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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index


MRI: CERVICAL SPINE W/O CONTRAST Result See description Description PROCEDURE:


Multiplanar multi-sequence images were obtained through the cervical spine without the use of IV contrast. Standardsequences were obtained.

Plain film of the cervical spine from 2016 FINDINGS: There is no evidence for compression deformity or subluxation. There are no areas of bone marrow edema. Craniocervical junction is unremarkable. The paraspinal musculature is unremarkable. No areas of abnormal cord signal identified.

Flow voids are noted within the vertebral arteries. Multilevel disc desiccation and disc space height loss is noted. This space height loss is most pronounced at C4-C5. There is straightening with mild reversal of the normal cervical lordosis centered at the C4-C5 level.

Mild multilevel endplate spurring is noted. There is no prevertebral edema identified.c

There is a hemangioma within vertebral body T2. C2/C3: Mild bilateral uncovertebral joint spurring as well as moderate left and mild right facet hypertrophy results in mild to moderate left and mild right neural foraminal stenosis without spinal canal stenosis.

C3/C4: Mild bilateral facet hypertrophy and uncovertebral joint spurring resulting in mild left-sided neural foraminal stenosis. There is no spinal canal stenosis. C4/C5: There is disc - osteophyte complex formation with a mild broad-based posterior disc bulge.

Mild to moderate bilateral facet hypertrophy is noted. Uncovertebral joint spurring is more pronounced on the left. This results in severe left and moderate to severe right neural foraminal stenosis and mild to moderate spinal canal stenosis with contact of the ventral surface of the cord with mild cord flattening.

There is mild increased T2 cord signal intensity within the ventral aspect of the cord best appreciated on sagittal image 7 of series 2. This may represent chronic changes of myelomalacia or compressive myelopathy given the focal cord contact at this level.

C5/C6: Moderate right uncovertebral joint spurring and mild bilateral facet hypertrophy result inc moderate to severe right neural foraminal stenosis. There is no spinal canal stenosis at this level.

C6/C7: There is a mild broad-based posterior disc bulge resulting in mild bilateral neural foraminal stenosis without spinal canal stenosis.

C7/T1: No significant disc bulge, neuroforaminal stenosis, or spinal canal stenosis identified.

IMPRESSION: Moderate multilevel discogenic and degenerative changes most pronounced at C4-C5 with mild to moderate spinal canal stenosis, ventral cord contact with mild cord flattening, suspected mild chronic cord changes/myelomalacia, and high-grade neural foraminal stenosis.
Welcome to the board. Since I do not know what experience you may have with neck problems, or what level of knowledge you have regarding the neck, I will begin with a bit of basic information...terms that are used in the MRI report, just in case you are not familiar with them.

Probably the two most common issues that people deal with when dealing with neck pain come from disc degeneration and stenosis. Intervertebral discs are the structure that separates the vertebrae of the spine. They act as a cushion and, along with the adjoining facet joints, are what allows us to bend and twist and enjoy movement in the back and neck. The disc is constructed like a jelly doughnut with a soft inner core surrounded by a tough, fibrous outer ring. The discs contain something like 90% moisture and yet do not have a direct source of replenishment. They get nourishment by absorbing it through the vertebral endplates that they fasten to. Consequently as we age, discs tend to lose moisture and flatten out and the disc spaces narrow. The sad part is that the spine begins the aging process in our twenties! Just daily living takes its toll and the spine begins to show degenerative changes, often beginning with the discs. This can result in things like degenerative disc disease, and bulging/herniated discs.

Second, stenosis, a Greek word that means "narrowing." In the spine there are two areas where stenosis the central canal, that contains the spinal cord, and in the neuralforamen. Simply put, foramen are the holes that are formed when the vertebrae are stacked up, where the nerves go as they exit the spine to go out to the part of the body they innervate. If something puts pressure on or expands into an opening, it can result in nerve irritation or compression. In the case of numbness the particular nerve is being compressed a great deal!

Now to your report. Oh, one more thing...radiologists use specific adjectives to describe "how bad" something is: minimal, mild, moderate and severe.
When something is judged to be minimal or mild, it will be ignored. Moderate will be noted, perhaps watched or treated and severe often means there is a problem requiring attention and sometimes surgery. Always remember that imaging is just one piece of the diagnostic puzzle. The information will be correlated to what is found on physical exam and a basic neurological exam. The spine specialist may see something differently from the radiologist who writes the reports. In fact, most spine specialists do not read the reports but prefer to view the imaging and make their own evaluation.

You will see that there are degenerative changes going on throughout the cervical spine, with the greatest changes occurring at C4-5. Most levels have foraminal stenosis or narrowing caused by either a disc issue or an enlarged facet joint...and it is judged to be mild to moderate.

C4-5 there is more degeneration going on...a disc bulge along with formation of little bone spurs along with arthritic changes and enlargement of the facet joints result in greater foraminal stenosis...severe on the left and moderate to severe on the right side...and stenosis in the central canal as well. All this extra "gunk" takes up room that is needed by the nerves to function as a result as the canal is being pushed in, it comes in contact with the spinal cord causing possible myelomalacia or possible myelopathy. Either of these can be a serious issue and should be investigated further by your spine doctor.

Generally speaking with severe stenosis and contact with the spinal cord, it is wise to be treated promptly.

Do you have an appointment with either an orthopedic spine or neuro surgeon?
If not, you should make one soon so you receive a proper diagnosis and plan of treatment. I'm not indicating you will need surgery, but at the very least the cord compression will need to be evaluated and followed.

Hope this helps you to understand some of the language in your report.
thank you very much for your time and this was explaied very well , thanks again and i do have appointment with Neurosurgeon in columbus ohio friday 4/22/16 hope he can help me without surgery ! thanks again.
I would suggest you read up on myelomalacia before your appointment so you will understand what the surgeon is talking about, or so you can ask questions. You might give some thought to what you want to know ahead of time, and write down your thoughts before you go in. Doctors are so short on time these days that they don't have time to go into anything in it helps if you know ahead of time what you want to learn from the appointment.

Good luck and let us know what you find out at the appointment!
went to Neurosurgeon and he showed me on the computer screen with an ink pen pointing at 'spine my Vertebre ' C2,C3,C4,C5,C6, said might have to put two long rods one on each side of my spine from my tailbone to bottom of my scull OR at Min. 2 6' pins with screws to support my neck and would be a long Recovery ay my age and other problems , he said you would probley kick me if i said "Surgery"wouldn`t you! (not until i have to have it and he said dont blame you). well it wil progress and you will know when you need the surgery because of the pain and movement,most .likely be seeing you in a few months.
I have similar symptoms especially at c4 to c6. I was told I have a hemangioma at base of skull one year after they found a disc bulge. Has your condition improved at all? I am concerned about the hemangioma but not the bulge. Best wishes in healing.

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