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  • aleeya
    Post count: 2

    I am 41 years old and I have been diagnosed with Degenerative Disc Disease. I had an MRI done on my neck after neck pain, numbness in arm and hand and fingers asleep an hour or two even after I wake up. (I also had carpel tunnel surgery in the same hand to try to relieve some of the symptoms in the hand.)

    The impression from the MRI reads as:

    1 Multi-level disease with degenerated discs seen at all levels.
    2 Left paracentral disc protrusion seen at C5-6 which effaces the cord.
    3 At C6-7 large disc protrusion is seen that extends into the neural foramina and neural canal the displaces and flattens the cord.
    4 normal marrow signal with bones in anatomic alignment.

    To me this is greek.

    The Dr that ordered the mri (pain management dr) did not have much to say about it other than an injection could help but eventually surgery will be the answer.

    In another place of findings, the page also reads

    Facet arthropathy is seen on the left at C3-4

    C4-5 left neural foraminal narrowing is present with facet arthrosis. Small central disc protrusion is seen. There is no effacement of the cord.

    C5-6 broad based left paracentral disc protrusion is noted. This effaces the cord and displaces it. The disc measures 10 mm in length. Neural foramen on the right is patent; the left neural foramen is encroached upon diffuse disc bulge.

    At C6-7 left paracentral disc protrusion is present that extends partially into the neural foramen measuring 17mm in width. There is flattening, effacement, and displacement of the cord. Lifting of the posterior longitudinal ligament is seen on the sagittal images.

    Could you help me understand what this impression means? Is this a very serious or common thing? (And to what degree?)

    For 10+ years I had problems with back pain and eventually that lead to surgery (XLIF) on my back, and I am just hoping my neck is not too serious to need more surgery.

    To my understanding this is not normal for my age.

    I believe I posted this in the incorrect forum and I will try to move it to a different forum about reading mri’s.

    ps: I Tried to figure out how to move this to a different forum, but I cannot figure out how. My apologies for posting in the incorrect forum.

    Donald Corenman, MD, DC
    Post count: 8468

    “A flattened cord” could be only somewhat concerning or a significant finding that needs to be addressed surgically. This depends upon two things. The central canal space which is the entire space for the cord and your examination findings and symptoms.

    The cord typically is shaped like a kidney bean when viewed on end. A bone spur or disc bulge can efface the cord and allow the cord to flatten at this area of stress. If there still is room for the cord behind the flatted area (which will be viewed as and area of white signal due to the CSF-water present), then the risk is not as great.

    If there is no further room behind the cord, then this places the spinal cord in jeopardy. The reason is that the spinal canal changes in volume with neck position. When you bend your head backwards (extension), the spinal canal actually looses 30% of the volume. A fall onto the front of the head will force a quick backwards bend. This can pinch the cord and cause a central cord injury (find a description this on the website).

    If there is still room in the back of the canal as noted on the MRI, the chances of this injury lessen.

    The other problem that could occur with cord flattening is myelopathy (again-look on this website for description). This is a chronic malfunction of the spinal cord and has specific signs and symptoms that are associated with this disorder.

    With either case (severe narrowing or presence of myelopathy), it is my opinion that this cord compression needs to be addressed surgically. If neither problem is present, then your risks of cord malfunction are lowered.

    Your neck pain is most likely derived from degenerative disc or facet disease. You can find full explanations of these disorder on this website.

    Dr. Corenman

    Post count: 2

    Thank you so much for your reply! It will help me a great deal in making future decisions. I appreciate your time and comment!

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