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Good Morning,
Thank you for all of the support you provide to us and our interpretation of results.
I am hoping you can help me understand the true impact of these MRI results. I was recently hit by a stolen four door truck, only after the driver jumped out and accelerated upon doing so. I was stationary (parked in front of my home). When all was said and done it was a five car pile up as he hit me hard enough to force me into the three cars (parked with a cars length distance between each). My vehicle was totaled. I have been in PT since June and am having chronic pain in neck and back, clavicle and right rib cage. My rib cage and collar bones are offset. What my PT called a lateral ring rib shift. I suffer shoulder blade pain (dominate right) and other symptoms I did not used to suffer. Weakness in hands and legs, and sometimes I still feel as if my brain is thinking like it did while concussed. Just a bit off.
I am to receive a spinal epidural so long as the MRI results are not prohibitive in hopes it provides relief to neck back and shoulders.
Do you think this is a proper way to treat? How do I mitigate the pain and weakness that is attributed to the findings, and does the straightening of the natural cervical lordosis explain blurry vision, lightheadedness and almost a bobble head kind of feeling? I have been largely unable to be active since being hit and am hoping to regain some mobility and relief in my neck and back with the proper treatment.
Since being hit my neck and back (as well as hips) have become quite bothersome. Any feedback is appreciated as reading through your forum I learned a tremendous amount.
This is my 3rd MRI since 2011 however c6-c7 showed only mild DDD at time of last scan. I did have a CT scan at the hospital following the accident. Will an epidural provide relief?
Thank you.
FINDINGS:
Marrow signal: Within normal limits.
Alignment: Mild straightening of the normal cervical lordosis without
subluxation.Cervical cord: Normal in signal and morphology.
The C1-C2 relationship is maintained.
C2-3: Unremarkable.
C3-4: Unremarkable
C4-5: Unremarkable
C5-6: Mild degenerative disc disease with small bilateral
uncovertebral joint osteophytes without significant stenosisC6-7: Moderate size Right paracentral Broad-based disc extrusion which
migrates about 3 to 4 mm superiorly and 4 mm inferiorly. This is
causing proximal right foraminal stenosis and moderate right central
stenosis.C7-T1 T1-2 and T2-3 and T3-4 are unremarkable
IMPRESSION:
C6-7 shows a right paracentral moderate-sized broad-based disc
extrusion, described above, causing proximal right foraminal stenosis
and moderate right central stenosis.C5-6 shows mild degenerative disc disease
Apologies. Perhaps to provide previous scans may be beneficial:
Examination: MR C SPINE WO CON – 3221161 – Aug 16 2011 1:18PM
Accession No: 9793659
Reason: EVAL FOR MS
REPORT:
INDICATION: Chronic pain and intermittent numbness and tingling.
COMPARISON: MRI brain on 11 2011
TECHNIQUE: Axial T1 and T2 and sagittal T1, T2, and STIR
noncontrast MRI of
the cervical spine .
FINDINGS: Alignment is within normal limits. Normal bone marrow
signal. No
compression deformity. Normal disc signal.
Cervicomedullary junction is within normal limits. Signal and caliber
of the
cervical spinal cord are within normal limits.
Paraspinal soft tissues are within normal limits.
The C1-C2 relationship is within normal limits.
C2-C3: No herniation or stenosis.
C3-C4: No herniation or stenosis.
C4-C5: No herniation or stenosis.
C5-C6: No herniation or stenosis.
C6-C7: Posterior disc osteophyte complex. Mild central spinal canal
stenosis.
C7-T1: No herniation or stenosis.
IMPRESSION:
1. C6-C7 mild central spinal canal stenosis.
2. Normal cord signal.2015:
INDICATION: Chronic neck pain, fibromyalgia, neuropathy, bilateral
decreased
sensation of arms and hands, intolerable arm pain, burning and
tingling,
TECHNIQUE: Sagittal T1, T2, STIR and axial T1 and T2-weighted
images of the
cervical spine were obtained. Following 6 mL intravenous Gadavist
gadolinium
repeat sagittal and axial T1-weighted images.
COMPARISON: MRI cervical spine 8/16/11
FINDINGS:
Cervical vertebral alignment has been adequately maintained.
The craniocervical junction is unremarkable.
C2-C3: No disc bulge or stenosis.
C3-C4: No disc bulge or stenosis.
C4-C5: No disc bulge or stenosis.
C5-C6: Minimal disc bulge and endplate hypertrophy. Minimal
stenosis. No
cord compression.
C6-C7: Small broad-based right posterior lateral disc protrusion. Mild
stenosis with minimal if any cord compression/displacement.
Findings are
similar to 8/16/11..
C7-T1: Minimal central bulge without stenosis.
T1-T2: No disc bulge or stenosis.
The cervical spinal cord has normal signal. No abnormal intradural
enhancement.
IMPRESSION:
1. C6-C7 small broad-based right posterior lateral disc protrusion
with mild
stenosis, minimal if any cord compression and no significant change
since
August 2011.
2. No abnormal signal or abnormal enhancement in the cervical
spinal cord.My other question is is this something, based on the seemingly progressive nature, that i can expect to continue to get worse. Or is it simply case by case and I do my best to mitigate pain and any further injury? I know I was not in a tremendous amount of discomfort prior to being hit in may and the right side of my body is out of whack. Truly would just love a professional set of eyes and a conclusive opinion, in vernacular. Although a scientist, I have a hard time fully comprehending the scans, over the plane of time, and with MVA now in consideration.
Lastly, I have been experiencing terrible hip pain (almost feels like plantar fasciitis but in my right hip bone). My PT states my hip flexors are terrible and that if i am able to rebuild core strength I should lessen the pain associated with chronic chostochondritis and whiplash. Is the hip pain something i should have checked while working with my neurologist? It recurs intermittently, as does the foot pain, and is miserable in the moment, but tends to subside. No body part is exempt from a twitch, muscle cramp, going numb, or a stabbing sharp pain.
Again. Thank you so very sincerely. Of the multitudes of doctors i have interacted with, to see your replies, and resulting knowledge means so much to so many of us.
Your symptoms could to be referral pain from either disc or facet origin or from a radiculopathy (“chronic pain in neck and back…shoulder blade pain (dominate right)… I still feel as if my brain is thinking like it did while concussed”). Your change in mentation is most likely from your concussion.
Your MRI notes a herniation at right C6-7 and a degenerative disc at C5-6 (“C6-7 shows a right paracentral moderate-sized broad-based disc extrusion, described above, causing proximal right foraminal stenosis
and moderate right central stenosis…C5-6 shows mild degenerative disc disease”). This could explain your shoulder blade pain on the right. Find a reputable spine surgeon who can diagnose your condition and then recommend a selective nerve root block for both diagnosis and possible treatment.I cannot explain your hip or foot symptoms from the information provided.
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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