help with mri (myelomalacia)
 

Hi everyone,

I wrote before about myelomalacia but didn't have my mri. Sorry about all the reading?

C2-3 level demonstrates a very small right paracentral spur without effect on the cord or associated foraminal narrowing.

C3-4 also notabble for right paracentrsl spur and disk protrusion. There id no effect on the cord, but there is significant right foraminal narrowing.

C4-5 demonstrates a broad disk prorusion and spondyltic ridge. This is more prominent right of the midline. This abuts the cord in the midline and causes significant right foraminal narrowing. There is mild left foraminal narrowing at this level.

C5-6 demonstrates a large right patacentral disk protrusion abutting and markedly deforming the cord central snd right of midline. Marked right foraminal narrowing associated eith thid with mild-to-moderate left foraminal narrowing relayed to uncovertebral joint overgrowth.

C6-7 demonstrates a small midline protrusion. This abuts the cord, but there is no frank deformity of the cord surface. No significant foraminal narrowing telatd to this.

C7-T1 level is mormal.

There is abnormal signal in the cervical cord demonstrated from mid C5 through mid C6. This is centered on the C5-6 disk space where there is a large right paracentral disk protrusion snd spur deforming the cord. Ptesumably, this is represents myelomalacia related to pressure effect. Elsrwhere, the cord is normal in signal characteristics. There is no syrinx.

IMPRESSION:
1. Large right paracentral disk protrusion and spur C5-6 abuts and markedly deforms the cord. Abnormal signal within the cord centered on this level represents reactive myelomalacia.
2. Significant but somewhat lesser disk protrusions snd spondylosis notex at levels as detailed by level above.

Any help explaining this to me would be appreciated.

Thanks
kim

I'll TRY to help. :eek:

At C2-3 you have a small bone spur

At C3-4 you have a small bone spur, but also a herniated disc with foraminal narrowing. The foramen are the holes that the nerves pass thru to get to the spinal cord. These holes are narrowing at this level.

C4-5 You have a broad herniated disc and also a bony ridge which is more prominent right of the midline - It abuts the cord in the midline and causes SIGNIFICANT right foraminal narrowing (see above). There is mid left foraminal narrowing at this level.

C5-6 You have a LARGE right paracentral herniated disc abutting and deforming the cord right of midline. There is marked right foraminal narrowing (see above) associated with mid to moderate left foraminal narrowing relayed to unconvertebral joint overgrowth (bony overgrowth).

C6-7 There is a small midline herniation. This abuts the cord but there is no frank deformity of the cord.

C7-T1 Normal

There is abnormal signal in the cord from mid C5 thru mid C6. This is because the C5-6 herniated disc and spur are deforming the cord. Presumably, this is myelomalacia due to pressure effect. With Myelomalacia, the cord is softened due to no blood flow. Abnormal signal indicated reduced or increased "electrical" activity in the cord.

I hope this helps in explaining your MRI a little. If you have any further questions, please let me know. Sometimes I assume people know what I'm talking about. LOL So don't hesitate to message me, or whatever and I'll try to explain a little better. I have to admit that this is a pretty "interesting" MRI. ;) Hugs, Lee

Thanks Leesa,

Thanks for responding to my mri. I am still in the dark as to what does deformed spine mean, will it always be that way or can anything be done about? Is it degenerative or caused by something else?
Tha pain really isn't that bad, I am on gabapentin right now but will the pi get worse? Thanks again for any info.

Kim

Hi Kim
 

I can't add anything to Leesa's review of your MRI. She is spot on. Make sure you get several opinions before you decide on any action. My own surgery was C3-7. I don't regret doing the surgery. It is a hard decision to make, and a bit of recovery time. I wish you all the best. ginnie

I was given a diagnosis of myelomalacia in 2006 following a spinal decompression operation. Previously, since the mid '80s I had had mild neuropathic pain in both legs and a slight walking problem but in early autumn 2006 the condition took a step change for the worse with the nerve pain becoming very intrusive and greatly impaired mobility. The operation appears to have stabilised the condition, with very little change over the last six years.

I tried various medications from 2006 onwards: amitryptiline (have I got that right?), gabapentin, etc., etc. even waccy baccy and ending with methadone but none of them resulted in any noticeable improvement, so I decided it was better for my mental health to stop taking the pills and accept that the pain and mobillity problems were part of me and so I decided to get on with life as best I could. Not everyone's solution I know, but it is mine.

I have had Myelomalcia in the cervical spine at C6-7 levels and focal cord atrophy with loss of disc height at the same area.

I have had prior issues of the cervical spine which includes stenosis and kyphosis. From the kyphosis Harrington Rods were inserted from C3 to T5 levles and a fusion done anterior at 2 levels I believe. Have to check which levels.

My surgeon is afraid to touch me surgically at this point. Lots of reasons. But I was under the impression that there wasn't too much that they could do for the myelomalacia,

In looking at prior records I note that the term myelomalacia was in MRI reports going back to 1996 or maybe earlier. Have to double check. But in comparing the films it is noted that it has progressed somewhat over the years.

Not sure what the right answer but again I thought treatment options were minimal at best.

You don't have a "deformed spine" -- the spinal cord was being "deformed" or pushed in by a large herniated disc. So your spine itself is NOT DEFORMED. The spine is the bony part. The cord is not.

What is done about it would be up to any surgeon. I would hope that you get SEVERAL different opinions about this. Don't take the word of one surgeon. You MUST get at least 3 opinions from different Neurosurgeons as to what needs to be done.

God bless and please take care. Hugs, Lee ;)

I haven't seen a surgeon yet, I am having a problem or problems with medical assistance. I really don't have alot of pain just uncomfortable. Do you have alot of pain?
I hope i's not that bad for you!!!

Thanks for letting me know.
Kim

Thanks for taking the time and explaining to me, you are too kind to explain these things to people. Still be in the dark without you!!!

Thanks kim

I worked for a pain management Dr for about 7 years. I have also had several spinal surgeries. Lumber, L4and L5, T4 thru T9. Cervical fusion at C7 and T1 and a triple cervical fusion above C7. I always told my patients to NOT have surgery until the pain was so extreme thatyou could not stand it anymore. It is a long and difficult recovery for some and some bounch back soon. Each person is different. It has to do with mental state, support system in place, If you follow instructions. Sometimes you can do everything right and it is still not better or maybe even worse. But at times you have to weigh the risks against the odds. At times it was worth it and at times it is not. I jus put my faith in God and my spine in the hands of a surgeon that is known to pray every morning before surgery. I am not sure what that has to do with it. But Ido know that he did the cerv ical and I have had exellent results. Whereas the lumbar and thoracic spine I have several problems. But it was by diffrent surgeons. So I wish you luck nd hope this helped a little. It is difficult to tell anyone anything about this. Because you can line up a hundred people, The same height, weight etc. WIth every known variable the same and have a hundred different results. There are so many factors that cannot be forseen. But I do wish you luck and you will be in my prayers. I do hope I helped. But it is ultimately in your hands and God's hands. Good Luck