[Donald Corenman, MD, DC]

#32128

I don’t necessarily need your actual images but the word-based radiological report of those images.

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.

[cttennan]

#32137

This was the 1st MRI from Aug 2018
Technique: Sagittal T2, sagittal T1, sagittal STIR, axial T2.

There is a transitional lumbar sacral junction with partially
sacralized right L5 vertebral body. Vertebral height is maintained.

At L5/S1, no disc bulge or lateralizing disc herniation is present.

At L4/L5, no disc bulge or lateralizing disc herniation is present.

At L3/L4, there is mild disc space narrowing with small anterior
marginal osteophyte formation. There is a small 1.2 cm in height by 5
mm in AP by 5 mm in transverse dimension right subarticular inferior
disc extrusion extending to the mid L4 vertebral body (series 6,
images 7-8). Disc herniation causes mild narrowing of the right
lateral recess with mild impingement of the subarticular right L4
nerve root. Bulging disc causes minimal inferior foraminal
encroachment.

At L2/L3, there is disc desiccation with mild disc space narrowing and
small anterior marginal osteophyte formation. Bulging disc causes
minimal thecal impression and minimal inferior foraminal encroachment.

At L1/L2, there is disc desiccation with tiny Schmorl’s nodes and tiny
anterior marginal osteophyte formation. There is minimal posterior
bulging of the annulus. No limiting central or foraminal stenosis is
present.

At T12/L1, there is disc desiccation. Small left paracentral disc
protrusion causes mild thecal impression without neural impingement or
limiting central stenosis.

At T11/T12, there is a shallow central disc protrusion causing minimal
thecal impression.

The conus terminates at T12/L1 and is normal in signal and in caliber.

Localizer images demonstrate an indeterminant 2.5 cm in height right
lateral renal lesion possibly a renal cyst.

IMPRESSION: MRI lumbar spine.
1. Transitional lumbar sacral junction.
2. Small right subarticular inferior disc extrusion at L3/L4 causes
mild impingement of the subarticular right L4 nerve root coursing
through the right lateral recess.
3. Small left paracentral disc protrusion at T12/L1 and shallow
central disc protrusion at T11/T12 cause minimal to mild thecal
impression without neural impingement or limiting central stenosis.
4. Indeterminant 2.5 cm right lateral renal lesion possibly a renal
cyst. Correlation with patient’s outside abdominal imaging suggested.
If none are available then renal ultrasound could be performed to
confirm cystic nature. 8/7/2018

This is the cervical and lumbar MRI from Dec 2018

From the skull base to T4 was imaged. There is mild cervical scoliotic
positioning convex towards the right. Vertebral height is maintained.

At C2/C3, minor left-sided uncovertebral joint hypertrophy is present
without causing significant foraminal encroachment.

At C3/C4, uncovertebral joint hypertrophy results in mild thecal
impression and minimal left foraminal narrowing.

At C4/C5, there is mild disc space narrowing with tiny anterior
marginal osteophyte formation. There is a broad-based disc osteophyte
complex effacing the ventral and dorsal subarachnoid space slightly
deforming the ventral cord. The central canal is narrowed to an AP
diameter of approximately 8.8 mm. Uncovertebral joint hypertrophy
results in severe bilateral foraminal stenosis.

At C5/C6, there is mild disc space narrowing with small anterior
marginal osteophyte formation. There is a bulging disc with
spondylitic ridging contacting the ventral cord. The central canal is
minimally narrowed to an AP diameter of approximately 9.6 mm.
Uncovertebral joint hypertrophy results in severe bilateral foraminal
stenosis.

At C6/C7, there is mild disc space narrowing with small anterior
marginal osteophyte formation. Bulging disc causes mild thecal
impression. Uncovertebral joint hypertrophy results in severe left
foraminal stenosis.

At C7/T1, bulging disc causes minimal thecal impression.

At T1/T2, small right paracentral disc protrusion causes mild thecal
impression without cord impingement.

At T2-T3, shallow right paracentral disc protrusion causes minimal
thecal impression.

At T3/T4, bulging disc with spondylitic ridging contacts the ventral
cord. The dorsal subarachnoid space is maintained.

No intrinsic cord signal abnormality is identified. Cervical medullary
junction appears unremarkable. Paraspinal soft tissues appear
unremarkable.

IMPRESSION:Noncontrast MRI cervical spine.
1. Cervical scoliotic positioning convex towards the right.
2. Mild cervical and proximal thoracic spondylosis.
3. Small disc osteophyte complexes cause mild thecal impression with
minimal to mild narrowing of the central canal at C4/C5 and at C5/C6.
No evidence for underlying cord signal abnormality.
4. Uncovertebral joint hypertrophy results in prominent bilateral
foraminal stenosis at C4/C5, bilaterally at C5/C6 and on the left at
C6/C7 with neural impingement.

PROCEDURE: Contrast-enhanced lumbar spine MRI.

There is a transitional lumbar sacral junction with partially
sacralized right L5 vertebral body. Vertebral height is maintained.
There is a minor lumbar levoscoliosis.

At L5/S1, no disc bulge or lateralizing disc herniation is present.

At L4/L5, no disc bulge or lateralizing disc herniation is present.

At L3/L4, there is mild disc desiccation with mild disc space
narrowing and small anterior marginal osteophyte formation. There is
evidence of interval right hemilaminectomy with resection of inferior
right-sided disc extrusion. Bulging disc with enhancing posterior
annular fissure causes minimal thecal impression and minimal inferior
foraminal encroachment. There is mild facet arthropathy with trace
facet joint effusions. Mild enhancing granulation tissue is identified
within the laminectomy bed.

At L2/L3, there is disc desiccation with mild disc space narrowing and
small anterior marginal osteophyte formation. There is a bulging disc
causing minimal thecal impression and minimal inferior foraminal
encroachment, unchanged.

At L1/L2, there is disc desiccation with tiny Schmorl’s nodes and
small anterior marginal osteophyte formation. There is minimal
posterior bulging of the annulus slightly eccentric towards the left
without causing neural impingement or limiting central stenosis. No
significant foraminal narrowing is present.

At T12/L1, tiny Schmorl’s nodes are present. There is a small left
paracentral disc protrusion causing mild thecal impression without
neural impingement, unchanged. Neuroforamina are patent.

At T11/T12, there is a shallow central disc protrusion causing minimal
thecal impression, unchanged.

The conus terminates at T12/L1 and is normal in signal and in caliber.

There is again evidence of a 2.6 cm in height T2 hyperintense lesion
within the lateral midpole of the right kidney probably a renal cyst,
unchanged.

IMPRESSION:Contrast-enhanced lumbar spine MRI.
1. Transitional lumbar sacral junction.
2. Interval right hemilaminectomy at L3/L4 with resection of inferior
right-sided disc extrusion.
3. Stable small left paracentral disc protrusion at T12/L1 and
shallow central disc protrusion at T11/T12 causing minimal thecal
impression.
4. Possible small right lateral midpole 2.6 cm renal cyst.
Correlation with patient’s outside abdominal imaging suggested. If
none are available then renal ultrasound could be performed to confirm
cystic nature.

This is the cervical MRI from a couple of weeks ago

Comparison is made with previous examination dated 1/8/2019.

Procedure: Noncontrast MRI cervical spine.

From the skull base to the mid T4 vertebral body was imaged. There is
mild cervical scoliotic positioning convex towards the right.
Vertebral height is maintained.

At C2/C3, minor left-sided uncovertebral joint hypertrophy is present
without causing significant foraminal encroachment.

At C3/C4, there is a shallow left paracentral disc osteophyte complex
contacting the ventral cord. The dorsal subarachnoid space is
maintained. Uncovertebral joint hypertrophy results in minimal left
foraminal narrowing, unchanged.

At C4/C5, there is mild disc space narrowing, tiny Schmorl’s nodes and
tiny anterior marginal osteophyte formation. There is a broad-based
disc osteophyte complex effacing the ventral and dorsal subarachnoid
space slightly deforming the ventral cord. The central canal is
narrowed to an AP diameter of approximately 8.6 mm compared with 8.8
mm, previously. Uncovertebral joint hypertrophy results in severe
bilateral foraminal stenosis, unchanged.

At C5/C6, there is mild disc space narrowing with small anterior
marginal osteophyte formation. There is a broad-based disc osteophyte
complex slightly eccentric towards the right contacting the ventral
cord. The dorsal subarachnoid space is maintained. The central canal
is minimally narrowed to an AP diameter of approximately 9.6 mm,
unchanged. Uncovertebral joint hypertrophy results in severe bilateral
foraminal stenosis, unchanged.

At C6/C7, there is mild disc space narrowing with small anterior
marginal osteophyte formation. Bulging disc causes mild thecal
impression without cord impingement or limiting central stenosis.
Uncovertebral joint hypertrophy results in severe left foraminal
stenosis, unchanged.

At C7/T1, bulging disc causes mild thecal impression.

At T1/T2, small superior right paracentral disc extrusion causes mild
thecal impression without cord impingement. Disc herniation has
slightly increased in size when compared to previous examination.

At T2/T3, shallow right paracentral disc protrusion causes minimal
thecal impression, unchanged.

At T3/T4, bulging disc with spondylitic ridging contacts the ventral
cord. The dorsal subarachnoid space is maintained.

No intrinsic cord signal abnormality is identified. Cervical medullary
junction appears unremarkable. Paraspinal soft tissues appear
unremarkable.

IMPRESSION:Noncontrast MRI cervical spine.
1. Mild cervical scoliotic positioning convex towards the right be
secondary to muscular spasm or patient positioning.
2. Stable cervical spondylosis with small disc osteophyte complexes
causing minimal cord impingement and narrowing of the central canal at
C4/C5 greater than than at C5/C6. Central canal stenosis has slightly
increased at C4/C5. No evidence for underlying cord signal
abnormality.
3. Slight interval increase in size of right-sided disc herniation at
T1/T2 causing mild thecal impression without cord impingement.
4. Uncovertebral joint hypertrophy again results in multilevel
prominent foraminal stenosis, unchanged. 2/13/2020

[Donald Corenman, MD, DC]

#32189

These are great MRI results but without symptoms, I cannot correlate these imaging findings. See
https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-neck-shoulder-and-arm-pain/ and
https://neckandback.com/conditions/how-to-describe-your-history-and-symptoms-of-lower-back-and-leg-pain/

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.

[cttennan]

#32190

The original lumbar spine MRI was a result of severe hip, and calf pain that happened after carrying a large suitcase down a flight of stairs. It started with a cramp in my hip and started traveled into the side of my calf a few days later. After a week it became difficult to sit for any period of time. I did not have any back pain. I would get a shock like jolt when I would stand up or turn at the waist. I developed weakness in the right leg along with drop foot and it became more difficult to walk. I thought I was having a problem with my hip and had no idea it was my back causing the problems. The pain level was about an 8. I went to the chiropractor to get an adjustment. I explained my symptoms to the chiropractor and he tried to adjust me. As soon as he positioned me a had the electric shock pain shooting down the right side. I decided it was time to visit the orthopedic for further evaluation. The Dr. immediately recognized the symptoms and referred me for a MRI and neurologist follow up. 2 weeks later none of the symptoms changed and I went to my neurologist appointment and was immediately scheduled for surgery. I had nerve compression at L3/L4 that was causing the problems. After surgery I had instant relief of the pain and symptoms. that was August 2018.

December 2018 my back felt better that it had in years. I was on a forklift at work moving some pallets and had stopped to let another forklift pull out of an aisle when I was struck from behind by another forklift. I immediately felt pain from my neck down to my tailbone. I was taken to the hospital for evaluation and a CT scan. The CT scan did not show any major trauma. For the next several weeks I was in a considerable amount of cervical and lumbar pain 8-10 when walking around and a 5-6 at rest. I started to lose sensation in my hands and had numbness in my fingers and thumb. The pain in the neck was dull aching pain with some shock pain when turning my head. I made an appointment with my surgeon for evaluation. I had some hyper-reflexia and tested positive for Hoffman’s sign. I had the 2nd MRI and the surgeon said there was nothing that needed immediate surgical repair. I was referred to PT and chiropractic care. I did the 8 weeks of PT and several months of Chiro care. The pain and numbness slowly got better but i never recovered completely (symptoms never fully went away). I still have numbness in my hands and electric shocks that run down my arms when I turn my head left or right. I am also having stiff neck and mid back spasms daily. The pain is in the base of my neck down to the middle of my shoulders pain is 5-7. The pain is mainly dull and achy with some sharp pains. Over the past 3 months the intensity has increased and the duration has also increased. It has been about 4 months of neck/upper back ache pain level 5-8. Pain in my left and right shoulder that goes down the triceps and the lateral forearm. Pain ranges from a 5-8 depending on activity. Also have loss of sensation in thumb and index finger left and right hand. They constantly feel numb. Lying on my back makes it feel a little more comfortable pain around 2-3. Dull ache between my shoulder blades 2-3 resting and 6-8 sitting at a desk or driving. It started to become difficult to sit at my desk and driving makes me uncomfortable. I hope this is helpful for your evaulation

[Donald Corenman, MD, DC]

#32201

“I had nerve compression at L3/L4 that was causing the problems. After surgery I had instant relief of the pain and symptoms. that was August 2018”. Your current MRI reads relatively normally. You don’t report significant symptoms in your lower back or legs.

In December 2018, “I was struck from behind by another forklift”. “I had some hyper-reflexia and tested positive for Hoffman’s sign… I still have numbness in my hands and electric shocks that run down my arms when I turn my head left or right…pain is in the base of my neck down to the middle of my shoulders pain is 5-7”.

C4-5: “central canal is narrowed to an AP diameter of approximately 8.6 mm compared with 8.8 mm, previously. Uncovertebral joint hypertrophy results in severe bilateral foraminal stenosis”.
C5-6: “Uncovertebral joint hypertrophy results in severe bilateral foraminal stenosis”
C6-7: “severe left foraminal stenosis”.

You have severe foraminal stenosis at C4-7 with potential radiculopathy of the C5, C5 and left C7 nerves. See https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/ and https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/.

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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