Spinal Cord Disorders Message Board
I am wanting to see if someone can help me understand my MRI results..
technique: sagittal T1 and T2 and axial gradient T2 and T1 sequence of the cervical spine are performed before the admin. of intravenous contrast. Subsequent intravenous contrast was admin. and axial and sagittal T1 weighted sequences were performed.
Finding: There is smooth reversal of the cervical curvature. The vertebral bodies are normal in height.
at the level of c2-c3, there is no evidence of focal disc protrusion or canal or neural foraminal narrowing.
at the level of c3-c4, there is posterior central disc bulging abutting the anterior margin of the thecal sac. There is no cord impingement. The neural foramina are patent.
at the level of c4-c5, there is a small central disc protrusion measuring approx. 3mm in anteroposterior extent superimpoed upon diffuse disc bulging. The disc protrusion causes mild mass effect upon the anterior margin of the spinal cord. The disc protrusion extends very slightly, asymmetrically towards the left. There is mild canal stenosis with only a narrow column of CSF remaining present posterior to the cord. The left foramen is narrowed due to asymmetric uncinate hypertrophy and associated asymmetric disc bulging.
at the level of c5-c6, there is shallow broad-based protrusion of disc material in the central/left paracentral location causing mild flattening of the left anterior margin of the spinal cord and mild reduction in anteroposterior diameter of the left aspect of the spinal canal. The left neural foramen is also mildly narrowed.
at the level of c6-c7, there is a small disc protrusion lateralizing slightly asymmetrically to the right causing mild mass effect upon the anterior margin of the thecal sac and partial effacement of the CSF anterior to the spinal cord. This disc protrusion may minima.lly contact the anterior margin of the spinal cord to the right of midline, but there is no cord deformity resulting. The spinal canal diameter is mildly narrowed. Bilateral neural foramina are grossly patent.
at the level of c7-t1, there is no canal or neural foraminal stenosis.
No areas of signal alteration are seen within the spinal cord. No areas of unanticipated enhancement are seen within the spinal cord or immediate surrounding soft tissues on the post contrast images. The visualized portions of the posterior fossa and craniocervical junction are grossly normal.
1. focal central disc protrusion at c4-c5 causing mild mass effect on the anterior margin of the spinal cord resulting in mild canal narrowing. The left neural foramen is also mildly narrowed at this level.
2. Broad-based central/left paracentral disc protrusion at c5-c6 causing flattening of the left anterior margin of the spinal cord and mild narrowing of the spinal canal diameter.
3. Centra/right paracentral disc protrusion at c6-c7 effacing CSF anterior to the spinal cord.
4. No abnormal enhancement.
I'll tackle it.
First some anatomy and word interpretation. Your spine actually starts at C1 but the neck is considered C3 to C7. Your spinal cord goes down through the vertebrae in your neck and at each vertebra, a pair of spinal nerves peels off(like a banana being peeled)and goes out to the body through holes called "formina". Where you see a words like "patent foramina", that means the holes are fully open. The spinal cord is covered with a thin sack containing spinal fluid(the thecal sac) that acts as a buffer to protect the cord. When you have a ruptured disk , they look to see if it is touching the nerves that exit the cord or touching the spinal cord itself or touching the sac that goes around the cord. It can also move in such as way as to block the hole where the nerves go out of the bone and they rank the severity of the blockage as minimal, mild, moderate and severe(and once I've seen very severe). When something touches the spinal cord, they can actually measure the width of the cord and tell you just how small it is as a result. Another measurement they take is the width of the spinal canal...the actual space within the bone itself. When you are born with a smaller than normal canal, they call it spinal stenosis.
So with that said...let's look at yours.
C3-4...bulging disk but it's not touching or blocking anything
C4-5...you have a disk that has ruptured to the back and left side. It is touching the spinal cord and making it so that the fluid around the cord is only seen in the back of the cord. It is also partially blocking the opening for the nerve on the left side. Measurements show a slightly smaller canal than normal.
C5-6...another ruptured disk is again affecting the left side. The spinal cord has been flattened slightly and the nerve that exits on the left has been blocked but "mildly". Your spinal cord has been measured as slightly less than it should be confirming that it is being flattened.
C6-7...anther ruptured disk but this time it's more right/center. It has touched the thecal sac and seems to have caused less fluid to be there and may touch the spinal cord just slightly in the center but the cord shows no sign of flattening or damage. The holes for the nerves are fine. Your spinal canal is slightly narrowed(stenosis).
So what does it all mean? Your nerves out to your body are pretty good but are probably causing you some pain. But the big problem is that your spinal cord has been affected...mildly but affected. It doesn't show any damage to the cord but it is being touched. This can cause numbness and tingling in your feet or legs and even trouble walking, like muscles that don't want to move.
That said, the cord can take a lot of pressure before you end up with big trouble. I had 5 levels of cord compression in my neck and at one level, my cord was half thickness. It had been slowly but surely compressed from 12 mms. to 6 mms. but it should be monitored. I let mine go almost too long although one neurosurgeon told me to wait even longer before I do surgery.
So what are your symptoms and what has been suggested? Anyone suggest surgery? What kind?
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