
    Re: MRI results

    Yes, it is true that many neurosurgeons do not have spine fellowship training. They may choose to set up a spine-only practice, or as you say, be the newbie and get them assigned, but I don't personally believe that makes them spine specialists. It is true, that neurosurgeons and orthopedic surgeons technically do have the right to operate on your spine regardless of additional training. For me though, that means they aren't doing surgery on my spine. I had no shortage of either ortho or neuro fellowship trained surgeons when I went looking.

    The one surgeon I talked to was a professor of neurosurgery at the large teaching hospital here. He ran the spine program including supervising and teaching in the spine fellowship program. He said the enrollment skyrocketed over his tenure there due to the development of minimally invasive techniques, imaging advances, etc that have led to a huge rise in spine surgeries. He was saying that before he left to start his own minimally invasive all-in-one practice, they were having to beat neurosurgeons and orthopedists off with sticks who were trying to get into the program. So, I think the trend may be changing where more neurosurgeons and orthopedists both will want to become spine specialists because it is just incredibly lucrative. It's probably true that many people don't know or care about the distinction between a surgeon who is fellowship trained and one who isn't. But I think with the advent of things like internet medical sites etc. people are becoming more educated, and possibly more discerning.

    Ok, enough rambling from me

     
    Old 12-04-2014, 06:39 AM   #10
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,198
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: MRI results

    I agree that most orthos must have fellowship-training to be a spine surgeon, and the fellowships have been around since the 80s whereas it is much more common for a spine neurosurgeon to not have fellowship training beyond the seven year residency, where they may have specialized in spine surgery the last two years of the neurosurgery residency.

    Most fellowship programs only take in 1-3 doctors per year so you can imagine there would be many more wanting to get in than can be accommodated.

     
    Old 12-05-2014, 05:54 PM   #11
    ksprings3
    Newbie
    (female)
     
    Join Date: Sep 2011
    Location: Vidor,TX
    Posts: 7
    ksprings3 HB User
    Re: MRI results

    Thank you both for your input. The neurologist I am seeing next Wednesday is a neurosurgeon. He has actually operated on several family members. I'm hoping my issue doesn't require surgery but my primary doctor seems to think that is the only option since MRI results are moderate to severe but who knows at this point. Again thank you.

     
    Old 12-06-2014, 11:27 AM   #12
    teteri66
    Senior Veteran
    (female)
     
    Join Date: Nov 2010
    Location: USA
    Posts: 9,198
    teteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB Userteteri66 HB User
    Re: MRI results

    The fact that the spinal cord remains normal even though the thecal sac is compressed, and the fact that all other disc levels may allow you to avoid surgery. In any case, Conservative measures will be tried first. It may be that the disc bulge will lessen on its own which might resolve the stenosis. In any case, hopefully you can go on for many years...watching and waiting.

     
    Old 12-11-2014, 10:38 AM   #13
    AB1988
    Newbie
    (female)
     
    Join Date: Apr 2014
    Posts: 8
    AB1988 HB User
    Re: MRI results

    Chuck, I also had muscle twitching in my calves, biceps, and other odd places. The twitching in my calves bothered (concerned) me the most. However, at this point anyway, I haven't had them since my ADR surgery on 12/2.

     
    Old 01-11-2015, 05:11 PM   #14
    ChuckStr
    Veteran
    (male)
     
    Join Date: Apr 2014
    Location: seattle wa USA
    Posts: 406
    ChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB UserChuckStr HB User
    Re: MRI results

    Yes, the twitching concerns me as well but I've had pretty good reassurance from a respected neuromuscular neurologist that nothing weird is going on. It was a little more scary given that my left arm lost some strength and showed denervation on EMG as well, but the pattern corresponded pretty exactly to the nerve compression on MRI and the strength has since returned nearly completely.

    Did you have spinal canal stenosis or only c5/c6 radiculopathy? It's great to hear that the twitching symptom seems to have gone away for you after the surgery. I hope the rest of your recovery goes smoothly as well!

     
    Closed Thread




    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 04:51 PM.





    2019 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!