[CrystalBus]

#31177

I have had 2 MRIs and been sent in circles to several doctors with no help at all.

REASON FOR EXAM:
Cervicalgia, neck pain/tightness/fills like neck car inches an also headaches and shooting pain down both arms and numbness in the 1st 3 digits of the right hand and history of MVA February 2019 per the patient/technologist note
COMPARISON: None
TECHNIQUE:
Multiplanar, multisequence MR imaging of the cervical spine was performed without contrast.
FINDINGS:
There is straightening of expected lordosis which can be seen related to positioning but can also be seen related to muscle spasm/splinting from pain in the appropriate clinical setting. Lower lumbar degenerative disc changes and arthrosis are present. The visualized lower head including the posterior fossa contents, paravertebral so tissues and visualized upper chest are normal.
At C2-3, disc space height is normal. The spinal canal and neural foramina are patent.
At C3-4, disc space height is normal. The spinal canal and neural foramina are patent.
At C4-5, disc space height is normal. The spinal canal and neural foramina are patent.
At C5-6, moderate to mild disc space height loss is present. There is broad-based posterior disc osteophyte effacing the anterior aspect of the thecal sac and encroaching upon the right neural foramen. The spinal canal is patent. The neural foramina at baseline are patent apart from very small bilateral arthritic uncinate spurs including the right neural foramen without the foraminal disc currently seen.
At C6-7, edematous degenerative endplate changes are seen which are rather prominent. There is no subluxation. Minimal broad-based posterior endplate osteophyte is seen. The spinal canal is patent. The neural foramina are patent with subtle encroachment upon the right neural foramen related to chronic arthritic hypertrophy. Chronic arthrosis is seen involving the uncovertebral joints bilaterally which appears overall mild.
At C7-T1, disc space height is normal. The spinal canal and neural foramina are patent.
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Full discussion is provided above. NOTE: The absence or presence of clinical significance of the above described findings will be determined by the referring clinician. These may or may not be clinically significant depending on clinical evaluation and presentation
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IMPRESSION:
1. C5-6 broad-based disc encroach upon the right neural foramen.
2. Lower cervical degenerative changes.
3. Straightening of lordosis.
4. Full discussion is provided by level above.
5. No fracture, dislocation, osteomyelitis/discitis, spinal mass, spinal canal stenosis, paravertebral so tissue lesion, orabnormal cord signal.

MRI Cervical Spine without Contrast – Details
Study Result
Narrative
MRI of the cervical spine without contrast September 04, 2019 at 1637 hours
Clinical history: Cervicalgia – motor vehicle accident 7 months ago. Complains of neck soreness bilateral arm/hand numbness and burning. Right side worse.
Surgical history: No surgery, has had injections 06/12/2019, 04/18/2019.
Technique: Multiplanar multiecho MRI of the cervical spine was performed.
Comparison: Compared with the prior study dated 03/29/2019 and correlated with the prior radiographs of the cervical spine study dated 02/20/2019.
Findings:
There is no significant interval change. Straightening of the cervical spine is identified, which may be related to muscle spasm. Anterior marginal osteophytes are again seen at C5-C6 and C6-C7 levels. T2 hyperintensities are again seen in the C5 and C6 vertebral bodies, likely of degenerative etiology. No fracture is seen. The cervicomedullary junction is within normal limits. The caliber and signal intensity of the spinal cord to the extent visualized are within normal limits. The pre and paraspinal so tissues are unremarkable.
C1/2: There is no central canal narrowing. The facet joints are within normal limits.
C2/3: Disc desiccation is seen. The disc height is within normal limits. There is no disc contour abnormality, central canal or neural foraminal narrowing. The facet joints are within normal limits.
C3/4: Disc desiccation is seen. The disc height is within normal limits. There is mild diffuse disc bulge indenting the thecal sac. No central canal or neural foraminal narrowing is seen. The facet joints are within normal limits.
C4/5: Disc desiccation is seen. The disc height is within normal limits. There is no disc contour abnormality, central canal or neural foraminal narrowing. The facet joints are within normal limits.
C5/6: Disc desiccation is seen with decrease in disc height. Posterior disc osteophyte complex is seen with bilateral uncinate hypertrophy. There is moderate right neural foraminal narrowing. No evidence of central canal narrowing. The facet joints are within normal limits.
C6/7: Disc desiccation is seen with decrease in disc height. Small posterior marginal osteophytes are seen with uncinate hypertrophy. There is bilateral mild neural foraminal narrowing. No evidence of central canal narrowing. The facet joints are within normal limits.
C7/T1: The disc height and signal are within normal limits. There is no disc contour abnormality, central canal or neural foraminal narrowing. The facet joints are within normal limits.
Impression:
No significant interval change.
Degenerative changes, predominantly at C5/C6 and C6/C7 levels as described.

[Donald Corenman, MD, DC]

#31189

“At C5-6, moderate to mild disc space height loss is present…disc osteophyte….encroaching upon the right neural foramen.
At C6-7, edematous degenerative endplate changes are seen which are rather prominent. There is no subluxation…The neural foramina are patent with subtle encroachment upon the right neural foramen related to chronic arthritic hypertrophy. Chronic arthrosis is seen involving the uncovertebral joints bilaterally which appears overall mild”.

This is an indication of IDR and degenerative facet disease at C6-7 (See https://neckandback.com/conditions/isolated-disc-resorption-cervical-spine-idr/) and DDD at C5-6 See https://neckandback.com/conditions/cervical-degenerative-disc-disease/ and https://neckandback.com/conditions/cervical-degenerative-facet-disease/

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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