Do not understand results of neck mri

Tagged: Neck MRI

Viewing 3 posts - 1 through 3 (of 3 total)

Author

Posts
Webdeb1
Participant

October 17, 2019 at 5:59 am

Post count: 2

#31308

Hello,

I am 58 years old (female). I had an injury in 1991 (sign fell on my head with 60 mph winds) with resulting neck fusion in 1994. I no longer live in the state where I had cervical fusion and hard to schedule doctors a ways from where we reside since we live in more rural area. Also, have had more pressing medical issues. Hard to get appts in my state even though we are insured. Over the years, had a few mri’s and have adjusted my lifestyle to continuing DDD. I also have lower back issues with spondylitis, pars defect, some disc bulging, etc. For lower back, I get along with occassional steroidal pads, occasional back brace, an injection 2 years ago, mild exercise and walking daily. Once in a while, my lower back goes out for several days, but I recover.

I am not very well versed in understanding my neck mri results. My neck is in pain quite often, but I have learned to live with it. Causes spasms and subsequent migraines from neck spasms, but imitrex always resolves migraine quite effectively. Neck cracks a lot upon movement. I am careful not to move neck quickly and range of motion is not too bad, considering, but I make do and still enjoy my hobbies. I seem to manage okay with imitrex for migraines, daily walks, wearing a soft brace for longer car rides, occasional traction over door. I had a neck injection about 10 years ago. I do not take any painkillers and cannot tolerate NSAIDS due to tummy issues. Tylonel does not do anything. I am stoic and do okay. Occasional massage helps loosen neck. I keep busy to distract from pain or I am tired from pain and just relax. I can tolerate the pain. I really do not want surgery again, but would if I was at higher risk. This life style has worked for me for several years now. For a couple years, I get numbness on my front right thigh when walking. Doctors cannot explain and think it is possibly Meralgia paresthetica. My Gp concurs. Stretching does help that condition and it is not a problem as I can still walk.

My last mri a couple years ago, I simply do not understand the terminology, even with google. But I get worried I could be at risk and maybe should not continue to ignore it. Can you please help me understand my last MRI? I really appreciate the help.

Here it is:

MR Cervical Spine wo Contrast

IMPRESSION:
1. Multilevel degenerative disc disease, spondylosis and facet arthropathy.
2. Degenerative changes most pronounced at C3-4, C4-5 and C5-6 where there is moderate or moderate to severe central canal stenosis and significant neural foraminal stenosis bilaterally as detailed below.
3. No acute abnormality.

INDICATION:
GENDER/AGE: Female,
ORDER INDICATION: R29.2:Abnormal reflex

TECHNIQUE: A magnetic resonance imager was used to acquire T1 and T2-weighted images in the sagittal and axial planes. The exam is technically adequate.

COMPARISON: 11/4/2016

FINDINGS: Alignment is normal. There is solid bony fusion of the C6 and C7 vertebral bodies. There is spondylosis throughout the cervical spine, with moderate to severe disc height loss at C3-4, C4-5 and C5-6. There is multilevel facet arthropathy.
There is no fracture identified. No prevertebral fluid collection or edema. Cervical cord shows slightly prominent central canal, as well as snake eyes appearance with punctate T2 hyperintense foci in the ventral aspect of the cord at the C6-7 level,
most likely related to compressive myelopathy.

Findings by level:

C2-3: No central canal or neural foraminal stenosis. No disc protrusion or extrusion.

C3-4: Posterior broad-based osteophyte/disc complex resulting in cord flattening and moderate central canal stenosis similar to prior exam. There is bilateral uncovertebral spurring and facet arthropathy resulting in severe left and moderate right neural
foraminal stenosis.

C4-5: Posterior broad-based osteophyte/disc complex flattens the cervical cord greatest on the right, resulting in moderate to severe central canal stenosis. There is moderate to severe bilateral neural foraminal stenosis.

C5-6: Posterior broad-based osteophyte/disc complex effaces the thecal sac resulting in moderate central canal stenosis without significant cord compression. There is bilateral uncovertebral spurring resulting in moderate to severe bilateral neural
foraminal stenosis.

C6-7: Solid bony fusion with no central canal stenosis or neural foraminal encroachment.

C7-T1: No central canal or neural foraminal stenosis.

Webdeb1
Participant

October 17, 2019 at 10:28 am

Post count: 2

#31309

I want to add one possible symptom which may or may not be related. When I flex my neck/head forward to look at my arm pit to shave my underarms (sorry tmi), I see stars similar to stars one might see before fainting. I do not feel faint and it only happens flexing neck in this particular circumstance. So I now use a mirror to shave underarms so this does not happen.

Donald Corenman, MD, DC
Moderator

October 19, 2019 at 7:15 am

Post count: 8660

#31312

You emote a perfect description of how to manage your symptoms. The symptoms are problematic but tolerable. Your MRI does have some concerning features however.

“C3-4: Posterior broad-based osteophyte/disc complex resulting in cord flattening and moderate central canal stenosis…There is bilateral uncovertebral spurring and facet arthropathy resulting in severe left and moderate right neural foraminal stenosis.
C4-5: Posterior broad-based osteophyte/disc complex flattens the cervical cord greatest on the right, resulting in moderate to severe central canal stenosis. There is moderate to severe bilateral neural foraminal stenosis.
C5-6: Posterior broad-based osteophyte/disc complex effaces the thecal sac resulting in moderate central canal stenosis without significant cord compression. There is bilateral uncovertebral spurring resulting in moderate to severe bilateral neural foraminal stenosis”

The foraminal stenosis I am not too worried about. This type of stenosis would cause nerve compression and radiculopathy which you do not complain of. It is the central stenosis that is somewhat concerning. The description of severe stenosis at C4-5 means your cord is in some jeopardy. The spinal canal narrows when your head is extended (bent backwards). If you had a fall impacting your forehead, there is a possibility of a spinal cord injury. With chronic compression, some patients develop myelopathy. See https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/ and https://neckandback.com/conditions/spinal-cord-injuries-neck/ and look at central cord syndrome.

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.
Author

Posts

Viewing 3 posts - 1 through 3 (of 3 total)

You must be logged in to reply to this topic.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel