[imsdac]

Hi everyone,

I just found this forum today researching my MRI results and I was wondering if anyone else could help shed some light on this report. I'm still waiting to hear back from my neurologist to go over it but in the meantime, I'm looking for any info I can get.

A little background. Last year I was diagnosed with occipital neuralgia after years of being misdiagnosed as having migraines without aura. I've had these headaches for years with pain that radiates down my right arm and numbness/tingling. It's always on my right side. I've had physical therapy and numerous steroid injections (occipital nerve blocks) and although it relieves the pain, it's always temporary. I am now on muscle relaxants as well as migraine preventative medications.

So, because of my continuous need for the occipital nerve blocks, I pushed my neuro into trying to figure out what exactly is causing these constant headaches/neck/arm/shoulder pain. She suggested an MRI of the cervical spine to see if I had a pinched nerve. So, these are the results that I got:

MRI OF THE CERVICAL SPINE WITHOUT CONTRAST

INDICATION: Cervical pain with right arm weakness and numbness.

TECHNIQUE: MRI of the cervical spine was performed under standard protocol.

COMPARISON: None.

FINDINGS:

Study slightly motion limited.

Very mild levoscoliosis of the cervical spine, which may be positional. Mild
(grade 1) retrolisthesis of C5 on C6. Preservation of vertebral body heights
without evidence for vertebral body compression fractures. Mild disc space
narrowing noted at C5/6. The prevertebral soft tissues are unremarkable. STIR
images demonstrate no abnormal signal. The craniocervical junction is
unremarkable, without evidence of Chiari malformation. The cervical cord signal
is normal.

C2-C3: The cental canal and bilateral neural foramina are widely patent.

C3-C4: The cental canal and bilateral neural foramina are widely patent.

C4-C5: The cental canal and bilateral neural foramina are widely patent.

C5-C6: Anterior disc osteophyte complex. Posterior disc protrusion with a left
lateral component. Disc material indents without definitely contacting the
anterior aspect of the cervical cord. The central canal is moderately narrowed
to 7.5 mm in maximum AP diameter. Tiny posterior annular fissure noted at this
level. Mild right-sided neural foraminal narrowing from uncovertebral joint
hypertrophy. The left neural foramen is widely patent. Very mild right-sided
ligamentum flavum thickening.

C6-C7: The cental canal and bilateral neural foramina are widely patent.

C7-T1: The cental canal and bilateral neural foramina are widely patent.

IMPRESSION:

1. C5/6 with an anterior disc osteophyte complex. Posterior disc protrusion with
a left lateral component. Disc material indents without definitely contacting
the anterior aspect of the cervical cord. The central canal is moderately
narrowed to 7.5 mm in maximum AP diameter. Tiny posterior annular fissure noted
at this level. Mild right-sided neural foraminal narrowing from uncovertebral
joint hypertrophy. The left neural foramen is widely patent. Very mild
right-sided ligamentum flavum thickening. Mild (grade 1) retrolisthesis of C5 on
C6 and disc space narrowing at C5/C6 noted.

2. Remaining levels of the cervical spine are unremarkable.

Sorry this is so long... if anyone can help decipher this, I would greatly appreciate it!

Thanks.

[Jomar]

[C5-C6: Anterior disc osteophyte complex. Posterior disc protrusion with a left lateral component. Disc material indents without definitely contacting the
anterior aspect of the cervical cord. The central canal is moderately narrowed to 7.5 mm in maximum AP diameter. Tiny posterior annular fissure noted at this level. Mild right-sided neural foraminal narrowing from uncovertebral joint hypertrophy. The left neural foramen is widely patent. Very mild right-sided ligamentum flavum thickening.]

From what I see the main thing is that c 5/c 6above- all else looks OK (patent means normal)

But could be some soft tissue causes or postural that can be treated with good PT. Or expert chiropractic if you are considering that option. Be sure to take the MRI report with you so anyone treating you will be aware of the c spine issue.

Soft tissue causes usually don't show on MRI, so a comprehensive PT evaluation might be worth getting before focusing on any invasive or surgical fixes.

[imsdac]

Thanks for your input. I've had chiropractic care in the past as well (sorry, forgot to mention it in my OP) and have had limited success with that as well. What concerned me was that I read that with Anterior disc osteophyte complex (bone spurs) that chiropractic manipulations can in fact be dangerous because the bone spurs can actually rupture the arteries that run in the neck when doing the manipulations. I'm not sure if that's true or not, but it's enough to scare me.

I guess I need to wait for my neuro to call back... the waiting is killing me. I'm honestly fed up of the constant pain and was hoping the MRI would give us a path to resolving this problem for good.

[Jomar]

I have anterior osteos too, c 4-5-6, and my chiro was aware of them.
So he took extra care to not adjust in those areas.
I went to him for many years with no problems.
He was skilled/experienced (25 yrs) in other healing modalities as well as adjusting.
Not a rookie at all...

But I didn't have any disk issues.
My pain was from chronic repetitive strain injuries & poor work postures.

[mg neck prob]

Hi,

The C5-6 disk does not yet seem to be affecting the spinal cord. It has squeezed the canal down to a width of 7.5mm, is narrow. Your spinal canal should be maybe twice that wide. The spinal cord itself shouldn't be less than 8mm-15mm. The C5-6 disk does not yet seem to be affecting the spinal cord. It has squeezed the canal down to a width of 7.5 though, which is narrow. Your spinal canal should be maybe twice that wide. The spinal cord itself shouldn't be less than 8mm. This could be causing problems with any of the nerves from this level down, which may include some of your arm nerve and some nerve below shoulder.

[imsdac]

Thanks for your reply. Should I be concerned by the "Tiny posterior annular fissure noted"? That's a tear in the disc, correct? So does this mean the disc is both bulging (Posterior disc protrusion with a left lateral component) and torn (the posterior annular fissure)?

[mg neck prob]

Originally Posted by imsdac

Thanks for your reply. Should I be concerned by the "Tiny posterior annular fissure noted"? That's a tear in the disc, correct? So does this mean the disc is both bulging (Posterior disc protrusion with a left lateral component) and torn (the posterior annular fissure)?

Yes there is a def concern at minal at least to be watched --- OK --little back ground. I had acdf (fusion surgery) c4-c7 in 2010 --and have no regrets. I would highly rec u seek 2 or consults with neuro or ortho spine surgeon . Im sorry whats are you symptoms again---I read post quickly do you have any tingling in fingers trouble with shoulder? Are your symptoms on the left side? You def have stenosis which is narrowing of your spinal canal it happens with age but yours is quiet narrow. As always you should seek out 6-8 weeks of conservative treament before considering surgery. Have you tried esi (espidural steroid in injections)?

[mg neck prob]

Originally Posted by imsdac

Thanks for your reply. Should I be concerned by the "Tiny posterior annular fissure noted"? That's a tear in the disc, correct? So does this mean the disc is both bulging (Posterior disc protrusion with a left lateral component) and torn (the posterior annular fissure)?

p.s re-read I think you have symptoms on the right?

forninal canal which is tiny hole where the nerve passes thru show thick on right side

[imsdac]

Originally Posted by mg neck prob

p.s re-read I think you have symptoms on the right?

forninal canal which is tiny hole where the nerve passes thru show thick on right side

Yes, my symptoms are on the right side. I have constant pounding headaches that radiate up from the base of my skull and have been treated with occipital nerve blocks (how I was diagnosed with occipital neuralgia in the first place. I also have pain in my neck and shoulder (scapular area) that radiates down my right arm like a "pinched nerve" feeling. It disturbs my sleep and my daily life. I have trouble turning my head to the right and I have to sleep with my right arm completely extended otherwise I get extreme pain with numbness & tingling.

I've had this pain for many years but it's gotten much worse in the past 3 to 4 years. I've had 2 years of physical therapy, massages, chiro, and the injections. I don't mind the nerve block injections but the relief never lasts longer than 6 weeks and my neuro doesn't want to keep giving them over and over which is what led us to look for a root cause.

[mg neck prob]

Intrestimg but annular tear causes no symptoms by itself. The c spine might have many herniated discs not causing you any issues. However when the inner disc material extrudes into the spinal canal it can place pressure on a nearby spinal nerve that can show severe symptoms assoc with this cond are weakness,numbness or tingling ,chronic pain ,pain radiating from the nerves.