MRI Impression....eh?
 

Hi all

Can anyone shed any light on the following "Impression" at the end of an MRI report?

A small central and moderate bilateral C5/6 disc bar which with possible minimal posterior elemental hypertrophy is resulting in moderate spinal stenosis with complete loss of surrounding CSF space and possible minimal effacement of the cord but no myelomalacia and moderate to moderately severe narrowing of both exit foramina, more marked on the right.

What on earth? Does this explain my pins and needles? Does this mean surgery? Any info would be most gratefully received!! Thank you :confused:

[A small central and moderate bilateral C5/6 disc bar which with possible minimal posterior elemental hypertrophy is resulting in moderate spinal stenosis with complete loss of surrounding CSF space and possible minimal effacement of the cord but no myelomalacia and moderate to moderately severe narrowing of both exit foramina, more marked on the right.]

I don't know all the terms used but bolded the basics.
Is there more pins & needles on the right side, is that in your arms/hands??

Do you have other symptoms?
It might helpful to list them, so others can share ideas along with more MRI information.

re MRI
 

Lets see if we can pull this apart for you. I'm not sure what a "disc bar" is, but the first sentence says that the middle of the disc is least effected while both sides are moderately effected. Hypertrophy is overgrowth, so there is some overgrowth at the side closest to your back. The spinal cord runs through the spine, and the extra growth is causing the space it runs through to be narrowed. (stenosis is just a big word for narrowing). CSF stands for cerebral spinal fluid. There should be space around the cord for this fluid to move, and the narrowing is preventing this fluid from moving. (The cerebral spinal fluid is the fluid that is taken during a spinal tap.). Myelomalacia is softening of the spinal cord, and the report says that is not present. (a good thing). Foramina are openings in the bone that should be there, but, and the report says that those openings are abnormally small.

Think of the spinal cord as a hose. Put a sleeve around the length of the hose. Between the hose and the sleeve there is fluid that can flow up or down. (hold the hose vertically). Think of putting your hand around the hose and its sleeve and squeezing. Now the fluid cannot go up and down. If you squeeze but not as hard, some fluid may be able to go up and down, but not much. At one point, squeeze the hose and sleeve hard enough that there is no space between the hose and the sleeve for any fluid.

All nerves originate from the spinal cord whether its directly or indirectly via nerves branching out. Kind of like a tree branch. Lets say the spinal cord is a tree trunk. Off it come large limbs, and off them come smaller branches. The further you get from the trunk, the smaller the branches are. Any disruption in the spinal cord can cause unwanted effects. Pins and needles, numbness etc.

I hope I didn't just confuse you more. If my explaination was too confusing, try tearing the report apart by looking up each word you don't understand online. That may help you peice it together. The reason for the big words is so every Dr. reading the report can understand exactly what is going on. If they use day to day terminology, there might be a different interpretation made by every Dr. who reads the report.

Sam

Thank you Sam! You've made that very clear and are obviously extremely knowledgeable, for which I am very grateful. As an opinion, would you think surgery would be the next step or is it something each consultant would have a differing opinion on and I'll just have to wait and see? Thank you again for taking the time and trouble to respond! :-)

re MRI impression
 

Pippybread,
glad I could be of some help. There are two camps when it comes to backs. One that wants to go for surgery and one that does not. I have several clients who have had back surgery over the past 15 years, and I can think of only one that was glad she did. The others claimed that it made the problem worse or didn't help at all.

Although I'm sure its a case by case decision, when I went to my first appointment with the physical therapist, he told me that often times, MRIs can give false positives. In other words, show something that leads the Dr. to believe surgery is needed when it isn't. They don't know until they get in and realize what they thought they saw, they didn't.

I can't speak for human Dr.s, I only see animal patients, but I can tell you this. If a set of radiographs or other information is set out, and ten Dr.s (or vets in my case), look at the picture, you will get at least three if not four different opinions. There are very few cases that come into my office that bypass at least two diagnostic tests that I would take to surgery. Those are the ones that I would bet my life on needed the surgery and needed it right then or death would be the outcome. I don't have the technology that the M.D.s do, or even the Veterinary colleges, so perhaps they have a different view, but before I agreed to let someone go in surgically on me that was that close to my spinal cord, I would want more than one opinion.

Hopefully I have not insulted any neuro specialists out there. The above was not meant as a degrading comment on medicine, human or otherwise. For all I know, neuro people do five back surgeries a day and know when the information is pointing towards surgery. What I am saying is that it never hurts to get a second opinion. Unless its an emergency, you usually have time. I hope your doc can help you out. Take a deep breath and don't panic.

Sam

Hi pippy bread
 

Welcome to Neuro Talk. Leesa is the best at helping with the MRI results. I can tell you however, anytime there are words like "Moderately Severe" or "complete Loss" or even" loss of the signal," that is a reason for concern. No matter what the Neruologist says to do, Make sure you go for a second opinion, even a third. Surgery is a last option, and should only be considered when all conservative methods have been tried. I know you are scared, believe me I was too when I came to Neuro Talk. I have had two spinal fusions. NT, got me through them with lots of support. keep a journal of your symptoms to give to your doctors. Yes the pins and needle feelings in the arms can be a result of this kind of problem in your spine. Just don't panic yet, and get that second opinion. You will get good information here, and help no matter what the prognosis. I do wish you all the best, and a good resolution. I will help in any way I can. ginnie:hug:

Thank you!! I am scared and feel very out of my depth....like I'm watching from the sidelines, so it's really comforting to converse with others and the advice is invaluable! Thank you for taking the time and trouble to reply

Hello Pippy bread
 

Neuro talk is here for you. So am I. I got lots of support for my own surgery. I was just as afraid as you are. It will be OK. Just get those other opinions and research everything you can. Take good care of yourself. ginnie:hug:

Hi,

Welcome to NT.

It is a wonderful community of people helping people. You are not alone.

There's lots of info here and on the web. Do your homework and get the second or third opinion.

Keep a diary.

Get yourself in as good of a physical condition as you can, with water for hydration of your whole body, foods enriched with protien and vitamins, rest if you can, and keep your spirits up. It will enable you to make better decisions and handle what lies ahead for you.

There are a lot of things we shouldn't do, like caffeine, smoking, overindulging in things that are not good for us. There's room for improvement in all of us.

It takes time to change, and time for the changes to take effect.

Do whatever you can to be positive about the situation.

Prayer is always good.

Keep asking questions and keep us posted.

Hi Pippy---I had acdf c5 thru c7 in 2010. Your MRI does not appear to be to bad. How are your symptoms ? Do you have neck pain,shoulder,numbness going down arms into fingers ? Most surgeons will only do surgery for spinal cord compression also based on neurlogical symptoms. Most good surgeons would advise conservative treatment first therapy,esi(epidural steroid injections) ...sometimes these disc can heal themselves with treatments .Once you do the surgery there is no turning back it comes with risks. I dont regret mine I did seek 3 consults first-- all agreed surgery 100% due to all the disc were severely spinal cord compressed. I was already going parlyzed in right arm. I was in such pain prior to surgery morphine wouldnt touch it. I dont regret my surgery ...gave me a life back. I will tell you 18 months post surgery-- Im having problems with neck and shoulder. I do have other spine issues as well. I dont regret my surgery I feel I had no choice. I just think its a decision I wouldnt enter into lightly due to future risks. Always again seek at least 2 or 3 consults first. Best wishes let me know how your doing . :hug: