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Back Problems Message Board

Back Problems Board Index

Re: Mri analysis
Jun 15, 2012
Welcome to the board. It appears from the radiology report that you have two distinct problems in your spine. Surgeons usually focus on the one that has the most potential to cause additional problems first. Surgery is never performed on two areas at the same time, except in very rare exceptions.

The cervical spine is much more delicate because the space is more narrow to begin with, and there is a potential for damage to the spinal cord with the potential for paralysis.

In general, the lumbar area may cause just as many problems and pain, particularly when it hurts to walk or move, sit or stand...but very few issues of the lumbar spine can be life-threatening or can result in paralysis.

At C5, C6 and C7 you have some degenerative changes that are having an impact on the nerves as they exit the spinal cord and go out into the body. The "neuro-foramina" are supposed to be open so the nerves can pass freely, but they are subject to arthritic changes, changes brought on by aging and "wear and tear", etc. and there can even be a build up of bony overgrowths (osteophytes) that fill in the space, resulting in nerve compression. (Think of an old lead pipe and how it fills up with gunk from mineral deposits, etc. After years of this collection, water can barely pass through.)

These spinal nerves conduct signals out to the hands, and innervate the clavicles, the outside of the arms, and run down into the hands and fingers. This would account for your loss of hand strength, and whatever tingling or numbness you may have.

The report describes this stenosis (which means "narrowing") as moderate to severe...which means the nerves need to be decompressed or the nerves may become permanently damaged.

There is another part of the board, the "Spinal Cord Disorders" where the people with cervical issues hang out. You could post there too as they have more experience with cervical spine issues. They could answer your specific questions about having a cervical fusion.

[B]L5/S1: 3mm anterolistheses secondary to bilateral L5 pars defects. Mild-moderate bilateral neural foiramina narrowing secondary to bulging and anterolisthesis. No focal disc protrusion. No spinal canal narrowing. Mild bilateral facet arthropathy.[/B]

You have a couple issues that are accounting for less room for nerves at this lumbar 5/sacral 1 level. Again, you have stenosis in the foramen at this level...but since it is described as mild to moderate, the resulting nerve compression is less than in your cervical spine, and thus, it can afford to wait for treatment. But it is probably this level that is accounting for your leg pain, pain in the buttocks, etc.

An issue at the L5/S1 is the major cause of "sciatic" pain. This may be caused by the stenosis and also by the "anterolisthesis" which is a spondylolisthesis -- this is when there is some instability at this segment where one vertebra slips over the top of the adjacent one. In your case, this is a result of a pars defect on both the left and right side...this is a small crack in a small bone (pars). The pars defect can be something that one is born with or it can be caused by degenerative changes or an accident like a fall or a car crash. Spondylolisthesis is graded on a scale of 1 to IV with IV being a 75% to 100% slippage -- something that would probably require surgery. A 3 mm slippage is a small amount. It is mentioned because it is contributing to the stenosis, along with a small disc bulge and some arthritis in the facet joints. These issues when put together result in a loss of space in the opening (foramina) which makes less room for the exiting spinal nerves. Since the L5 and S1 nerves innervate the back of the leg and down into the foot, you may have pain anywhere along these pathways. (If you like looking up things online, look for a "dermatome map." It is a diagram that will show you which nerve innervates which area of the extremity.)

The Comment area of the report is like a summary of everything that was mentioned earlier -- so you can see you have the problem at C%, C6 and C7 , and the lumbar issue at L5-S1.

Spondylitic changes, put simply, are undesirable changes in the vertebral bodies and intervertebral discs in your spine. They are part of the normal wear and tear that we all eventually experience. It is these changes that are contributing to your foraminal stenosis.

As you know we are not doctors. The above comments are based on my own personal experiences and hopefully will help you understand the language better so that when you talk with your doctor, what he tells you will make better sense and you will be able to discuss your problems with the doctor.

Good luck and please feel free to post with any comments or questions.

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