[Alaskaguy9]

#27002

I am a 42 yrs old male who has had neck and pain issues for the last five years. I have my good days with sometimes no pain, but lately more bad days. I would appreciate it if you could give me any advice looking at these MRI findings I just had done recently.

Contrast: None
Technique sagittal T1 spin echo and T2 fast spin echo, sagittal STIR, formanial oblique sagittal T2 fast spin echo, and axial gradient echo or T2 fast spin echo through the cervical spine.

C2-C3 Loss of disc signal. no central stenosis. No neural foraminal narrrowing. No neural impingenment.

C3-C4 Loss of disc signal. Minimal, diffuse disc bulge. No central stenosis. No neural foraminal narrowing. No nerual impingement.

C4-C5 Loss of disc signal. Mild, diffuse disc bulge. Mild narrowing of the central canal secondary to disc disease. Mild bilateral nerual foraminal narrowing secondary to disc disease. No neural impingement.

C5-C6 Loss of disc signal and height. Moderate, diffuse disc bulge. Severe narrowing of the central canal secondary to disease with slight flattening deformity cervical spinal cord. Moderate bilateral uncovertebral joint hypertrophy. Severe bilateral neural foraminal narrowing secondary to disc and uncovertebral joint disease with flattening deformity of the exiting C6 nerve roots bilaterally.

C6-C7 Loss of signal. Moderate, diffuse disc bulge. Severe narrowing of the central canal secondary to disc disease without flattening deformity of the cervical spinal cord. Mild bilateral uncovertebral joint hypertrophy. Moderate bilateral neural foraminal narrowing secondary to disc disease and uncovertebral joint hypertrophy. no neural impingement.

Impression
Multilevel degenerative disc disease

Multilevel uncovertebral joint hypertrophy

Severe C5-C6 and C6-C7 central canal narrowing. Mild C4-C5 central canal narrowing

Severe bilateral C5-C6 neural foraminal narrowing. Moderate bilateral C6-C7 neural foraminal narrowing. Mild bilateral C4-C5 neural foraminal narrowing.

Slight flattened deformity of the cervical spinal cord at the level of the C5-C6 disc secondary to central canal narrowing.

Flattened deformity of the exiting bilateral C6 nerve roots secondary to neural foraminal narrowing.

I also have a finding for my Lowerback

L5-S1 Loss of disc signal. Mild diffuse disc bulge. Mild biteral facet hypertrophy. No central stenosis. Left foraminal disc protrusion. Left foraminal disc protrusion causes moderate to severe left neural foraminal narrowing and impinges on the exiting left L5 nerve root. Mild right neuroforaminal narrowing secondary to disc disease and facet hypertrophy.

Impression

L5-s1 degenerative disc disease

L4-L5 and L5-S1 facet arthropathy

No central stenosis

Moderate to severe left and mild right L5-S1 neural foraminal narrowing. Mild bilateral L4-L5 neural foraminal narrowing.

Flattening deformity of the exiting left L5 nerve root secondary to left disc protrusion.

Any help or giving me an idea how bad this is I would appreciate.

Michael

[Donald Corenman, MD, DC]

#27005

Your neck is more concerning than your lower back but that back is a close second. You have severe central and foraminal stenosis at C5-6. This will affect the spinal cord and the C6 and C7 nerve e roots. See https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/ to understand central stenosis and see https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/ to understand what a C6 and/or C7 nerve compression looks like.

For your lower back, you have degenerative disc disease at L5-S1 with compression of the left L5 nerve root. See https://neckandback.com/conditions/causes-of-lower-back-pain/ for lower back pain and see https://neckandback.com/conditions/symptoms-of-lumbar-nerve-injuries/ to understand what an L5 nerve compression looks like and we’ll start there.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Alaskaguy9]

#27020

Thank you for the reply Dr. So based on this can I expect the Neurosurgeon to recommend surgery, or what would you suggest to your patient?

[Donald Corenman, MD, DC]

#27021

It really depends upon your history, symptoms, activity level and expectations. If the cord compression is severe, you have to be careful of injury causing cord damage.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Alaskaguy9]

#27267

Good afternoon Dr. Corenman,

I had the consultation with the Neurosurgeon and he seemed to pretty rushed and quick with his recommendation that all he could do for me was surgery since injections and PT had no positive effects in previous years. He just wanted to wait 30 days for me to quit smoking and gave me another appointment. I am just wondering what your opinion is, he said that that the severe stenosis is pretty bad with the nerves being compressed.

thank you in advance.

Michael

[Donald Corenman, MD, DC]

#27323

I think that with severe central cervical stenosis, you need to consider surgery soon. Since smoking can affect an ACDF surgery (https://neckandback.com/treatments/anterior-cervical-decompression-and-fusion-acdf/) by decreasing the fusion rate by as much as 30%, he has good cause to worry about you. No surgeon wants their good work ruined by smoking.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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