Can Someone Please Help Me Understand My MRI Report?
 

Hi I am new here. I am a 55 yr old female. I have problems in my neck area with herniated and bulging discs at several levels. I also have radiculapathy in both of my arms. My symptoms include pain from neck thru shoulders and in my arms down to my fingers with numbness off and on in my fingers. Sometimes fourth finger and pinky and much of the pain goes into my third middle finger, mostly on my left hand. The pain in my arms can be almost anywhere and is a lot in my top part of my arms front and a lot in back and around the elbow but also below my elbows down on into my hands. I also experience pain down in back of my shoulders with pain shooting up from my shoulder blades, a lot on the right side.

I am on Lyrica 100 mg 3x day and 10mg Flexeril twice a day. Even on these meds my pain pretty much stays at about a 3-4 level all the time. I don't sleep well, I toss and turn all night .I have had these problems for awhile. The Neuro Dr told me about 3 yrs ago he could do surgery the but I decided not to. I dont want surgery, dread it. I want to go as long as I can without it, but I am afraid the time is running out and I will probably have no choice.

My Primary Care Dr just ordered a new MRI on my neck. after showing him the MRI report from 3 yrs ago, he said that I have to go see a neurosurgeon and only commented that I had some serious problems that need to be looked at by a specialist. I did the MRI and I have the report but dont understand any of it. He referred me to Shreveport, La LSU Hospital. They are supposed to call me with an appt but I know that they are probably backed up from past experience so it may be awhile before seeing anyone up there. Could someone please help me to understand the reading of this report? I would be so appreciative of any help! The report is as follows:

FINDINGS: There is loss of the normal cervical lordosis. Note is made of congenital narrowing of the cervical spine. Vertebral body height and alignment are maintained throughout the cervical spine. No abnormal signal within the spinal cord. The craniocervical junction is unremarkable.
Multilevel intervertebral disc dessication. Intervertebral disc height is maintained throughout the cervical spine. No abnormal marrow signal. The paravertebral soft tissues are unremarkable.

C2-C3 Unremarkable

C3-C4 Intervertebral disc bulge. The central canal is narrowed to 8 mm. No neural foraminal narrowing.

C4-C5 Right paracentral intervertebral disc protrusion which narrows the right lateral recess and contacts the right side of the cord. The central canal is narrowed to 8 mm. There is mild right neural foraminal narrowing. No left neural foraminal narrowing.

C5-C6 Diffuse intervertebral disc bulge with superimposed left paracentral disc protrusion. There is complete effacement of the ventral subarachnoid space. The left paracentral disc protrusion narrows the left lateral recess and contacts the left side of the cord. The central canal is narrowed tp 7 mm. Moderate bilateral neural foraminal narrowing.

C6-C7 Diffuse intervertebral disc bulge with right lateral disc protrusion. Complete effacement of the ventral subarachnoid space and contact of the central cord. The central canal is narrowed to 6 mm. Severe right and mild left neural foraminal narrowing.

C7-T1 Diffuse intervertebral disc bulge with superimposed right lateral disc protrusion. Complete effacement of the ventral subarachnoid space. The central canal is narrowed to 7 mm. No neural foraminal narrowing.

IMPRESSION: Congenital narrowing of the cervical spinal canal with multilevel intervertebral disc bulges and protrusions. At C4-C5, right paracentral disc protrusion contacts the right side of the cord. At C5-C6, left paracentral disc protrusion contacts the central aspect of the cord. At C7-T1, diffuse intervertebral disc bulge narrows the spinal canal to 7 mm.

Thanks in advance for any help....

Hi ~ I'll try to help:

At C3-4 you have a disc bulge - the central canal is narrowed to 8 mm -- that's TOO MUCH.

At C4-5 - you have a disc protrusion which contacts the right side of the cord, and the central canal is narrowed to 8 MM -- TOO MUCH. There is mild foraminal narrowing. The foramen is the hole that the nerves pass thru to get to the spinal cord.

C5-6 - You have a disc bulge & also a protrusion. Due to this the ventral subarachnoid space has been completely wiped out/closed. The central canal is narrowed to 7mm - too much.

C6-7 - You have a disc protrusion. The ventral subarachnoid space is completely closed and there is contact with the central cord. The central canal is narrowed to 6mm. SEVERE right & left neural foramen narrowing.

C7-T1 - You have a disc bulge & a disc protrusion. The ventral subarachnoid space is closed. The central canal is narrowed to 7mm. No neural foramen narrowing.

I should mention that the "arachnoid" space (I THINK) is a lining which travels almost the whole length of the spinal cord. There are other "linings" between the arachnoid space and the cord, but I cannot remember what they are! I hope DUBIOUS will chime in a correct me if I'm wrong. I tried looking it up here on the Medical Dictionary, but I couldn't get it to work! :eek: And I can't remember my anatomy. :rolleyes: So I could be very very wrong. :(

I hope this helps a little. I wish I could have helped you more. Please take care and God bless! Hugs, Lee :)

Thank you Leesa for your quick reply :) Yes you have been helpful. I couldnt figure out what effacement meant lol and a little confused on the arachnoid space. The med dict here must be down, not working for me either. I will find another one. Somehow I guess I overlooked on the report that the C3-4 had narrowed down to 8mm also. I didn't realize that almost my whole spinal canal has narrowed that much! Thank you for observing what I didn't. I really don't know how much longer I can or even should go before having surgery. I'm not getting any younger :) Hopefully I won't have to wait too long for that appt. I really do hurt a lot even on the meds. I really love the Roger Miller quote! So true. I want to be the one who walks. Thanks again for your help and may the Lord bless you also. :))

I agree with Leesa!

Surgery is going to be in your near future. The cord is generally 11mm you have a 60% cord compression at one location with several others right behind it. I did the same as you and held out as long as I could. The radiculopathy at the levels you have it are painful, but be very glad it isn't at c6-7 or you would think about performing the surgery yourself I had the pleasure of knowing them as well as you do at as many areas. You could lose function of the limb on a complete radiculopathy, but that is secondary to the function of everything from the neck down should your cord get any further compressed. There are people paralyzed with that amount of compression! Hate to bring bad news and again I am not a doctor but I have the T-shirt :)

Thank you gatorhead for your reply, appreciate it very much. I was confused on size the spinal cord should be. When I checked around on the net I found all different sizes lol. One had 9-11mm and another place said about 14mm and another still 17-18. But no matter what size I realize mine has become too tight in all the levels. I think my worst level is at C6-7 isnt it? Wow, I know you have been there where I know I don't wanna go! I do have some very bad days but most are a 3-4 with the medication. Dr has increased the Amitriptaline to 50 mg at nite so I am getting a little more rest now. Not a lot but an improvement. I didn't put in my post but I have Fibromyalgia also. Sometimes it is hard and confusing to me to distinguish one pain from the other. I just know I hurt but sure don't want that T-shirt. Sorry that you have. :frown:

Am I understanding that you had the surgery? If so what exactly did they do and how much better are you now? You know, I read on a different board someone commented to someone else who had a 6mm compression at the same C6-7 level as I and they told them that if they even sneezed wrong they could end up a quad! Definitely an eye opener. Are you saying that there are quadraplegic people who had 60% compression at that level? Wow, I just didn't realize the severity that is possible.

Yes bad news but I would rather have bad news from someone who has been there and possibly help me make the right decision than all good news from someone who hasn't been there and doesn't know what they are talking about.

Please tell me about when and what they did to fix your neck and how you are doing now. Thanx again!

I have had the surgery.....twice! Yes I was told the same thing, that a sneeze, cough or hard stool could be all that it took to make me a quad, or worse! Mine was down to 3mm and 4mm and the doc's couldn't believe I was able to function. That was at C4-5 and C5-6. Had disc removed and bone graft put in at both levels without instrumentation this is known as a ACDF because they went through the front. I broke C5-6 or it never healed, still up in the air as to which, but it caused C6-7 to completely rupture, to the point the surgeon said it was one of the worst he had seen and sympathized with the pain it must be creating. He confirmed after the surgery it was as bad or worse than the films showed. That pain is the one I will never forget nor want ever again!

I had to have C5-6 redone and then he removed the disc at C6-7 and replaced it with a bone graft as well then he tied everything together with a titanium plate and screws. This was a different surgeon than my first one.

I am happy with the results so far, It has only been 6 months. I still have the pain in the neck and into the shoulder blade and down the arm. That being said as I am having tests to figure out what is going on, I have learned that I have two torn tendons in my shoulder and arthritis has also set up shop. This may be the cause of that pain. It remains to be seen whether or not it is.

Now mine may have been prevented, the second surgery, had the original surgeon done the c6-7 level the first time around as it was herniated and torn prior to the surgery. There is a condition known as the domino effect where the levels above and below go bad over time. That being a know probability he should have done it because it didn't last 6 months! Do your research. Talk to people, you will find out it is a common procedure and lots of folks have it done. There will be good names and bad names and then you go and feel the doctors out and pick the one you like and trust. Best of luck to you!

Oh my! A 3 and 4mm?? I would say you are prob a walking miracle that you are not quadraplegic. Though I know you are still in pain, you still came out on the better end.

My husband is dealing with a torn rotator cuff and arthritis and it is very painful for him. So I have an idea of what you are going thru on that.

That's something else that is bothering me, the domino effect. I heard a long time ago that once they go in like that, they will have to keep going in. But no matter what, I know I will have to have the surgery sooner than later anyway. It is what it is. :(

I will try to keep up with your posts to see what happens with you. I certainly do wish you the best on your spine and shoulder. As for myself, I really have no idea how long it will take for Shreveport to give me that appt. We will see. Thanks again Gator, God bless you!

Hello Ressie cup,

Leesa did great job on your mri-- and Gator gave some good advice. I agree with both 100% this isnt going to get better without surgery. You are at high risk if you were to get into a minor fender bender of perm damage. I know its horrible to be in pain-- but this surgery does help 90% of people. Some of us have other spine issues due to disease. I dont regret my surgery at all. I hope u get in soon and I wish you the best!!!! Keep us updated ok?

Thanx mg! Your words are encouraging and I appreciate that as also the others here who have been so kind to read my report and offer good advice. Thank you for your best wishes and I will update as soon as I know something. God bless you! :)

I thought I might add the surgery is a breeze! The second one I had a little more pain with but I thought the worst part was wearing that dreaded J collar 24/7 for 3 months after the first surgery. The second one I had internal fixation so it wasn't needed. After the first one I ate and spoke fine immediately afterwards. The second one I couldn't talk or swallow at all and that lasted for a few days. I went home the next day on both of them. So as far as the surgery being painful, I actually found it to be less than what I went in for :)

I am wondering about something. I have significant osteoporosis. I wonder how will that work into a have to surgery? Surely a plate, bolts and screws wont hold up long like that. Unless they choose to fuse it all but still wondering if that would hold. I am curious if you know of anyone else facing or faced a surgery with significant osteo and how it is holding up for them. I may end up posting that question. I just went this week and did a new bone density, haven't gotten the results yet to see if my meds are helping it any.

That is something I am not familiar with as I have excellent bone density. That would definitely play into the type of surgery and the approach. It may also make you an unlikely candidate for surgery as well. Definitely one of the top questions I would discuss with the surgeon PRIOR to going ahead with it ;)

Yes that will probably be my first question.

[QUOTE=ReeseCup913;931588]I am wondering about something. I have significant osteoporosis. I wonder how will that work into a have to surgery? ]

Hey Resse Cup---actually I was told after surgery I have severe osteoporosis--wasnt shocked I come from a long line of spine patients in our lineage. The Dr got me approved for a Bone Growth Stimulator---which looks like a horse collar--- you wear 4 hrs a day for 4 or 6 weeks If I can remember length of time ---u dont feel anything wearing it but its suppose to really help in achieving a sold fusion, it worked for me. I would just make sure u seek at least 2 consults. Let us know what dr says on this will be intresting to find out since mine was found during surgery .

Thank you mg, I'm so glad ithe Bone Growth Stimulater worked for you. I have never heard of it before but gives me some hope because I was thinking that I might not be a candidate for surgery and that's a scary thing considering any more tightening of the cord will prob result in things I don't want to even think about. But I will remember to ask my Dr about the stimulater. I will let ya'll know what he tells me. Thanx again for this valuable piece of information!

I also had and used the bone growth stimulator!

I'm going to ask about it! Thanx :)

Hi Reese
 

Yep, what leesa got out of your MRI is about the best that any of us could do. I so hope things turn out for you. I want you to have hope that it will. My surgery turned out good, so it does happen. ginnie:hug:

Thanx Ginnie! I do have hope, just kinda afraid I guess. There are so many nice and kind people on this board including you. I am thankful for all of you!

The neurosurgery clinic in Shreveport LSU have very good and qualified specialists. I have been up there several times and have seen them. I feel comfortable with them. But of course I wasn't looking at surgery then either lol. But again, I know they are good. I guess what makes me uncomfortable is that those Shreveport drs are about 3 1/2 hours away from my home so if they send me home the following day and somethings comes up, I have no neurosurgeons around here that will take my medicaid card. That means another trip up there that is not that easy for me to make. But I know the Lord will make a way for everything that I need. Oh me of little faith! He has been so good and come thru for me so many times in the past. How easily we tend to forget sometimes. I know it's all going to turn out ok. Thank you Ginnie for your encouragement! I so appreciate all of you who have talked with me and encouraged me. You guys are awesome! :)

Hi Reese
 

[Being afraid is very normal. When I came to this site, I was in a panicked state and crying. Terrified, freaking, you name it. The folks here got me calmed down and talked to me as long as I needed to settle down some. They also got me though that surgery with confidence. None of it is easy if you have to go that route, but it can turn out OK.
Not having a doc. in your area, tell your physician that. Let them keep you an extra day in the hospital if at all possible, just to make sure things are OK. These days they shove you out sometimes sooner than you shoud go.
I refused to go, no joke, that second day, the nurse would not let me up to get my own cloths, bathe, saying it was too soon, yet they were ready to send me home. My pain levels were not under control either, so I simply told my doctor, I wanted to stay one more day. No problem! Let me know how you do, and keep that list of questions for your Doc. It will be OK. ginnie:hug::smileypray:

I also have Osteoporosis, but they never suggested a bone growth stimulator for me. I went to the heads of Neurorsurgery at two LARGE hospitals, and they BOTH told me because of my osteoporosis, I could NOT have any further surgery, and neither of the surgeons would even TOUCH me. :confused: So my only option now is pain medications.

Leesa---Im sorry that sucks so bad!!! Does the pain meds help? Did u have back and neck ? I seen u had the procedure to burn the nerves --did that do anything?? Your such a sweet person-- I hate the idea if you have to live in life long pain.

Oh Leesa, I am so sorry that they deemed you untouchable! I am praying that they will still be able to do something to help me, but if not, I know that God's grace is sufficient. God bless you Leesa.

Ginnie I sure will ask to stay an extra day if they let me do a surgery. I am believing it's all going to work out! Glad it went good for you. God bless :)

resse cup:

Haven't seen you online was wondering how your doing now??

Hi mg, I am doing ok. I have been pretty busy since Thanksgiving. I spoke w/my Primary care dr and explained how the nerve pain has gotten so much worse and throbbing in my arms and hands. He increased my Lyrica to 150 mg 3x day and the amitriptaline to 50 mg. That is helping me much better. I fell I can function a little better without that throbbing pain. I am still waiting for that appt with the neuro dr.

I also am preparing to have some cataracts removed and have a monofocal lens implant in each of my eyes. I will have them done in Jan. one week apart if all goes well with it. I will at least have my vision better as far as distance goes. Will still have to wear over the counter glasses for close vision.

Hope all is well with you also. Thanx for checking in on me. Appreciate that! God Bless you :)

Thanx for your reply Dubious! Today has been a pretty rough day. And I had been doing better! Woke up this morning and could barely move my head. That and arms has hurt all day. I know my cord diameter is really pretty tight and I am really surprised I don't have more problems than I do. That is a blessing I am thankful for in spite of the pain I do feel. At least I can feel pain, that being the blessing. I am choosing to see my cup as half full instead of half empty. I promise I will post as soon as I know something. Thanx again. :)