[KristiK]

#22880

_PROCEDURE: MRICERVICALSPINE

PATIENT DEMOGRAPHICS: 26, white, female, 5’0, 110 lbs, exercises regularly

CLINICAL HISTORY: Upper back pain (both constant dull and occasional sharp) and numbness (solid numbness between shoulder blades, not tingling) for the past three years. 2 months of physical therapy recently did not cause any improvement, and it made things worse. Exercises in physical therapy that caused sharp shoulder pain also led to intense pressure and tingling in neck and base of skull, with tingling going into the jaw line.

COMPARISON: None

TECHNIQUE: High-field, multiplanar, multisequence MRI of the cervical spine was performed.

FINDINGS: No evidence of recent fracture. No aggressive nor destructive marrow pathology. No abnormal signal of the cervical nor upper thoracic spinal cord. No paraspinous soft tissue abnormality detected. Visualized intracranial contents are unremarkable. Arterial flow voids intact.

C2-C3: Compensatory lordosis effaces subarachnoid space around dorsal spinal cord with dorsal cord flattening. Normal midline sagittal canal diameter. No disc herniation. No nerve impingement.

C3-C4: Kyphosis associated with minimal ventral cord flattening. Ample subarachnoid space preserved dorsal to the spinal cord with normal midline sagittal canal diameter. Ample fat preserved around intraforaminal right and left C4 nerve root.

C4-5: Dorsal disc bulge between 1 and 2 mm with shallow ventral cord can cavity. Subarachnoid space narrowed and nearly effaced around dorsal spinal cord without dorsal cord deformity. Midline sagittal canal diameter 10 mm. Fat preserved around intraforaminal right and left C5 nerve roots.

C5-C6: Kyphosis centered at this level with broad-based dorsal disc bulge between 1 and 2 mm creates ventral cord flattening. Subarachnoid space partially effaced around dorsal spinal cord. Midline sagittal canal diameter between 9.5 and 10 mm. Ample ubarachnoid space and fat preserved around intraforaminal right and left C6 nerve.

C6-C7: No disc herniation. 1 mm retrolisthesis and disc bulge without disc herniation. No ventral cord flattening. Subarachnoid space partially effaced around dorsal spinal cord. Midline sagittal canal diameter 10 mm. Ample fat preserved around intraforaminal right and left C7 nerves.

C7-T1: Normal

Normal central AP canal diameter of the cervical spine is 13-15 mm. A midline sagittal cervical AP canal diameter of less than 12 millimeters has increased association with clinical symptoms including myelopathy and/or radiculopathy.

IMPRESSION:
1. Multilevel cervical canal compromise and cord flattening described above. No cervical nerve or upper thoracic cord edema nor myelomalacia identified.
2. No cervical nerve root impingement identified.

[Donald Corenman, MD, DC]

#23124

There is no evidence of nerve compression in your MRI. The cord is somewhat compressed but there is no reported symptoms of myelopathy present. I am not clear what the origin is of your symptoms. Has your thoracic spine been addressed diagnostically?

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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