[demodebi]

any help would really be appreciated....

Cervical spine mri with anesthesia support
MR SEQUENCES:
1. coronal T2
2. axial gradient T2
3. sagittal T1, T2, STIR

FINDINGS:
Osseous Structures: There is convex right lateral curvature of the cervial spine. There is sollid osseous interbody fusion of C4 and C5, and there is an anterior plate and screws and interbody graft at C6-7. Metallic artifact from fixation hardware partially obscures adjacent structures. The exam is felt to be diagnostic. There is multilevel facet arthrosis most pronounced on the right at C2-3 and C3-4, and associated with periarticular marrow edema at these facet joints compatible with active or inflammatory arthritis. There is ankylosis of the left C4-5 facet joint. There are multiflevel small endplate spurs. There is reversal of the usual cervical lordotic curvature. The alignment is otherwise unremarkable.

Spinal Cord and Canal: There is no Chiari malformation or intraspinal mass. The cervical cord is of normal signal intensity

Intervertebral Disc Levels: C2-3: There is a minimal annular disc buldge. Facet hypertrophy mildly narrows the right neuroforamen

C3-4 There is a minimal annular disc bulge. Facet hypertrophy mildlynarrows the right neuroforamen.

C4-5 There is no central canal orneuroforamina stenosis at this level of fusion.

C5-6: same as above

C6-7 Uncovertebral osteophytes result in mild to moderat narrowing of the neuroforamina greater on the right

C7-T1: There is an annular disc buldge and superimposed right foraminal protrusion abutting the cord without compression and resulting in moderate to severe narrowing of the right neuroforamen.

The visualized upper thorasis intervertebral levels are unremarkable.

IMPRESSION:

1. c4-c7 anterior cervical fusion surgery
2. c7-t1 annular disc buldge and superimposed right foraminal protrusion abutting the cord without compression and resulting in moderate to severe right neuroforamen stenosis.
3. Active or inflammatory arthritis of the cight c2-3 and c3-4 facet joints associated with periarticular marrow edema
4. Please refer above for detailed level by level description of findings.

RIGHT SHOULDER MRI with anesthesia support

MR SEQUENCES:
1. axial gradient proton density fat suppressed
2. sagittal t1-t2
3. coronal t1-t2, t2 fat suppressed

FINDINGS: Supraspinatus Outlet. There is a mild arthrosis of the acromioclavicular joint. the acromial undersurface is anteriorly hooked (type III) and there is a mild lateral acromial downsloping. there is trace fluid within the subacromial subdeltoid bursa.

Rotator cuff. there is a heterogeneous intermediate increased signal intensity, thickening and fraying of the supraspinatus tendon compatible with moderate tendinosis. the rotator cuff musculature is unremarkable

Glenhumeral joint: there is a small effusion. there is abnormal increased signal intensity and fraying of the superior glenoid labrum compatible with SLAP tear. the long head of the biceps tendon appears normal and is appropriately located within the bicipital groove.

Misc. There is no Hill-sachs lesion

IMPRESSION:
1. Moderate rotator cuff tendinosis
2. Superior glenoid labrum tear (SLAP)
3. Mild arthrosis of the acromioclavicular joing
4. small glenohumeral joint effusion

THANK YOU FOR ANY HELP IN UNDERSTANDING YOU CAN GIVE ME....

[Leesa]

Hi ~ I'll try to help

First, there is multilevel facet arthrosis -- the facets are the "wing-like" structures on each side of the spinal cord. Sometimes you can see and feel them if you hunch your back over. Arthrosis degenerative disease of the joint.
There is also ACTIVE inflammatory arthritis and ankylosis of the left C4-5 facet joint. Ankylosis is stiffness or fixation of a joint by disease or surgery. The curvature of the neck is not normal - this can be caused by muscle spasms.

C2-3 Minimal annular disc bulge. Facet hypertrophy mildly narrows right neuroforamen. Facet hypertrophy is overgrowth of bone. The neuroforamen are the holes that the nerves pass thru to get to the spinal canal. Yours are becoming narrow.

C3-4 Same as above

C4-5 Normal

C5-6 "

C6-7 Uncovertebral bone spurs result in mild to moderate narrowing of neuroforamina/mostly on right. (see above)

C7-T1 Annular disc bulge and right foraminal protrusion abutting the cord without compression resulting in moderate to severe narrowing of the right neuroforamen. (see above)


I'm afraid I CANNOT explain the should MRI. I'm only good at cervical and lumbar MRI's. I'm sorry. Perhaps if you posted ONLY your shoulder MRI, someone would be able to explain that. I hope so anyway!! Maybe if you posted it TO DUBIOUS personally -- he's excellent!!

If you have any questions, let me know, ok? Hugs, Lee

[demodebi]

Thank You soooo much!!!!....

Now the million dollar question....what can/should/could be done???....how dangerous is it...???....will this cause the pain I am having?.....I'm on morphine and norco.....and after 1 1/2 hrs need to take more....kwim?

again thanks...I was beginning to feel alittle lonesome..lol

[demodebi]

also how do I post to TO DUBIOUS ????...is he in this forum or another?..thanks again!

[Jomar]

Originally Posted by demodebi

also how do I post to TO DUBIOUS ????...is he in this forum or another?..thanks again!

On any post by a member you can click the username on the left and a drop down will appear with options , like to PM them.

Or do a member name search and find them that way.

[Leesa]

Debi ~ I do NOT think that your cervical spine is a surgical event. I don't think that surgery would help you AT THIS TIME. BUT, if you'd feel better, take your films to a NEUROSURGEON for his opinion. If he mentions surgery, take the films to 2 MORE surgeons, as you should NEVER take one doctors opinion on something like this.

Surgery is only for mechanical problems. Surgery is NOT for pain. Usually after surgery, you are left with the same pain or worse. Plus you have the "Domino Effect." This is where the levels above/below fail. That is because they have to take on more of the load. Then when you have surgery to fix that, the levels above and below THAT fail, and you have to have surgery to fix it, and it goes on and on and on. It's a vicious circle. The doctors don't tell us about that.

Your best bet would be either physical therapy or pain management. Physical therapy would be my first choice. I would try that for a good while, and if that doesn't help, I'd go into pain management. There are procedures they can do to relieve your pain.

Best of luck to you dear Debi. I hope everything works out well for you. PLEASE let us know how things go, okay? Or you can private message me. God bless and please take care. Gentle hugs, Lee