Thoracic CT and Cervical XRay Results..help!
 

Hi everyone - I just found this forum and was really really hoping for some help.

I've been having a lot of symptoms the last 4-5 months that have taken me to the ER once and many Dr visits. Pain behind my shoulder blade area (Suprascapular nerves I'm told), shoulder pain, some numbness/tingling down my arm, neck pain, and being lightheaded.

I went to the ER a few months ago due to really bad pain in my scapula and numbing down my arm which scared the heck out of me! I had a CT done of my thoracic which showed mild bone spurs up and down. I've also had a Xray of my cervical spine recently which I have below.

Sounds like I have some good narrowing going on in my left C5/C6, which is the same side all my symptoms are. Could that, along with my bone spurs, be the cause of all my symptoms?

I'm going for a neck MRI in about a week to get more detailed info, as well as a neurologist. I had a brain MRI done, which came back clear.

Thank you so much for any help! This hasn't been a very fun last few months wondering what the heck is wrong with me, esp with a wife and 2 small kids!


PROCEDURE: XR CERVICAL SPINE 4 OR MORE VIEWS

FINDINGS:
From skull base to C7 vertebral body is visualized on the lateral
radiograph. There is motion artifact on the swimmer's view which
is suboptimal.

Alignment: Stroke normal cervical lordosis.

Disc spaces: Intervertebral disc spaces are maintained.

Bones: Vertebral body heights are maintained. No acute fracture
is identified. The odontoid process is intact and the
atlanto-axial relationship is maintained. Significant
neuroforaminal narrowing on the left at C5-C6. There is mild
facet arthropathy

Soft tissues: There is no significant prevertebral soft tissue
swelling.


IMPRESSION:
Straightening of the normal cervical lordosis. Minor degenerative
changes of the cervical spine. Neuroforaminal on the left at
C5-C6.

It would be much better to have an MRI, which would show the soft tissue, such as the discs. But this is what it means:

The straightening of the cervical lordosis -- this means your neck doesn't have the curvature that it should have.

Degenerative changes of the cervical spine: This means that you have degenerative disc disease, which is drying out of the discs. They flatten and tend to bulge/herniate causing the disc space to become narrower. When the disc space narrows that means that the vertebra are getting closer together due to the upper one "sinking" down because the disc flattened.

Neuroforaminal narrowing at C5-6: The foramen are the holes that the nerves pass thru to get to the spinal cord. Your foramen are getting narrow at C5-6 level on the left.

Mild facet arthropathy - This means that the joints of the facets are diseased. Probably osteoarthritis. The facets are those "wing-like" structures on each side of the spinal cord, and you can see/feel them if you hunch your back over. ;)

This isn't a bad or serious X-ray. But I'd rather see an MRI - there could be discs that are bulging or herniated, or other things that could be wrong. It's hard to say because an X-ray doesn't show anything but bone. An MRI shows both bone AND soft tissue. So it would have been better if he had done an MRI with and without contrast material. You might ask him to do one. :confused:

I wish you the very best. Keep us informed on what's going on, okay? Hugs, Lee

Thank you Lee! I am getting an MRI in about a week, so hopefully I'll have more info then. Thanks again!

Make sure you bring us the report, and post it here, okay? We can decipher it for you. Hugs, Lee

So here are the results from my MRI. Reads as though there are a few things going on but nothing major, I guess. Sure doesn't feel that way sometimes though :)

My biggest question is, what is cord indentation? is there a dent in my spine? Google really didn't help much with that.

Any thoughts on below would be great. Thank you again!!!!


INDINGS:
Osseous Structures: There is normal cervical lordosis. No
vertebral body compression fracture or subluxation is seen. There
is no evidence of acute bone marrow edema. The facet joints are
normally aligned bilaterally.

Disc Spaces: There is no evidence of significant central
stenosis or neural foraminal narrowing at C2-3. At C3-4, there is
mild spondylosis and disc bulging resulting in mild cord
indentation and minimal left-sided neural foraminal narrowing. At
C4-5, there is mild spondylosis, disc bulging and uncovertebral
osteoarthritis resulting in mild cord indentation and no
significant central stenosis or neural foraminal narrowing. At
C5-6, mild spondylosis and disc bulging is present resulting in
no central stenosis or neural foraminal narrowing. The C6-7,
C7-T1 and T1-2 levels are unremarkable.

Ligaments: No abnormal signal or tears.

Spinal Canal: Visualized spinal cord is normal in caliber and
signal. No epidural fluid collections.

Craniocervical Junction: Within normal limits.

Prevertebral and Paraspinal Soft Tissues: Visualized portions
within normal limits.

IMPRESSION:
Mild degenerative disc disease resulting in mild cord indentation
at C3-4 and C4-5. Minimal left-sided neural foraminal narrowing
is present at C3-4.

Ok ~ I'll try to decipher it. ;)

At C3-4 You have Spondylosis, which is any degenerative disease of the spine which causes symptoms such as pain, tingling, numbness, etc. There is disc bulging which indents the spinal cord and also there's left sided neural foraminal narrowing. The foramen are the holes that the nerves pass thru to get to the spinal cord, and they are becoming narrow.

At C4-5 Mild Spondylosis (see above) and disc bulging, and uncovertebral osteoarthritis resulting in mild cord indentation. Osteoarthritis is usually seen in mid to older age and there are degenerative changes in bone and cartilage of one or more joint with progressive wearing down of apposing joint surfaces with consequent distortion of joint position.

At C5-6 Mild Spondylosis (see above) and disc bulging.

All other levels are normal.


Remember that I'm NO DOCTOR. But from what I see here, I doubt that there is any surgical need here. If you're having pain, I'd ask my doctor to send me to physical therapy. I'm SURE that would help you. :) Physical therapy MOST OFTEN helps with pain. So see what he says, and let us know, ok? You certainly do not want surgery when it's not needed!!!

But you can take your films and get an opinion from a Neurosurgeon. That's the best thing to do. That way you'll know for sure. ;) I wish you the very best. Take care & God bless. Hugs, Lee

Is your arm & scap pain on both sides or only one side?

Any other symptoms at all, even if you aren't sure it is related?


Doc hasn't sent you for expert evaluation by advanced PT after all this time??
Advanced PTs, and some doctors, know how to do a hands on eval to see if sx are spinal related or possibly soft tissue, or something else.
They can also check for triggerpoints, muscle spasms and such.

Hi sugit
 

Welcome to NT. Glad you found us. Lots of us have gone through spinal surgery. I agree with Leesa, definately MRI. That is the best way to discover what the cervial spine is doing. Then after that opinion, get another opinion before you opt for surgery. Do all concervative measures first. I am fused C3-7, had two surgeries to do that. Yes your symptoms down the arms can indeed be from cervial issues. What ever happens we will all be here for you to support you. Leesa was the one who calmed me down when I came here looking for help. Lots of good souls, to ease your way. I wish you all the best. ginnie:hug:

Thanks everyone. I have an appointment with a neurologist in about a month ...tough to get an appointment with them unless it's important...so I'm fine waiting :)

It's took a while to get to this point b/c I changed doctors after I didn't feel like I was being taken seriously by my old one. My new one has been great.

Arm, shoulder and scap pain are all on the left side, which seems to be where the results seem to say I have some problems. My sternocleidomastoid on my left side spasms quite a bit, not pain just uncomfortable and tense. Neck pain is primary in the back of the neck.

I have some facial discomfort on the left side from time to time, not pain or numbness really, but just an odd feeling around the cheek area. My Dr sent me in for a brain MRI, which came back normal. No MS, mass effect, ect. (whew!)