[lmy13]

#8772

Hi Doc,need some major advice had a mri that says i have borderline stenosis 8 mmm ap cervical cord size in few areas c5.6 disk spur and material in anterior epidural space with complete effacement,bony right narrowing 8mm ap cord size,c57 disk and spur material anteriorly especialy on right side right lateral recess and right foraminal narrowing ,slight indentation of right side of cord no no displacement of compression .c 3.4 disk and spur material in anterior epidural space in symetrical fasion,uncinate hypertrophy narrowing left foramen,ap measurment is 9 mm , c4 .5 disk and spur material in anterion epi dural space simetricaly bony narrowing both sides no central stenosis or cord compression. 2 nd mri of same area says some linear hyperintense “SIGNAL” near mouth level thought to be from swallowing or movement.. straigtning of c spine… and c 3..4 congenital narrowing ,uncovertabrl hypertrophy broad based disk osteophytes flatens anterior ventral csf compartment causing left moderate to right moderate foraminal narrowing,canal narrowing w/borderline spinal stenosis.same for c4 ..5….. c 5…6 right para central broad base disk osteophytes ,uncov hypertrphy cause bilateral foraminal narrowing, canal narrowing w/borderline stenosis.. c6…7 disk herniation indents anterior ventral csf compartment canal narrowing,borderline spinal stenosis..right facet disease causing moderate to severe foraminal stenosis.. c7 ..8 no significant stenosis or narrowing..now my docs exam showed .. i have weakness in arms hand legs balence issue,pain in shoulder arm and and neck and headaches dizziness tingeling and knumbness in my finger and side of great toe positive slr,ue 4/5 reflexes 3/4 planters and flexers b/l decreased sensation in big toes and right sied urinary dificulties and and some lack of sensation arms,im am having difficulty with babance,difficulty with doing small stuff with hands ,grasping things is difficult and numbness and tingeling are always present in my right hand and fingers and this is only my neck issuemy lumbar spine is just as bad but thats another forum.. …decrease rom in neck .now my delema is although the neur doesnt think these finding are of major signifcance and although he feel there are issue of concern (foraminal stenosis and nerve involvement)is the question that in question,how much causes issues… my internist feel a bit more concerned and of coarse im pretty unconmfortable with alot of pain and issue that interfere with my adls im confused why there is such a difference of opinions and the same with the radiologist repot why such difference in wording and opinions..i know what i feel and its certanly very far from normal ..your opinion would be greatly appriciated , now ive heard so many things on cord contact some say it has to be a certain amount to cause symptoms other say nerve and cord are very sensative and minor amounts can produce issues and also what happens with movement doesnt that increase the stenosis thus cause symptoms to worsen if there borderline impingement and stenosis..feel like im going crazy..

[Donald Corenman, MD, DC]

#8779

Paragraphs please next time to allow me to follow your train of though more easily.

“I have weakness in arms hand legs balence issue,pain in shoulder arm and and neck and headaches dizziness tingeling and knumbness in my finger and side of great toe positive slr,ue 4/5 reflexes 3/4 planters and flexers b/l decreased sensation in big toes and right sied urinary dificulties and and some lack of sensation arms,im am having difficulty with babance,difficulty with doing small stuff with hands ,grasping things is difficult and numbness and tingeling are always present in my right hand and fingers and this is only my neck issue”

These are classic symptoms for myelopathy (see website) and myelopathy is associated with cord compression.

This MRI reading indicates cord compression

“borderline stenosis 8 mmm ap cervical cord size in few areas c5.6 disk spur and material in anterior epidural space with complete effacement,bony right narrowing 8mm ap cord size,c57 disk and spur material”

Spinal canals are typically at least 13mm in diameter.

I had a hard time understanding if you had cord signal change on your MRI.

Did you have flexion/extension X-rays taken and if so, what did they reveal. Remember that the MRI is performed with you lying down and the X-rays reveal what gravity and motion does to your neck.

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.

[lmy13]

#8784

yes their was an abnormal cord signal but it was refered to as it was thought to be caused by swallowing or motion at time or mri..humm..Im not sure about that since the herniation is at the very same place..also theres a degenerative endplate signal abnormality of the l4 vertibral body.guessing that another issue all together. also in l4-5 herniation pressing fat between herniation and ventral surface or exiting nerve root,no significant nerve root comp or displacement,moderate face hypertrophy, moderate thickening of ligamentum flavum ,fluid in facet joints.oh gees that another mri all together l5 si small herniation making contact on nerve root.. I did have x ray of c spine but says in the report was very generised and over 1 /1/2 ys ago 6-7 anter osteo phyte degen disk space narrowing moderate multi level deg change straighnening of c lordes mild scoloiosis with 3 mm retrolisis at l4-5 does say it ap was abtained but it doesnt report it..skimpy at best.. sorry for the non paragraphs this area doesnt leave much room for editing and it delete whae you try too ,forgive the typos my hands arent to cooperate these days..

[lmy13]

#8790

Hi dr I replyed to your question but im guessing you didnt get to it yet,,the is reference to cord signal in first question,and I responded with the same info i highlighted where it say hyperintensitie in cord signal..also just realised how to do the paragraphs..

[Donald Corenman, MD, DC]

#8791

There are false signals due to motion artifact on some MRIs. If there is a signal change in the cord and it is right at the narrowest section of the canal, this signal is more likely due to cord injury than artifact if we factor in your symptoms.

You probably have some problems with your lumbar spine also but your cervical spine problems are more important at this point and need to be addressed. You need an opinion from another spine surgeon as it sounds like you have myelopathy.

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.

[lmy13]

#8800

there seems to be 1 white spot a circle at the narrowing and 2 slight one ubove and below I tried to attach an image but i dont know how..

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