[nfred]

#35006

Hello!
I just recently saw the results from a MRI I had back in 2020. I wasnt given the results at the time of the test. At the time I had lessened sensation in my rt leg and also developed an inability to urinate for which I was catheterized for 2 months, which resolved on its own. I am now experiencing severe left sided facial pain, it feels nerve to me and it is constant and waking me up at night. I have an appointment with a neurologist in june, but I am wondering if I should see a neurosurgeon. I am 41 years old.
This is the result of my C/T spine MRI:

Mild multi-level disc desiccation most pronounced at c6-c7. posterior elements and paraspinal soft tissues are normal. There is a 6mm linear focus of T2/STIR signal hyperintensity within the right hemicord centered at the c6-c7 level. There is no abnormal enhancement.
c4-c5 – There is facet and uncoverterbal joint arthropathy which contributes to mild to moderate left neural foraminal narrowing.
c5-c6 – There is a right paracentral disc herniation and ligamentum flavum thickening causing mild spinal canal stenosis without foraminal narrowing.
c6-c7 – There is a disc osteophyte complex and ligamentum flavum thickening which contributes to moderate spinal canal narrowing and moderate bilateral neural foraminal narrowing, left greater than right.
Thoracic Spine
There is mild anterior loss of height of the t8 vertebral body with an intravertebral disc herniation along the superior t8 endplate. normal curvature.
There is an intravertebral disc desiccation the t6-t7 level with an associated right paracentral and subarticular disc herniation which mildly remodels the right ventral cord.
IMPRESSION:
1. Cervicothoracic spondylosis, as detailed above, most prominently contributing to moderate spinal canal narrowing and moderate bilateral neural foraminal at c6-c7 level.
2. Linear focus of T2/STIR signal hyperintensity within the right hemicord at the c6-c7 level is nonspecific and may reflect myelomalacia in the setting of the aforementioned spondylosis. There is no abnormal enhancement. While a demyelating lesion and cord edema may have a similar appearance, they are considered less likely but cannot be entirely excluded in the absence of prior imaging.

Thank you for your help

[Donald Corenman, MD, DC]

#35007

Facial pain generally is not caused by cervical spine issues as the cervical nerves really don’t ascend into the head. Facial pain can be caused by cranial nerve involvement but these nerves are generally not affected by the cervical spine. The trigeminal nerve might be involved.

You do have cervical stenosis (“moderate spinal canal narrowing and moderate bilateral neural foraminal narrowing”) with some cord involvement (“Linear focus of T2/STIR signal hyperintensity within the right hemicord at the c6-c7 level is nonspecific”) and you may have had a prior cord injury without knowing it. Do you participate in neck risking activity (MTN biking, Skiing, skateboarding, contact sports??).

At this point, a neurologist would be the appropriate choice.

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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