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Cervical Spinal Stenosis?
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TOPIC: Cervical Spinal Stenosis?

Re: Cervical Spinal Stenosis? 2 years, 6 months ago #1574

Hello Dr. Corenman. I have the written report of the MRI but not the disk. I imagine if I ask our doctor for it I could get a copy. Our doctor said he's not that good at reviewing MRI's. This is the report from the radiologist if you don't mind reading. I just don't know how to interpret what it is saying, and thank-you for your time.
Clinical History: C6-C7 foraminal steniois less so on right. Weakness of grip and strength bilateral arm.
Technique: Saggital T1W and T2W images of the cervical spine have been obtained, as well as axial ED T2W images.
Magnetic Resonance Image Findings:
No subluxation is seen.
No disc herniation or stenosis is noted at C2-C3 and C3-C4.

At C4-C5, moderate broad-based anterior endplate marginal osteophytes with diffuse disc bulging are noted. However, there is no disc herniation or stenosis.

At C5-C6, minor broad-based anterior and posterior endplate marginal ostoephytes with diffuse disc bulging (i.e. osteocartilaginous bars) are noted. There is encroachment of the canal, but no cord abutment or deformity is seen. There is moderate left foraminal stenosis due to encroachment by moderate marginal osteophytes at the left uncovertebral joint. Minor osteophytes are noted at the right uncovertebral joint with mild right foraminal stenosis.

At C-C7, disc space narrowing and fatty endplate changes are noted. Minor anterior and moderate posterior endplate marginal osteophytes with diffuse disc bulging (i.e. osteocartilaginous bars) are noted. There is encroachment of the canada, but no cord abutment or deformity is seen. Marked osteophytes are noted at the left uncovertebral joint with marked left foraminal stenosis. Minor osteophytes are also noted at the right uncovertebral joint with mild right foraminal stenosis. No disc herniation or stenosis is noted at C7-T1.
The cervical cord is normal in size and configuration. Nor abnormal signal intensity is seen.

Interpretation: Endplate osteophytes with diffuse disc bulging (i.e. osteocartilagnious bars) at C5-C6 and C6-C7, osteophytosis at the uncovertebral joints at C5-C6 and C6-C7. Canal stenosis with no cord abutment or deformity and bilateral foraminal stenosis at C5-C6 and C6-C7 (moderate at C5-C6 and marked at C6-C7 on the left at both levels).

Thanks Dr. Corenman.

At C5-C6, minor broad-based anterior and posterior endplate marginal osteophytes with

Re: Cervical Spinal Stenosis? 2 years, 6 months ago #1578

MRI findings are important but need to be compared to your symptoms and physical examination findings. All the symptoms you note are "Weakness of grip and strength bilateral arm".

I can tell you what symptoms you could have based upon the MRI findings. You have no real central cervical stenosis per the radiologist so myelopathy should not be present (see website for description). The most significant findings you have are moderate to severe foraminal stenosis on the left of C5-6 and C6-7.

This would cause left arm pain and paresthesias (pins and needles) that radiate down to the thumb and fingers on the thumb side of the hand. You might have a weak left triceps and biceps muscle. You might have problems with strong grip in your left hand. Bending your head backwards (extension) could cause the pins, needles and pain to increase down your left arm.

Dr. Corenman
Dr. Corenman

This answer is for educational purposes only and is not a substitute for a diagnosis from a qualified professional. Do not try to diagnose or treat yourself based solely upon reading this material.

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Re: Cervical Spinal Stenosis? 2 years, 6 months ago #1590

I wonder when they did the MRI, how far down the neck they go. He seems to have a lot of pain at the very base of the neck, I'm not sure where the cervical spine ends and joins the rest of the spine. When he rolls his left shoulder it makes this snapping sound - think an x-ray of his arm said something about crepitus and scapula. The nape of his neck is very painful, he says it feels like there's a large nail being driven into it. He ran a big grinding machine at work that had a pneumatic assist for opening the left door that was never hooked up from the time the machine came, so 2,600 opening and closings of that door per week - I think that's why the left side is worse.

Where the problem seems to be in diagnosis is that he's likely had the stenosis developing over a period of time, and then he had the trauma lift of the tool box. I'm trying to find scholarly articles also that confirm that trauma can cause or heighten the stenosis. Compensation cut him off after a few weeks; the workplace said his injury didn't match his job description....it's a real nightmare and no income for over a year now. Comp. says they believe it's a gradual onset injury.

If they think it's arthritis then they'll say everyone gets it - mind you this happened at 43 years of age, and no history of arthritis in the family. He can't work at this kind of heavy job any more, and seems to be in pain from even grating cheese etc.

I'm wondering if I should get the disc, report and try to find a spine specialist here near London, Ontario Canada. I'm also wondering if he needs an mri of his upper back/nape of neck area.

The weakness/numbness is worse in the left arm and hand. This is a real ordeal, I appreciate your words.

Re: Cervical Spinal Stenosis? 2 years, 6 months ago #1604

Pain at the base of the neck is the hallmark of degenerative disc disease of the neck itself. Thoracic disc issues can cause pain at the base of the neck too but I have found that 95% of this pain is generated by the cervical spine.

Everyone will develop "arthritis" although I do not like that word for the degenerative changes of the neck. Most individuals do not develop significant pain regardless of the degeneration and the degenerative changes make the neck vulnerable to injury.

You do need a spine specialist to help sort out this dilemma.

Dr. Corenman
Dr. Corenman

This answer is for educational purposes only and is not a substitute for a diagnosis from a qualified professional. Do not try to diagnose or treat yourself based solely upon reading this material.

back pain forum • lower back pain forum • spine surgery forum • neck pain forum
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          This website is for educational purposes only.  Do not try to diagnose or treat yourself based solely upon reading this material.  For a medical diagnosis, please see a qualified professional.
           
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