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  • tvlbunny
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    Post count: 1

    Hello, I’m a 46 year old female who has suffered from back pain pretty much all of my life. About 3 years ago I began having terrible migraine’s and there wasn’t any medication that could come anywhere near touching the pain. Over the past 6 months or so I began experiencing noteworthy numbness, tingling, and weakness in my right arm. Aside from the challenges with my arm, my upper back has hurt worse than ever. My muscles are in a constant state of contraction and I feel that I’m always at the chiropractor with him putting my ribs back in place. Long story a tad bit shorter, following are my MRI results, I’m waiting referral to a neurosurgeon. What is your interpretation from the MRI results?

    Findings: Reversal of the cervical lordosis. Alignment is maintained. Vertebral body heights are normal with no fracture or compression deformity. Disc desiccation and mild disc height loss at C4-C5 and C5-C6 with mild anterior spurring. Bone marrow signal is appropriate throughout. The cervical cord demonstrates no abnormal signal or myelomalacia. Cervicomedullary junction is normal. Prevertebral and posterior soft tissues are unremarkable.

    C2-3: No significant disc bulge, canal or foraminal stenosis. Left uncovertebral spurring.
    C3-4: No significant disc bulge, canal or foraminal stenosis.
    C4-5: No significant disc bulge, canal or foraminal stenosis.
    C5-6: 2.5 mm disc bulging ligamentum flavum thickening effacing the dorsal and ventral CSF, resulting in moderate central canal stenosis. Uncovertebral spurring resulting in minor bilateral foraminal narrowing.
    C6-7:1.5 mm disc bulge and ligamentum flavum thickening effacing the dorsal and ventral CSF, resulting in mild central canal stenosis. Left uncovertebral spurring resulting in minor left foraminal narrowing.
    C7-T1: No significant disc bulge, canal or foraminal stenosis.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    Your complaints: “I began having terrible migraine’s and there wasn’t any medication that could come anywhere near touching the pain. Over the past 6 months or so I began experiencing noteworthy numbness, tingling, and weakness in my right arm” fit with two potential diagnoses.

    Generally, headache complaints that manifest from the neck originate from facet disease of the upper cervical vertebra (Occiput thru C4). There is no identification of facet disease at these levels by the radiologist but might have been missed or might not have enough degeneration to be appreciated. If present the way to identify these are with facet blocks and a pain diary (see hyoerlinks).

    Your right arm probably is generated from radiculopathy (nerve compression) but the radiologist notes on mild compression (“Uncovertebral spurring resulting in minor bilateral foraminal narrowing”). A selective nerve root block with a pain diary can ferret this out (again-see hyperlinks).

    https://neckandback.com/neck/#:~:text=Epidural%20Injections%20and%20Selective%20Nerve%20Root%20Blocks
    https://neckandback.com/treatments/facet-blocks-and-rhizotomies-neck/
    https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-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.
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