[ladybug5563]

#11043

Cervial MRI 2014

FINDINGS: There is straightening of the normally observed cervical lordosis and diffuse cervical disc dehydration dhange. The posterior fossa is clear. Discogenic changes in the midcervical spine are most pronounced, characterized by endplate ridging, early disc height loss, and formation of dorsal disc osteophytes.
C2-C3: There is minimal posterior extension of disc annulus. Joints are intact. There is no central or foraminal narrowing.
C3-C4: Minimal dorsal disc narrowing. There is very slight ridging of the right facet joint. No stenosis.
C4-C5: 2 mm dorsal disc osteophyte complex, minimal uncinate ridging. No stenosis.
C5-C6: 5 mm dorsal disc osteophyte complex effaces the anterior epidural space, contacting and slightly flattening the ventral cord surface. Uncinate spur on the left causes a moderately sever narrowing of the foraminal outlet.
C6-C7: 5 mm broad disc osteophyte complex in continuity with spurred uncinate joint margins causes a moderate narrowing of the central canal and moderate to moderately severe left and mild to moderate right neural foraminal narrowing.
C7-T1: Tiny 1 mm left paracentral protrusion does not have mass effecton the cord. the neural foramina are widely patent.
T1-T2: Minor facet joint ridging but no stenosis.
T2-T3: More significant facet spur at this level is associated with moderate to moderately severe right and moderate left neural foraminal narrowing.

IMPRESSION:
1. Moderate to moderately severe central and foraminal narrowing at C5-C6 and C6-C7 as above.

2. There is significant foraminal stenosis at T2-T3 from facet spur formation. There is no cord edema and no bone stress response. Noted straightening of the normally observed cervical lordosis may alter spinal biomechanics and can be associated with muscle spasm.

Lumbar MRI 2014

Conus and cauda Edina have a normal appearance. The fluid sensitive sequence shows edema across the left facet joint at L5-S1. Intervertebral discs are normal in signal and height at every level. Numbering assumes five non rib-bearing lumbar vertebrae.
T10-11 through L1-L2: Unremarkable.
L2-L3: A small foraminal protrusion is depicted both right and left as on the prior study. In association with mild facet capsular thickening and ridging, this causes mild foraminal canal narrowing. Sagittal image 10 series 3 shows left foraminal annular fissure.
L3-L4: Mild facet capsular thickening and very small foraminal protrusions with fissures bilaterally associated with moderate foraminal narrowing. Central canal is clear.
L4-L5: Mild endplate bony ridging, very subtle posterior extension of disc annulus, modest hypertrophy of facets and very slight narrowing of the neural foraminal outlets.
L5-S1: On the left, the pars interarticularis appears irregular, thin, some scelorisis but also edema-like signal change. There is a tiny synovial cyst within capsular tissue behind the left neural foraminal outlet, sagittal image 11 series 6. There is a very minor degeneration/ridging of the right facet joint. disc margin is clear. there is only minimal narrowing of the neural foraminal outlets. Degenerative-type cyst if seen along the inferior facet surface on the left on axial image 29 series 7.
IMPRESSIONS:
1. left-sided pars irregularity and facet arthropathy/inflammation L5-S1 has progressed from the prior inflammation is more apparent on the current study which includes a STIR sequence. There is only a minor narrowing of subjacent neural foraminal outlet and no evidence for nerve root impingement at L5-S1.

2. At L2-3 and L3-4 a small foraminal protrusions persist and are stable. There is associated early facet DJD and mild to moderate neural foraminal narrowing at these two levels.

[Donald Corenman, MD, DC]

#11046

MRIs do not live in a vacuum. You need to correlate the symptoms and physical examination findings to the images to understand what could be causing the pain.

You could have C6 or C7 radiculopathy (nerve root compression-see cervical radiculopathy on the website) or you could have myelopathy (see cervical stenosis on the website) based upon your MRI findings (“Moderate to moderately severe central and foraminal narrowing at C5-C6 and C6-C7 as above”). Look also at “symptoms of cervical nerve injuries” to understand what these nerve roots can cause regarding symptoms.

In the lumbar spine, you might have the beginnings of an isthmic spondylolisthesis, pars fracture or degenerative spondylolisthesis based upon the reading (“left-sided pars irregularity and facet arthropathy/inflammation L5-S1 has progressed from the prior inflammation is more apparent on the current study which includes a STIR sequence”). You can read about these disorders on the website.

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.

[ladybug5563]

#11062

Are there any type of surgery options available for my problems that I could research?? I started epidural injections but they are not helping.

[Donald Corenman, MD, DC]

#11064

There are surgery options available but you must first have a diagnosis through a thorough history, a physical examination, review of all your images and any confirmatory tests.

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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