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bardogg 11-21-2013 08:11 PM

cervical/lumbar stenosis MRI results
 
Greetings everyone -- I was diagnosed with lumbar and cervical stenosis recently. I have persistent numbness/tingling in both pinkies and my right foot. I also get radiating pain down my right thigh, which is disk-related. Recently my lumbar region has been persistently achy. I also couldn't walk straight with my eyes closed in a recent dr. exam. Finally, I think my grip in both hands is weakening and that I may be getting clumsier.

I just received the cervical MRI results and wanted to get any reactions/advice. I have an EMG scheduled for tomorrow and follow-up with neuro doc (not a surgeon) in early Jan.

I've read a bit about stenosis and my sense is that it's either surgery or wait--there's really nothing in between, correct? My symptoms are annoying but not debilitating by any means, but I don't want to have nerve damage.

Thanks for any advice/reactions. Here are my MRI results, cervical first then lumbar:

HISTORY: Neck pain with radiculopathy.

COMPARISON: None.

RESULT:

Counting reference: Craniocervical junction.

Alignment: Alignment is anatomic.

Craniocervical junction: Craniocervical junction is normal.

Cord: Cervical spinal cord is normal in signal intensity.
Bone marrow signal/fracture: No evidence of pathologic marrow
infiltration. No evidence of prior fracture.

Cervical soft tissues: The paraspinal soft tissues are unremarkable.

C2-C3: Canal and foramina are patent

C3-C4: Uncovertebral change mildly narrows the left foramen. The
central canal and right foramen are patent.
C4-C5: Uncovertebral change moderately narrows the left foramen. The
central canal and right foramen are patent.


C5-C6: Interspace is moderately narrowed. Prominent disc osteophyte
change is asymmetric to the left with mild ventral lateral cord
compression on the left, severe left and mild to moderate right foraminal
encroachment.

C6-C7: Interspace is mildly narrowed. Prominent disc osteophyte change
the left results in mild ventral lateral cord compression with severe
left foraminal encroachment. Right foramen is patent.

C7-T1: Canal and foramina are patent
IMPRESSION:

Diffuse cervical spondylosis notable for mild ventral lateral cord
compression on the left and severe left foraminal encroachment C5-6 and
C6-7. Foraminal encroachment and additional degenerative changes as
detailed above.

RESULTS:
There is minimal degenerative loss of disk height at L4-L5 and moderate
to severe degenerative loss of disk height at L5-S1.

L4-L5: Mild generalized bulging disk with questionable superimposed
shallow broad-based right foraminal disk protrusion, mild degenerative
facet and ligamentum flavum hypertrophy combine to cause mild bilateral
foraminal stenosis. Central canal patent.

L5-S1: Mild generalized bulging disk with superimposed shallow
broad-based right foraminal disk protrusion, degenerative facet and
ligamentum flavum hypertrophy combine to cause severe right and
mild-moderate left foraminal stenosis. There is asymmetric narrowing of
the right lateral recess. Central canal patent.

Dr. Smith 11-23-2013 02:08 AM

Hi bardogg, welcome.

Quote:

Originally Posted by bardogg (Post 1031077)
I've read a bit about stenosis and my sense is that it's either surgery or wait--there's really nothing in between, correct? My symptoms are annoying but not debilitating by any means, but I don't want to have nerve damage.

Maybe yes—maybe no. First line treatment is usually physical therapy, and for pretty good reason. Cervical surgery is a risky proposition that should not be taken lightly. Studies have shown that long term, surgery results are no better than physical therapy. There are a few other therapies that should be considered/tried before surgery as well.

This recent post has some of the articles, studies, & links.

http://neurotalk.psychcentral.com/post1014835-57.html

Doc


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