help me to understand cervical spine MRI
 

Need this explained so I can understand. After I heard the words, "You have severe damage", almost everything else was a blur. I am female, 5 ft tall, 120 pounds, and almost 60. I have been doing heavy lifting at work for 3 years, with lots of repetitive motions and reaching up over my head all day. I have filed a workers comp claim-has not yet been approved. Doc is talking about going through the front of my neck to fix if pain and numbness in arm does not subside. Hard to process all of this......




Occiput to T4 evaluated in the sagittal plane. Mild to moderate disc space narrowing at the c5-c6 level. The craniocervical junction, cervical thoracic junction are normal in appearance.

C2-C3 Normal
C3-C4 Normal

C4-C5 Diffuse disc bulge with a residual AP diameter of the central spinal canal of approx. 10 mm. Mild right foraminal stenosis.

C5-C6 Diffuse disc bulge central disc protrusion with effacement of the anterior aspect of the cord and residual AP diameter of the canal of 7 mm. Uncinate process hypertrophy with severe right foraminal stenosis.

C6-C7 Diffuse disc bulge with an AP diameter of the canal of 8-9 mm. Uncinate process hypertrophy with significant right foraminal stenosis.

C7-T1 Normal

There are no paraspinal masses identified. The vertebral bodies and disc spaces are otherwise normal.

Impression



1. Discogenic disease at C5-C6 and C6-C7 with a residual AP diameter of the central spinal canal 7 mm and 8-9 mm respectively.

2. Severe right foraminal stenosis C5-C6 and moderate to severe right foraminal stenosis C6-C7 due to discogenic disease in uncinate process hypertrophy.

3. Mild effaccement of the anterior aspect of the cervical cord at C5-C6.

I'll try to explain it:

C4-5 You have a disc bulge of 10mm--quite big. There is mild right foraminal stenosis. The foramen are the holes that the nerves pass thru to get to the spinal cord. Stenosis means narrowing. So the foramen is narrowing.

C5-6 You have a diffuse disc bulge, and also a central disc herniation which wipes out the front aspect of the cord. You have a bone-spurring process that tends to "hook," plus there is SEVERE right foraminal stenosis (see above)

C6-7 You have a diffuse disc bulge of 8-9mm. You have a "hooking" process of bone spurring with significant right foraminal stenosis (see above)

There is NO DOUBT that you have pain!! :eek: But do NOT jump into surgery, please!!! Before you agree to ANY surgery, take your MRI and get at LEAST 2 other opinions from NEUROSURGEONS (NOT neurologists!!) You must have more opinions on this as this is a very serious operation. Any time you're dealing with a spinal operation, it's Serious!!!

If all 3 surgeons agree that surgery is necessary, then I guess it is. But if even one suggests that physical therapy be tried FIRST, go for it. In this country too many spinal surgeries are being done, when physical therapy would have given the SAME RESULTS. Latest studes HAVE shown that people who have had spinal surgery ended up with the SAME results as people who have had physical therapy. :eek: Now that just shows us that surgeons are all too ready to operate!!!

Plus there is the danger of the "Domino Effect." This happens more often than not. This is where the levels above/below fail, because they've had to take on more of the load -- the doctors never tell you about this. And also, surgery is ONLY for mechanical problems. It is NOT for pain. Most of the time, you're left with the same pain after surgery that you had before or even worse. :( So don't expect pain relief. You MIGHT be lucky, but most of us aren't. :(

I wish you the very best. If you have further questions, go to the "Spinal Disorders" forum and post them there. You'll get more replies there. God bless and take care. Hugs, Lee :)

Thank you. I forgot to mention that the doctor says that due to all of this, I also have a pinched artery. That scared me. He was surprised that I was not experiencing difficulty in walking. What artery would that be and does that make my condition more serious?

hope you get some results
 

[QUOTE=knowledge hungry;977101]Need this explained so I can understand. After I heard the words, "You have severe damage", almost everything else was a blur. I am female, 5 ft tall, 120 pounds, and almost 60. I have been doing heavy lifting at work for 3 years, with lots of repetitive motions and reaching up over my head all day. I have filed a workers comp claim-has not yet been approved. Doc is talking about going through the front of my neck to fix if pain and numbness in arm does not subside. Hard to process all of this......




Occiput to T4 evaluated in the sagittal plane. Mild to moderate disc space narrowing at the c5-c6 level. The craniocervical junction, cervical thoracic junction are normal in appearance.


Hi Knowledge hungry welcome to neuro talk, I have the same thing at my c6-c7 and the pain was unbearable with out the surgery I decided to go the physio route and medication it has been a long journey but I am doing fairly well on most days. My med regiment is Lyrica 450mg day, cymbalta 120mg a day, oxyneo 40mg a day and percacet 5mg for break through up to 3 times a day, meditation at least 40min a day and I might add I rolled my eyes at my specialist about that one and well she was right. I also have exercises that the pain team layed out for me that I do every single day and wow I am now living I have most of my life back. If I can be of any help just let me know.

Wow! I applaud you for the way you are handling your pain situation! Sounds like you are just taking it one day at a time. I am seeing another doctor for a 2nd opinion in a few weeks, then I will be able to better make a decision as to how I need to handle this....just tired of hurting...

Great to meet you!!
 

Welcome to NeuroTalk.

I'm very new here myself, but I am glad you found us.
it seems to me you are starting in the right direction, and I hope you can get your pain issues managed soon

I didn't see it mentioned here yet, but I would advise you start a notebook to write all your questions in, then you may bring that to the next doc, and you don't leave that appt until you get your questions answered.
I always seem to forget what I wanted to ask once the face to face occurs.
And keeping a journal really helps.
Hope this helps
:Heart:

Hi knowledge hungry;

Yes surgery should be a last resort --but yours are very large herinations and I think you may end up like a few of us on here with spinal fusion(acdf) from c4-7--i had it done 2010 I dont have regrets at all. It gave me my life back. How bad is your pain??? I was in really bad shape before surgery pain was mind blowing . I wont sugar coat---- with those size herinations--- i have a feeling surgery may be your best option. Most important are you getting pain down arms with fingers going numb?---This surgery its done for neurlogical reasons to prevent perm nerve damage. However-- most of the time it provides great pain relief too. I agree always get 2 consults. I wish you all the best!!! Feel free to ask more ? if you like.