level shows mild bilateral uncinate process hypertrophy right frater than left. There is a mild facet degenerative changes left greater than right. Findings cause mild bilateral neuroforaminal stinosis. no central canal stenosis present.
level is within normal limits without central canal or neural foraminal narrowing
level shows a large central disc protrusion/herniation with bilateral uncinate process hypertrophy and bilateral facet degenerative changes. This causes moderate to severe central canal stenosis. I do not see evidence of obvious abnromal signal within the spinal cord authough imaging is limited secondary to the patient's size. There is bilateral facet degenerative changes and mild uncovertebbral joint hypertrophy. Findings cause moderate bilateral neuroforaminal narrowing right greater than left.
level shows mild bilateral uncovertebral joint hypertrophy and no 70 no frontal stenosis present.
level is within normal limits
then it says in impression that his disc protrusion//herniation causing moderate central canal stenosis with flattening of cervical spinal cord
and neuroforaminal narrowing in c3-c4 and c6-c7
i am trying to understand what all this means
also his regular dr told him he had narrowing of the spin in his lower back but that there is nothing that can be done for this? I believe that the narroing of the spine is called spinal stinosis and that there is a surgery.
Hubby sees the spine surgon tomarrow but want to understand this mri it is not the most recent i dont have that one yet.
Anatomy class time.
Your neck is made up of 7 vertebrae. The top 2 are connected to form the main part where you turn your head and are considered to actually be different from the rest of the neck...that is why they start at C3.
So you have this bone. If you look down on the shape of the vertebra from the top, it looks a little like a butterfly shape. Down through the middle is the opening of the spinal canal. It contains the spinal cord and it's covering, the thecal sac which is filled with spinal fluid to further protect the spinal cord. At each vertebra, a pair of spinal nerves peels off the cord like peeling a banana and they exit the spinal cord and the bone at either side at a place called the foramina(means "opening" in medical lingo). Between each vertebra there is a disk that acts as a cushion for the bones. The vertebrae themselves have all sorts of little joints and protuberances that act with each other to stabilize the spine...joints like the facet joints that stabilize twisting and the uncinate processes and the uncovertebral joints. Haven't quite figured out what both of them do in particular. But as joints, they can all get arthritis(degeneration) and deteriorate(hypertrophy)which means they hurt when you move certain ways.
Anything that presses on the spinal nerves causes pain. Pressure on the spinal cord does not but does produce problems below the level of the pressure...things like muscles that don't move right, numbness or tingling in arms or legs, dropping things with your hands, walking like a drunk(spastic gait). Symptoms can show up in the toes before the arms with pressure in the neck. Opposite of what you'd think.
The word stenosis means "closing up" whether it's the holes where the nerves go through or the spinal canal itself or an artery in your heart or any other place where an opening is more closed up than it should be. Some days I wish my husband would develop "stenosis" of the mouth!:D
So the MRI shows he has 2 main problem areas. At C3-4(they always give you the areas as 2 vertebrae together since the disks are the major problems and they are in between) he basically has arthritis and it causing the holes where the nerves go through to close up. On a scale of 1-5, he's a 2[they use the terms minimal(1), mild(2), moderate(3), severe(4) and very severe(5)]. At this level, it should causing pain in his neck and shoulders.
At C5-6, he has a major problem. Those same holes where the nerves go through are a 3 with the right worse than the left. This can affect the arms all the way down to the thumb and index finger with lots of pain. But the big problem is the spinal cord itself. It too has "stenosis". A disk has broken out of it's covering and along with arthritis in those same weird joints, they have filled the spinal canal to the point where he has moderate(3 out of 5) to severe(4 out of 5) closing up of the spinal canal itself and it's pressing on the spinal cord itself. This could be producing the symptoms I mentioned above(dropping things, legs stiff and hard to move, numbness and tingling, trouble walking).
The reason this is a big problem is that IF and it is an if the cord were to suddenly lose it's blood supply due to all this pressing on it, he would instantly become paralyzed from that level down...we're talking chest down paralysis or if it's comes a little lower, waist down paralysis including hands and wrists. It did not say in the MRI report just how compressed his cord is but a normal cord is about 11-12mms. wide. When I had my first surgery, my cord was down to 6mms. at the narrowest(I had 4 levels of cord compression). But the MRI did say his cord showed no signs of damage to it(that's good).
He will probably be recommended for surgery to relieve the cord compression as well as relieve the nerve compression. Only C5-6 needs to be addressed now...C3-4 is still a ways away from needing repair according to this MRI.
There is a new surgery to fix spinal cord stenosis without fusion and it's called a laminoplasty but it's only done at the biggest of medical centers...very new. The more standard fix is to fuse the 2 vertebrae together from the front after removing of the disk and bone spurs and whatever else is closing up the canal.
Whatever you do, please be advised that we who are here regularly have noticed that the better the surgeon, the better the outcome. Make sure it is a "spine surgeon", whether it be an ortho or neurosurgeon. A full time spine surgeon does a much better job than an ortho or neurosurgeon who does spines "part-time".
Any questions or you get the new MRI, let us know. Anatomy class for today is over!