Do not understand results of neck mri

///Do not understand results of neck mri
Do not understand results of neck mri

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  • AvatarWebdeb1
    Participant
    Post count: 2

    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.

    AvatarWebdeb1
    Participant
    Post count: 2

    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.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7070

    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.
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