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Spinal Cord Disorders Message Board


Spinal Cord Disorders Board Index


Cervical disc mri
Oct 10, 2016
Been watching this for years and recently developed all kinds of issues. Weakness both arms, intermittent pain down right arm into thumb, difficulty twisting/opening jars etc with both hands, vague shoulder pain. None of the pain and weakness is off the charts, but certainly noticeable. If I do PT (which N said may be an option), will it really help or am I just putting off the inevitable? (past Chiari 1 Malf surgery mentioned, which is no longer an issue)

Findings:

Suboccipital craniectomy with partial resection of dorsal C1 arch
redemonstrated

Mild reversal of cervical lordosis. Stable.. No abnormal intramedullary
signal.. Visualized marrow within normal limits.

C2/3: No significant abnormality.

C3/4: Severe left facet joint degeneration stable. Moderate left neural
foraminal narrowing. Small central extrusion stable..

C4/5: Small grade 1 anterolisthesis. Severe left facet degeneration. No
significant change..

C5/6: Decreased disc space height. Large broad central extrusion/osteophyte
complex. Moderate cord flattening. Ligamentum flavum hypertrophy. Moderate
spinal stenosis. No abnormal intramedullary signal. Cord flattening has
progressed.. Moderate bilateral neural foraminal narrowing, greater on the
right...

C6/7: Loss of disc space height. Endplate degenerative changes. Moderate
left neural foraminal narrowing. Moderate broad based central
extrusion/osteophyte complex. No significant change..

C7/T1: No significant abnormality.


IMPRESSION:

Reversal cervical lordosis with severe degenerative changes worse at C5-6
with large broad central extrusion/osteophyte complex causing moderate cord flattening which has progressed. Moderate spinal stenosis. No abnormal
intramedullary signal.

Stable postop changes craniocervical junction from Chiari impression..
Welcome to the board. Sometimes insurance carriers require a course of physical therapy before they will OK surgery. Otherwise, with the amount of severe stenosis indicated on the MRI, I would guess more surgery is in your future.

Most of the stenosis issues indicate that the foramina as mentioned above are almost completely blocked, making it difficult for the affected spinal nerves to exist and remain healthy...but apparently none of this is any worse than when the previous MRI was performed.

The exception to this is at C5-6 where there was previous cord flattening and it has become more flattened. There is an extruding disc, meaning the disc material is coming out of the disc, causing the disc space to narrow. This degenerative process is causing some small bone spurs to grow on the adjoining vertebra ( disc osteophyte complex) which result in enlargement of the joint at this spinal segment. Since space is so limited in the neck, anything that gets bigger than it should be puts pressure on the nerves and, potentially on the spinal cord itself. This has the potential to be very harmful. If the spinal cord is compressed it can damage the cord itself, damaging the nerves contained within the cord. It can result in a disease called myelomalacia which causes the spinal cord to soften and can be very serious.

Personally, when someone has severe stenosis, I don't see how PT can help...but I am not a doctor so perhaps just don't understand all the intricacies. It appears you have had these bulging discs for awhile, so I doubt at this point PT is going to help heal the discs!





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