[andrewjwd]

Hi. So happy to find this forum and see an there's a place where people can discuss these types of issues. I'm 37 and have been having this issue in my neck for 17 years. No injury that I can remember, just woke up one morning with a stiff neck and it got worse and worse. Seems to flare up about every 1 to 2 years and lasts for 3-6 months. I have pain in my neck when looking up or to the right and radiates down my arm to my finger tips. But just my thumb and first finger. This flare up in my worst yet, and the numbness is near 100%. Pain last week was so severe, it was unimaginable. I tell people it's an 11. 10 is the most severe pain you can imagine, and 11 is the pain you didn't know the human body could experience. I'm feeling better after taking 5 days of prednisone and I'm currently in PT. However I'm not sure it's really helping. Anyways, I see a nerosurgeon sometime in the next couple weeks. I'm just exhausted from being in so much pain, but scared to have surgery if that's what it comes down to. Anyways, here's my MRI, let me know what you think.

AGE: 37 years DOB: 12/8/1976 GENDER: Male

PROCEDURE: MRI CERVICAL SPINE WO CONTRAST, 4/15/2014 3:56 PM

COMPARISON: Cervical x-ray on March 28, 2014.

CLINICAL INDICATION: NECK PAIN AND RADIATION. Neck pain
radiates to the right arm and fingers on and off.

TECHNIQUE:
MRI of the cervical spine was obtained with the following
sequences: Sagittal T1-weighted, T2-weighted, and STIR. Axial
GRE and T2-weighted.

FINDINGS:
Osseous Structures: There is straightening of the cervical spine
the curvature, which could be seen in muscle spasm versus
positioning. Cervical spondylosis is seen at C4, C5, and C6
vertebrae. No significant loss of vertebral body height is
present. The bone marrow signal is mildly heterogeneous, which
could be seen in red bone marrow reconversion.

Ligaments: No abnormal signal or tears.

Spinal Canal: Visualized spinal cord is normal in caliber and
signal. No epidural fluid collections.

Craniocervical Junction: Within normal limits.

Prevertebral and Paraspinal Soft Tissues: Visualized portions
within normal limits.

Findings at individual levels are as follows:

C2-3: No significant disc osteophyte complex, spinal stenosis,
or neuroforaminal stenosis.

C3-4: Focal central disc osteophyte complex bulge is present
without causing significant central canal or neural foraminal
stenosis.

C4-5: Mild left paracentral disc osteophyte complex bulge is
present. No central canal or neural foraminal stenosis.

C5-6: There is a large asymmetric right paracentral and right
neural foraminal disc osteophyte complex protrusion which causes
moderate to severe right neural foraminal stenosis and moderate
right lateral recess stenosis. This measures approximately 2 cm
transverse, 0.6 cm AP, and 1 cm CC. The disc osteophyte complex
protrusion impinges on the right C7 descending nerve root. The
osteophyte complex protrusion effaces the anterior thecal sac
right paracentrally, and displaced the cord posteriorly slightly
to the left. This results in moderate right paracentral canal
stenosis. The left neural foramen is patent.

C6-7: Moderate broad-based posterior disc osteophyte complex
bulge is present superimposed by uncovertebral hypertrophy. This
results in moderate to severe bilateral neural foraminal
stenosis, moderate bilateral recess stenosis, and moderate
central canal stenosis. Bilateral C8 descending nerve roots may
be affected by the disc osteophyte complex bulge.

C7-T1: No significant disc osteophyte complex, spinal stenosis,
or neuroforaminal stenosis. Left-sided ligamentum flavum
thickening is seen.



Impression:

IMPRESSION:

1. Large right paracentral and right neural foraminal disc
osteophyte complex protrusion at C5-6, which causes moderate to
severe right neural foraminal stenosis and moderate right lateral
recess stenosis, moderate right paracentral canal stenosis. It
impinges on the right C7 descending nerve root.
2. Moderate broad-based posterior disc osteophyte complex bulge
at C6-C7 superimposed by bilateral uncovertebral hypertrophy. It
causes moderate to severe bilateral neural foraminal stenosis,
moderate bilateral lateral recess stenosis, and moderate central
canal stenosis. This may impinge on bilateral C8 descending nerve
roots.

Please correlate with clinical examination for right C7 and C8
radiculopathy, and the left C8 radiculopathy.