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Spinal Cord Disorders Message Board


Spinal Cord Disorders Board Index


Findings: cervical spine normal in size and signal intensity. No abnormal spinal mass or fluid collection noted. There is mild straightening of the normal cervical lordosis. Vertebral body heights are fairly well maintained. Intervertbral disc space height loss in noted from C4 through C6. Disc desiccation is present at these levels as well. thhere is no bone marrow edema identified. C2-3: no substantial disc bulge or neural foraminal stenosis. C3-4: mild posterior disc bulge effaces the anterior thecal sac without evidence of central or neural foraminal stenosis. C4-5: Mild to moderate posterior central disc bulge effaces the anterior thecal sac, abuts the anterior spinal cord but does not cause central canal oe neural foraminal stenosis. C5-6: moderate posterior disc bulge is identified with a large left paracentral componet. There is no central canal stenosis. Moderate left neural foraminal stenbosis. C6-7: Mild left paracentral disc bulge is identified without central canal stenosis or definite neural foraminal stenosis. C7-T1: no substantial posterior disc bulge. No central or neural foraminal stenosis. IMPRESSION: Multilevel degenerative change within the cervical spine from____________________, there is evidence of _____________neural foraminal stenosis. What's with the blanks. They seem like they would be pretty inportant. Thanks for any help
Hi - I can help you out here. I will explain and they give you a couple ideas for questions for the Dr. at the bottom of the page. I will break it down sentence by sentence. I know you hurt quite a bit, but the good news is there are much worse things that can go on in your spine and you don't have them! The sooner you knock down the inflammation the better you will be. Of course the doctor reading the actual films when you meat will know the exact nature of the problems but here it is in general terms.

Findings: cervical spine normal in size and signal intensity. No abnormal spinal mass or fluid collection noted. [COLOR="RoyalBlue"] (You can probably tell this is good news)[/COLOR]

There is mild straightening of the normal cervical lordosis. [COLOR="royalblue"] (This could be from your positioning on the table or a muscle spasm. Lordosis is a medical term to describe the curve of your cervical spine)[/COLOR]

Vertebral body heights are fairly well maintained. [COLOR="royalblue"](Means there is good spacing between is the upper part of cervical spine. In your cervical spine you have levels C1-7. Although there are seven cervical vertebrae (C1-C7), there are eight cervical nerves (C1-C8). All nerves except C8 emerge above their corresponding vertebrae, while the C8 nerve emerges below the C7 vertebra. )[/COLOR]

Intervertebral disc space height loss in noted from C4 through C6. Disc desiccation is present at these levels as well. thhere is no bone marrow edema identified. [COLOR="royalblue"] (We have discs at every level of our vertebrae, they separate one level from another. The discs are kind of rubbery, the outer part of the disc has a fibrous ring band that surrounds a gel like inner material that is made up of chemical nutrients and water. Dessication means they are drying out - this is common as we age. When the discs dry they become more prone to bulge or herniate (that means when the inner material escapes the band and leaks where it doesn't belong - like on a nerve root. Edema is swelling - you have none.) By the way these are exactly the levels I predicted you had problems with so I totally understand this as this was one of my problems.)[/COLOR]


C2-3: no substantial disc bulge or neural foraminal stenosis. [COLOR="royalblue"] (good)[/COLOR]

C3-4: mild posterior disc bulge effaces the anterior thecal sac without evidence of central or neural foraminal stenosis. [COLOR="royalblue"] (One of your discs is bulging out- it doesn't say how large it is, effaces means rubbing up against, the thecal sac surrounds our spinal cord and contains the cord and fluid that protects it. But there is no evidence of compression or pinching, but there could be some irritation from stuff like this.)[/COLOR]

THESE ARE THE AREAS YOU HAVE THE MOST PROBLEMS:

C4-5: Mild to moderate posterior central disc bulge effaces the anterior thecal sac, abuts the anterior spinal cord but does not cause central canal oe neural foraminal stenosis. [COLOR="royalblue"](As before you have a bulge but at these levels it is not compressing any important structure so that is good news. It might be rubbing and causing some irritation though).[/COLOR]

C5-6: moderate posterior disc bulge is identified with a large left paracentral componet. There is no central canal stenosis. Moderate left neural foraminal stenosis. [COLOR="royalblue"] (The foramins are like little canals where nerve roots peel off the spinal cord and exit to go to body parts, like your arms, etc.. When something makes the opening smaller, like a bone spur (osteophyte) or a disc bulge, then there might be some compression of the nerve root and cause pain down a path on your arm. This is called a dermatomal pattern and there are body maps on the internet you can see the path for each of the cervical levels C1-7. Mostly when the formins get closed and compress a nerve you get pain that shoots down your arm and can go all the way to your fingers. This is called radicular pain. )[/COLOR]

C6-7: Mild left paracentral disc bulge is identified without central canal stenosis or definite neural foraminal stenosis.

C7-T1: no substantial posterior disc bulge. No central or neural foraminal stenosis.

[COLOR="royalblue"]When the transcription people can't understand they leave blanks that get corrected later. but there isn't anything in the blanks that isn't already called out in the text above - so don't worry![/COLOR]


IMPRESSION: Multilevel degenerative change within the cervical spine from____________________, there is evidence of _____________neural foraminal stenosis. What's with the blanks. They seem like they would be pretty inportant. Thanks for any help


Ask the doctor if there is anything he saw that makes him feel you need surgery. There is no mention of bone spurs (osteophytes) which is pretty uncommon for widespread disc problems so ask him if there are any. This is what might be missing from the text. Ask him if your pain correlates to the MRI findings. Ask him if it is definitely disc material pressing on nerve roots?


Next Dr. will probably offer some things that fall under conservative therapies. When it is disc pressing on the nerves it is good to wait and do the therapy because sometimes disc bulges can retreat back and open up room again. If it is a bone spur pressing on nerves then there is nothing that will take the pressure off for most people but having surgery. Every once and a while someone has traction and that helps but those are not many in numbers. The nest conservative therapies to try are oral prednisone, rest, ice, heat, and epidural injections. Sometimes an injection can really help knock down the inflammation and pain.

Once you read over this you can ask quetions - hope it will help! NP





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