I have been injured at work. I am out on WC right now and am having a really hard time convincing any of the medical ppl I see that I have an injury. I have fought for an MRI of neck/back, which are the areas I was injured. I was granted a cervical MRI only.

The results are:

FINDINGS: there is generalized absence of cervical lordosis with element of cervical kyphosis being centered at C5. Vertebral body heights are well preserved. Mild 2 mm retrolisthesis at C5 relative to C6. Diffuse disc space dessication with early narrowing, most prominent at C5-6. Marrow signal is well preserved. Cord maintains normal signal throughout its cervical extent. The visualized posterior fossa unremarkable.

C2-3. Normal.

C3-4. Diffuse disc osteophyte complex with right paracentral predominant protrusion component causing cord contact and flattening at this aspect, AP cord dimension of 6mm. Uncovertebral involvement resulting in mild left and moderate right neural foraminal stenosis.

C4-5. Diffuse disc osteophyte complex with anterior CSF effacement, approaching, but not clearly contacting the cord. Early uncovertebral involvement resulting in mild right neural foraminal stenosis. Left neural foramen remains widely patent.

C5-6. Diffuse disc osteophyte complex with slight right paracentral predominance resulting in cord contact and flattening. Central canal stenosis with AP thecal sac dimension of 6 mm. Early uncovertebral involvement with mild right and moderate left neural foraminal stenosis.

C6-7. Diffuse disc osteophyt complex with left paracentral predominance. Early uncovertebral involvement with mild left neural foraminal stenosis. No right neural foraminal stenosis. Anterior CSF effacement with no cord contact.

C7-T1. Normal.

Impression: multilevel degenerative changes of the cervical spine, most prominent at C3-4 and C5-6 where there is significant central canal stenosis with cord contact and flattening. Multilevel neural foraminal stenosis as described above.


Now, I am a 44 year old female who is feeling that all the "insurance doctors" are saying that my injury is because I have arthritis. I have told all of them that I have lived with arthritis for many years and I have NEVER felt this kind of pain. I am losing bladder control. I have pain radiating from my neck to my shoulders and down my arms. I am starting to drop things occasionally from my hands. I have had carpal tunnel surgery bilaterally, so this was ruled out as well.

Does anyone have any suggestions about what this MRI actually says?

I am not a doctor, first off. But I have handled w/c claims for over 12 years, retired 8 years ago due to my own health issues.

The MRI indicates that you have what are considered pretty normal changes for your age. Osteophytes are degenerative changes in the disk, commonly called spurs. We all have degenerative changes in our spine as we age. These are not caused by injury. It appears that these were there before your injury. Stenosis is where the space your spinal cord passes through has narrowed. This is also a common degenerative finding. The MRI report does not indicate a disk herniation. Even if it did, these are not always indicative of injury.

That said, your symptoms increased or got much worse or you had new symptoms you never had before following your accident. I don't know what state you are in or whether your state differentiates between aggravation of preexisting conditions or counts them as new manifestations, but in most/many states your employer (w/c) is responsible for returning you to the condition you were in prior to your industrial accident. This can be difficult since you had arthritic changes before your injury, but you should be able to document that you did not have bladder incontinence, or the other symptoms you are experiencing.

I would begin gathering your medical records so you know what they say about what you were and were not experiencing before your injury. That way you will have them for your records, and can provide them if you seek a second opinion. I always suggest doing some of this yourself, because you never know what records your comp examiner is sending or not sending. I am afraid it is up to you, the injured worker, to watch out for your own interests here, not because your employer or the claims person is not to be trusted but because in the world of medicine we are fast learning that we must be diligent and educated about our conditions.

You did not say if they are denying your claim or treatment. You also did not say what kind of accident or injury you sustained (lifting? fall? slip? pushing/pulling?) You also did not say whether you have ever had any other treatment for your cervical spine. Was your CTS surgery before or after your injury? If you have ever injured or been treated for cervical spine injury or conditions before, those records could be very important, as they will be a baseline, against which any new changes could be compared to help assess the extent of your new injury.

I am sure you would rather hear that the MRI missed something or that the doctor misread it, but the fact is that our spines begin to show signs of wear sometimes as early as our 20's. If your accident resulted in changes they do not appear to be visible on MRI. This is why prior records are so important. It is kind of like showing your maintenance records on your car to the insurance claims adjuster after an accident to show that your steering was fine before the accident, but now is in need of adjustment as a result of a recent collision.

If you have not yet been to a neurologist, see if you can get authorized for a consult, or even see one on your own. Nerve damage is sometimes difficult to pinpoint, as many here in this forum can attest to. Sometimes w/c will make you feel like you are swimming upstream . . . but in all cases it is your body, so it is in your best interest to take as much control of your diagnosis and treatment as you can. In other words, take care of yourself as if this injury happened at home; I have seen too many injured workers wait for others to "fix' them. Your body doesn't care where it was injured, even though your pocketbook might. Be a full participant in your care and rehab, whatever that is. And it doesn't hurt to maintain regular contact with your employer with updates on your progress.

I hope this is helpful. If you have any more facts you feel might help us help you, please post them. The workers compensation system is not perfect, but it is better than having no coverage like workers over a century ago did. Your best bet is to educate yourself, stay calm and on point, understand that no one is going to walk you through this experience, hold your hand, or give you anything that isn't prescribed by law. Speaking of the law, be sure your state comp board (what ever it is called) sends you some basic information about both the law and your rights, and how your claim will be handled. Pay attention to filing deadlines, especially if you will be protesting any adverse actions. And if all else fails and you find yourself fighting for basic coverage for treatment or time loss (if you can't work), you may want to discuss your case with an experienced worker's compensation/industrial insurance attorney. And don't hire your brother-in-law's tax attorney or someone in your church group . . . you want a business relationship with someone you don't interface with in your personal life.

I suggest you ask an expert on this, unless you would be happy with a layman"s best guess.

if you have known arthritis, do you have previous xrays? also, the radiologist repeatedly says "early" this would lead me to believe it may be easier to say it was accident related.... good luck