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Spinal Cord Disorders Message Board

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Help understanding my MRI
I have alot of pain in my shoulder down to my left arm and now pain in my upper right arm. I was given MOtrin and no one has explained my MRI to me . I don't expect a diagnosis just want to understand what is going with my neck in layman terms. Thank You

1. There is an annular disc bulge with additional focal central disc protrusion component with abnormal mass effect on the ventral surface of the spinal cord at the level of C4-C5. There is questionable focal region of early myelomalacia related changes level at C4-C5. Furthermore, there is moderate to severe left neural foraminal narrowing and mild to moderate right neural foraminal narrowing at C4-C5. 2. Additional annular disc bulge and facet joint arthropathies present at C3-C4 and C7-T1 without appreciable central spinal canal stenosis or neural foraminal narrowing. Additional small focal disc protrusions are also present at C5-C7 with mild central spinal canal stenosis. 3. Nonspecific vertebral body fusion spanning from the level C5-C7 of unknown clinical significance.
Welcome to the board.

You have quite a bit going on in your spine. From the description of your symptoms and the MRI results it is quite likely that these issues are indeed caused by the problems in your cervical spine. If you are not being treated by a spine specialist Neuro or Ortho surgeon, a good next step would be to get in to see one. Those docs are the experts in diagnosing and treating conditions of the spine. They have specialized training in spinal conditions and limit their practices to surgically and non-surgically treating spinal issues. It can take several weeks to get an appointment with those folks so I would start now. Motrin is unlikely to do anything for you and the fact that was prescribed indicates your current doc is out of his/her depth.

To understand your MRI you need to know just a bit of spinal anatomy. I never know what others know about this so ill try to keep it as brief and high level as possible. I'm happy to give more detail if you like and there are a few others who may chime in as well. You have 7 cervical vertebrae labeled C1at the base of your skull to C7 roughly at the bottom of your neck. These run through the front of your spinal canal and join up with bones at the back (those ridges you feel in the back of your neck) to forum a channel. Your spinal cord runs through this channel. Each pair of vertebra are separated by a spongy disc to allow free movement and shock absorption. Also the upper and lower vertebra of each pair have bony protrusions that form an exit hole for the nerve roots of the spinal cord to exit and supply the muscles of the upper body. In general, degeneration from age, injury etc. can cause the discs to bulge or herniate or the various joints to form bone spurs, all of which can impinge on the spinal cord (central canal) or nerve roots (neuroforaminal).

In your case at C4/C5 the disc is protruding enough to push on the spinal cord at that level. This can cause a host of symptoms including pain, numbness, incoordination in your hands or arms but can also cause issues in any area below that compression, so balance issues, cramping etc. in the feet and legs. The symptoms are often progressive over time as well so having that monitored is probably a good idea. The report mentions possible myelomalacia which can occur if the spinal cord is compressed for a significant amount of time. This can be associated with poorer outcomes but is also often misdiagnosed on MRI so its important to have qualified follow-up with a spine specialist. In addition you do have narrowing (stenosis) of the exit holes for the nerve roots at this level. The scale is usually minimal, mild, moderate, severe, with yours being moderate/severe on the left and mild/moderate on the right. This can lead to pain/sensory symptoms in the areas served by that nerve root so may be directly related to the shoulder/arm pain you are experiencing.

You have some other degenerative changes including disc protrusions and arthritic bone spurs (arthropthies) causing mild stenosis throughout your cervical spine. Theses are most likely asymptomatic at this point but having this monitored is probably a good idea.

Finally your C5-C7 vertebrae seem to have spontaneously fused. There was a person on the board who had this and had a condition known as ankylosing spondylitis. I don't know if other conditions cause this or not. Another reason to get in to a spine specialist.

Good luck and let us know how you get on...

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