Hi Everyone,

I am new to this board and am looking for information on my MRI. The results look a little scary to me. I have a appt. with a neurosurgeon next week and am trying to get a head of the game with all the knowledge I can get before I see him.
I am a 51 year old female and was involved in a car accident last July. My Dr. finally ordered a MRI 7 months later and these are the results.

Findings: The cerebellar tonsils descend 5 mm below the foramen magnum. The spinal cord demonstrates normal signal intensity and morphology and at the vertebral bodies demonstrate normal signal intensity without evidence of vertebral body height loss or edema. The disk spaces demonstrate moderate desiccation and narrowing at C6-C7 with Modic 2 type endplate changes.. Prevertebral soft tissues and surrounding soft tissue structures are within normal limits. Segmental analysis reveals the following:

C2/3: There is no canal or foraminal stenosis
C3/4: There is very mild bilateral foraminal stenosis secondary to facet arthropathy slightly more pronounced on the left. There is a small central diskal protrusion. The canal is congenitally narrowed.
C4/5: There is congenital narrowing of the canal with a right central diskal protrusion and bilateral facet hypertrophy. This results in moderate to severe right and moderate left foraminal stenosis with moderate canal stenosis and flattening of the right portion of the cord.
C5/6: There is a central and right central diskal extrusion with congenital canal narrowing and bilateral facet hypertrophy. This results in moderate to severe left and only mild right foraminal stenosis, however, there is moderate Canal stenosis with deformation of the anterior contour of the cord.
C6/7: There is a broad based disk-osteophyte complex, congenital canal stenosis and bilateral facet hypertrophy. There is resultant moderate bilateral foraminal stenosis early more pronounced on the left secondary to the disk osteophyte. There is mild canal stenosis at this level without deformation of the cord contour.
C7/T1: There is no significant canal or foraminal stenosis.

Impression:
1. Congenitally narrow canal superimposed by diskal protrusions and extrusions results in significant canal stenosis at the C4-C5 and C5-C6 levels.
2. Uncovertebral and facet arthropathy result in foraminal stenoses as described above.
3. A borderline Chiari one malformation.


I also didn't mention all the symptoms I have going on with this mess. I have pain in my left shoulder, scapula area and tingling in my left hand. Also have tingling and numbness in right hand. I had a EMG done and that Dr. said I have carpal tunnel syndrome in my right wrist. I do not do a job where I would get carpal tunnel. I do believe this is coming from my neck and so does my P.T.
I've been in P.T. since Aug. and also do Acupuncture. Not really getting any relief from either.
I drive for a living and have a lot of anxiety after the car accident. Also having a lot of anxiety of the possibility of having surgery.
Thanks in advance for all your feedback and help!

I'll try to help decipher with MRI:

At the top is says "moderate dessication & narrowing of C6-7: this means that the discs are drying out. When the discs dry out they flatten and bulge and sometimes herniate. The "narrowing" -- I'm not sure WHAT'S narrowing.

C3-4 Mild bilateral foraminal stenosis -- the foramen are the holes that the nerves go thru to get to the spinal cord, and they're getting narrow. Facet arthropathy is disease of the facets - probably arthritis. There is also a small central disc herniation. The spinal canal is congenitally narrow meaning from birth.

C4-5 Congenital narrowing of spinal canal with right central disc herniation & facet hypertrophy. Hypertrophy is overgrowth of bone. This results in moderate to SEVERE and moderate left foraminal stenosis (see above) with moderate canal stenosis (the spinal canal is getting narrow) and flattening of the right portion of the cord. The Foraminal stenosis could be causing this.

C5-6 Central and right central disc herniation with congenital canal narrowing with bilateral facet hypertrophy (see above). This results in moderate to SEVERE left and only mild right foraminal stenosis (see above) . However there is moderate canal stenosis (see above) with deformation of the anterior contour of the spinal cord.

C6-7 Broad based disc-osteophyte complex -- this is a herniation along with bone spurs. Plus congenital canal stenosis (see above) and bilateral facet hypertrophy (see above). This results in bilateral foraminal stenosis (see above) more pronounced on left secondary to disc osteophyte. Mild canal stenosis at this level without deformation of cord contour.

The radiologist also mentions a Chiari 1 malformation, and for the life of me I cannot remember what that is. I'm sorry. But you DO have some concerns here and the one that bothers me the most is at C4-5, where the cord is flattened. You should ask your doctor to get you a referral to a NeuroSURGEON (NOT a Neurologist!!!) and get an opinion. If this Neurosurgeon suggests surgery, take your films to 2 other Neurosurgeons and get opinions from them too, because spinal surgery is VERY SERIOUS. Surgery should be a LAST RESORT after all conservative methods have been tried.

Also, surgery will NOT remove all your pain. Usually after surgery you're left with the same pain or worse. Surgery is for mechanical problems. So don't expect pain relief. Some people DO get pain relief and they're lucky.

Any, get some opinions on what should be done. Like I said, I do see some concerns here, and I hope others will chime in too. God bless and take care. Hugs, Lee