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Can you explain this MRI report to me please , thank you

There is a mild scoliosis of the Thoracic spine convex to the right

There is a mild loss of height involving the superior endplates T1,T2,T3 vertebral bodies

The Thoric spinal cord is within normal limits in signal intensity , there is No evidence of a thoric syrinx

At T3-T4 , there is a minimal central disk protrusion effecting the ventral CSF , ((( THIS IS THE ONE I AM CONCERNED ABT , WOULD THIS BE SOMETHING THAT COULD OF RECENTLY HAPPENED , I HAD NO BACK INJURY EVER TO MY KNOWLEDGE, CAN PRESSURE FROM BEING IN A HOTUB THAT CAUSED DIFFUSED SPASMS CAUSE THIS, THE OTHER QUESTION IS CAN THIS CAUSE MUSCLE STIFFNESS IN MY UPPER SHOULDER BLADES THAT WOULD CAUSE NECK STIFFNESS AND FACIAL STIFFNESS, AS MY NECK AND FACE MUSCLES ARE EXTREMLY TIGHT , THERE CAN BE ANOTHER POSSIBLE REASON FOR THIS , BUT WAS WONDERING IF THIS ALSO CAN CAUSE THIS, CAN IT ALSO CAUSE BURNING PAIN ALL OVER MY BODY? OR EFFECT MY ARMS OR HANDS TXS )

AT T4/5 -THERE IS A MILD CENTRAL DISK BULGING

AT T5,6 AND T 6,7 THERE IS A MILD CENTRAL AND LEFT SIDED DISK BULGING

IMPRESSION

NO EVIDENCE OF A THRORIC SYRIINX

MILD LOSS OF HEIGHT INVOLVING THE SUPERIOR ENDPLATES OF T1,T2,T3 VERTEBREA , THIS IS MAY BE POSTTRAMATIC AND APPEARS OLD

AT L5,S1 THERE IS A MILD DISK BULGING WHICH IS A BIT MORE PROINENT ,POSTERLATERALLY AND INTERNALLY ON THE LEFT WITH A VERY SMALL ANNULAR TEAR .THERE IS A MILD DEGENERATIVE CHANGE OF THE FACET JOINTS

AT L4/5 THERE IS A MILD DISK BULGING AND MINOR OSTEOPHYTE , THERE IS A MILD DEGENERATIVE CHANGE OF FACET JOINTS

AT L3/4 THERE IS A MILD DIFFUSE DISK BULGING AND MINOR OSTEPHYTE WITH A SMALL POORLY DEFINED CENTRAL ANNUALAR TEAR WITH FOCAL CENTRAL DISK BULGING OR MINIMAL DISK PROTRUSION MILDLY INDENTING THE THECAL SAC

AT L2/3 THERE IS A MILD DISK BULGING WITH A SMALL CENTRAL ANNULAR TEAR THERE IS MILD DEGENERATIVE CHANGE OF THE FACET JOINTS

THE L1/2 LEVEL IS UNREMARKABLE

THE DISTAL CONUS IS WITHIN NORMAL LIMITS IN SIGNAL INTESITY

IMPRESSION

AT L5/S1 THERE IS A VERY SMALL POSTERLATERAL AND LATERAL ANNULAR TEAR ON THE LEFT WITH DISK BULGING

AT L3/4 THERE IS MILD DIFFUSE DISK BULGING AND MINOR OSTEPHYTE WITH A SMALL CENTRAL ANNULAR TEAR WITH FOCAL CENTRAL DISK BULGING OR MINMAL DISK PROTRUSION

AT L2/3 THERE IS A SMALL CENTRAL ANNULAR TEAR

ALSO WAS WONDERING CAN LYME CAUSE THESE CHANGES IN MY SPINE . THANK YOU

Hello Dr. C.,
11 years ago I was involved in a near fatal MVA. Since my ACDF, I have had progressive pain (mostly in the last couple of years) in my neck and increasing numbness to my right inner arm and 4th and fifth fingers including palm. I have had some numbness and tingling to my left as well but not as much. Weakness accompanies the above symptoms and also coldness. I have also noticed numbness in my abdomen (weird I know). I have tried everything over the years mostly on my own. Initially I tried TENS, PT, hot/cold packs, Steroids, injections, NSAIDS, Muscle relaxers( highly allergic to those though). Wish not to take narcotics due to their limited help and also I have young children. I am a healthy 42 year old female that is active in youth sports. I am not over weight or engage in any risky behavior or habits. My doctor finally talked me into the MRI although I have been reluctant because I am quite sure I need another surgery. I have come to terms with the need to be more aggressive in treatment but I was wondering what you think so that I can be more aware of options. Thank you in advance!!
MRI Findings:
alignment of spine normal. There is anterior cervical discectomy and fusion c4-5. mild bone marrow edema is present at superior endplate of c7. there is a cord signal abnormality at c7 level consistent with degeneration. Otherwise the cord demonstrates normal signal without mass or syrinx.
There is multilevel degenerative disc disease as detailed below:
c1-2: normal
c2-3: posterior ligamentous hypertrophy with mild canal stenosis.
c3-4: annular disc bulging and posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate neural foramina narrowing.
c4-5: discectomy with fusion. no canal stenosis or neural foramina narrowing.
c5-6: annular disc bulging posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate to severeneural foramina narrowing.
c6-7: right paracentral disc protrusion resulting in right neural foramina narrowing. posterior ligament and hypertrophy.
c7-t1: normal.
Impression: c4-c5 ACDF. multilevel degenerative disc disease as described above worst at c3-c4 and c5-c6 with canal stenosis and mass effect on the cord.

Hello Dr. C.,
11 years ago I was involved in a near fatal MVA. Since my ACDF, I have had progressive pain (mostly in the last couple of years) in my neck and increasing numbness to my right inner arm and 4th and fifth fingers including palm. I have had some numbness and tingling to my left as well but not as much. Weakness accompanies the above symptoms and also coldness. I have also noticed numbness in my abdomen (weird I know). I have tried everything over the years mostly on my own. Initially I tried TENS, PT, hot/cold packs, Steroids, injections, NSAIDS, Muscle relaxers( highly allergic to those though). Wish not to take narcotics due to their limited help and also I have young children. I am a healthy 42 year old female that is active in youth sports. I am not over weight or engage in any risky behavior or habits. My doctor finally talked me into the MRI although I have been reluctant because I am quite sure I need another surgery. I have come to terms with the need to be more aggressive in treatment but I was wondering what you think so that I can be more aware of options. Thank you in advance!!
MRI Findings:
alignment of spine normal. There is anterior cervical discectomy and fusion c4-5. mild bone marrow edema is present at superior endplate of c7. there is a cord signal abnormality at c7 level consistent with degeneration. Otherwise the cord demonstrates normal signal without mass or syrinx.
There is multilevel degenerative disc disease as detailed below:
c1-2: normal
c2-3: posterior ligamentous hypertrophy with mild canal stenosis.
c3-4: annular disc bulging and posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate neural foramina narrowing.
c4-5: discectomy with fusion. no canal stenosis or neural foramina narrowing.
c5-6: annular disc bulging posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate to severeneural foramina narrowing.
c6-7: right paracentral disc protrusion resulting in right neural foramina narrowing. posterior ligament and hypertrophy.
c7-t1: normal.
Impression: c4-c5 ACDF. multilevel degenerative disc disease as described above worst at c3-c4 and c5-c6 with canal stenosis and mass effect on the cord.

Dr. Corenman,

I have a surgical consult this coming Thursday with an ‘iFuse System’ orthopedic specialist, and look forward to some sort of resolution soon. Last week, my SI joint anesthetic injections provided 100% relief for approximately 3 hours, and my pain was replicated in all five clinical maneuvers of the joints. In the meantime, I had a few more general questions regarding some symptoms, as well as modalities of PT that may, or may not be, recommended before or after my procedure(s):

1. One of my more significantly painful symptoms is the inability to lie completely flat on my back for any length of time. For instance, during my recent clinical exam, which involved undergoing the 5 diagnostic provocative SI maneuvers, I was asked to lie supine on the exam table. As soon as I lie completely flat and attempt to fully relax or “un-tense” my lumbar and pelvic regions, my sacral area and low back literally “lock up”… By this, I mean that I’m completely unable to roll myself back over, and if asked to raise my leg off the table (straight-leg raise from the hip), the pain is excruciating and is localized to the areas just right and left of where the top of the sacrum begins and L-5 ends. It then migrates through both hips, but does not feel like the radiculopathy experienced by, say, a ruptured disk (the pain is more of an intense stabbing pain rather than burning or tingling, etc.). Your thoughts on this?

2. My lumbar spine is fused from L3 to S1.. I also have a significant discrepancy in leg length, with my right leg being over 3/4-inch shorter than my left. In patients who’ve been fused to this level, are there modes of PT or gentle adjustments that can correct this discrepancy? Will an SI fusion prevent any efforts at correcting this in the future? Can you please explain how leg length discrepancies are adjusted?

3. Once my SI joints are fused, what modalities of PT will I be able to tolerate? Since the purpose of lumbar or SI fusions is to immobilize those areas, are there any adjustments or manipulations that can be done without causing damage or irritating those fused areas?

4. Some of the orthopedic peer-reviewed literature suggests that SIJD can be attributed to misaligned or otherwise “torsed” pelvic structures, and / or stretched or abnormal ligament and tendon positions. Can these be corrected or adjusted prior to an SI joint fusion? If the supportive network of ligaments and tendons is out of alignment, won’t this defeat the purpose of stabilizing the joint(s)? If those structures aren’t properly realigned before surgery (via PT or chiropractic manipulation), couldn’t this just continue the pain and postural problems?

5. Finally, I recall you stating that the sacrum can’t actually be displaced. I’ve seen some literature in PT journals that speak to the issue of the sacrum being subluxed, or otherwise “popped out of place”… Can you expound on this a bit to clarify what they’re referring to?

Thank you so much, as always.

S.W., NC