Archives

MRI CERVICAL SPINE
HISTORY….ANTEOLISTHESIS
MAGNETIC RESONANCE IMAGING
PRODUCTURE(S) c-spine ne with 1 pul seq-vc

Anterolisthesis of c2 c3
Findings…Sagittal t1 flair were obtained through the cervical spine. Axial gradient echo sequences were obtained rfom c2 and c3

Comparrisons 8/9/2012 CT
Their is no Chiari 1 malformation. No cord signal abormality is seen.There is reversal of of the normal cervical lordosis. There is a multilevel degeneration disc disease with severe degenerative disc disease from C4 -. C7
There is multilevel bilateral facet oa

c2-c3…There is a 5mm anterolisthesis of c2 on c3 unchanged causing mild to moderate spinal canal stenosis. There is associated didc bulge containing the cervical cord but no cord signal abormamality. There is to .
mild to moderate right neural foramen narrowing secondary to osteophyte.
The Posterior longitudinal ligament appears intact.

Can’t make out c3 and c4 from printer

c4 c5There is posterior osteophyte contacting the cord. Mild to moderate spinal canal stenosis There is is moderate left neural from narrowing and mild to moderate right neual foramen narrowing.

c5 c6There is left paracentral/lateral recess disc osteophyte complex contracting the cord.No cord signial
abnormality. T here is moderate spinal canal stenosis. There is moderate left neural foremen narrowing, and mild right neural foramen narrowing.

c6 c7 Small disc osteophyte complex. N osignificent spinal canal stenosis.There is mild left neural foremaen narrowing.

impression
There is a 5m anterolistheses of c2=c3 associated with mild to moderate spinal canal stenosis. Fusion of of the left c3-c4 facet which may be the cause of for the hypomobile of the upper cervical spine at c2-c3 causing anterolisthesis. F lexion/extension xrays may be helpful to assess for stability.
There is moderate spinal canal stenosis at c5 c6. There is mild to moderate spinal canal stenosis at c4-c5 Multilevel degenerative disease.

I typed this with one finger on note and put on word by word. Hope it make sense and Dr Coleman can tell me what it means please. Carol

I started using a crutch to help with the lower back pain and getting around. About a year after that, I started using 2 crutches because the instability of using just one was causing my hips to sublux easier. In 2009, I started using forearm crutches to take the strain off my hands/wrists (as opposed to the canes). I was using the crutches for both back pain and to create stability when my (mostly right) hip would easily slip from where it was supposed to be and create instability.

I do not use them anymore, except in emergencies, as of a year ago, because of reoccuring should subluxing and discloations (that were said to have been aggravated by using the crutches). I have done intense PT to get my core muscles stronger and help with the pain of getting around. My hips are still unstable, as are my shoulders, but I know that sometimes with EDS there are just things you have to deal with. The back and related nerve pain though, I cannot handle and cannot get the pain levels to an acceptable level to function and hold a job outside the home.

I will also say that my EDS wasn’t dx’d until 2006 (by a geneticist), and all related problems before then were attributed to weight, or that it was all in my head (“You can’t possibly have had your kneecap dislocate from someone leaning on it.” when I was in the ER), and that my back wouldn’t get worse because I was so young (I’m 38 now) and most PT people would always focus on trying to make me more flexible instead of helping me control my body more. Some even freaked out that some of my joints were too loose and why wasn’t I feeling the appropriate pain from them? :( I had chiropractic care for a while, which initially helped, but the last instance in 2006 left me with 2 additional bulges and a herniation (thoracic level), so I will not go again.

Thank you for your reply. My history of spine involvement goes back a ways, so I’ll try to get out what are (hopefully) the most important and useful parts.

I first sought help for my lower back pain in 2003 after NSAIDs and exercises weren’t helping. It started out as a sharp pain in the middle and slightly to either side of my back, about 2″ above my buttocks. After my MRI, they said there was disc damage, but that the pain would go away if I lost weight. I was 250lbs+ (at 5’2″). So that year I got gastric bypass (for my back and for other health reasons) and lost over 100lbs. I became more mobile and was able to walk more and get around. My back got considerably worse after about a year. I started using a cane, then two canes (my PT didn’t want me to favor any one side), then forearm crutches. It helped my back a lot, pain-wise, but was very hard on the rest of my body. I have a small folding cane I keep with me for emergencies, but other than that, I cannot use anything to get around with because of my shoulders. I have since gained back about 30lbs, and I know this does not help with bone/joint issues, but I can only get around so much with this pain. I have kept the same weight for about 5 years, but I feel like if I was in less pain, I’d be able to get down to a healthier weight and help my back out even further.

Also of note, is that in 2007, my legs started swelling (mostly the right), but didn’t pit until this year. I’ve had many tests to make sure it’s not clots or the like, but there’s been no definite answers to it. I fell on my tailbone in the kitchen off a stool 2 months after the edema started and it got worse. I mention this because since the last ‘shift’ in my back and the nerve pain got worse and changed position, for the first time since this started, the edema in my legs is going down. It’s still there, but my left leg is almost normal, and my right leg has gone down considerable. I don’t know if it related, but I thought I’d mention it because you never know.

There are a few different kinds of pains that I deal with from my back. One, I’ll call the ‘regular’ pain, it’s there most of the time. It’s in the center of my lower back, just a few inches up from the gluteal cleft. It’s a ache, sometimes sharp, and the area is painful to the touch, or with light pressure. It’s about 80% back and 20% leg, as the pain sometimes refers down. I’ve had it for a while. It also runs between 4-8 on the pain scale, and seems to do a bit better with a heating pad, NSAIDs, and percocet.

The second one is called the ‘bad’ pain. It’s horrific blinding pain that seems to start at even the smallest of motions (as opposed to falling or lifting something heavy). I don’t know how to make this pain go away, but it is much worse when moving my core or trying to raise my leg (mostly right leg). It’s a severe, and deep ache, with sharp stabs too. It’s about 100% back (with rare pain down a leg if I move), and it rarely goes away. The pain is pretty consistent too, and at 8-10 on the pain scale. It isn’t helped with medications. Occassionally. that pain can be dulled down by heat, or (when I’ve had one) a TENS unit. It lasts about a week or so with extreme pain, and when it does start to subside, it can be brought back instantly with a slight wrong movement for a few weeks.

The third pain, is the ‘new’ pain. It started in the last few months, and things have changed significantly. My back has always been ‘loose’, it shifts and clicks with the slighted movement. The only exceptions with that is when my back sort of goes into ‘lock down mode’ when I’m having a lot of pain. This pain seems more independent to the others (in that pain is different and has different triggers), and is centered more around the nerve that goes from the lower right side of my back over the buttock, and slightly down my right leg. I would say 90% buttock, 10% back. It has the sharp twinge that if I bend, sit, cough, move wrong, or even tilt my head down, it feels like a cattle prod touched my backside. It’s usually worse in the morning, and a little less temperamental at the end of the day. This pain is the only one where, when it’s not hurting really bad, is almost pain free. So on a pain scale, it’d be 0-9, 9 being where it feels like electric shocks are going through me. If I do manage to ease into a sitting position, when I stand back up, the pain shoots through the right buttock area and it feels like a muscle cramp is around it.

In general though, I have some kind of back pain 24/7. At best, it’s a minor annoyance and can be controlled with pain meds, and at worse, it’s completely debilitating and I cannot perform daily functions at all, or need considerable help. I don’t think I have a limp or anything, but for years, the toe area of my right shoes always wear down first. I cannot bend backwards, even slightly, without significant pain, and when the new nerve pain hits, I cannot bend forwards or sit without pain and difficulty.

I used to be a hairdresser, but retired after multiple injuries and degenerative changes made it to painful. I became a receptionist after that, but sitting and lifting small things (carrying mail, large file folders, putting things on shelves) made things uncomfortable too. I would love nothing more than get a hold of this pain and take my life back.

I hope this info is more useful. I will be bringing this info with me to the specialist when I go too, so if there are any missing pieces, don’t hesitate to ask me about them.

Thank you again for your response.