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Spinal Cord Disorders Message Board

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Hi Joanne....sorry I'm just getting to your MRI results now but I had a bad weekend myself....go to see if I have surgery on Wednesday.

So I'll try to explain your MRI results so that you understand them. Where they give you that long list of vertebrae with "hypertrophic" changes, that basically means arthritis as well as changes in the ligaments around the joints. If you were to look at the spine from the top down with the vertebra cut in half, you'd see the front of the vertebra is big disk of bone, round in shape, and in between each vertebra is a disk acting as a cushion between the bones. Behind the disk of bone is the hole where the spinal cord is. It has a covering called the Thecal Sac and that holds spinal fluid in around the cord. And then there is some room for the entire cord and covering to move within the spinal canal. The canal is anywhere from 12-18mms wide and the cord is usually about 11-12 mms. wide.

The disk is a hard but flexible "doughnut" that sits right in front of the canal...literally abuts the canal. Inside it is softer with a harder ring around it to hold the contents inside. With age or injury, that hard outer ring can develop a soft spot and cause the entire thing to bulge out the side or it can actually rupture and the insides then come out(herniated disk)and form a smaller 'width wise" bulge but often longer as it squishes out and can continue to squish. So when a disk starts to bulge, if the bulge is backwards, then it hasn't far to go to hit the Thecal Sac and then can push even further and hit the spinal cord. This is what you have at C3-4, C4-5 and C5-6. The only difference is where the bulge stops. At C4-5, the disk is hitting the thecal sac and your spinal cord but at the other 2, it's only hitting the sac and just touching the cord(means no signs of indentation in the cord).

Luckily for you, the big pain maker is when these bulging disks also hit the spinal nerves. These are nerves that peel off the spinal cord at each vertebra(kind of like peeling a banana) and exit through small holes in the vertebra and go out to the body. The cord, like the brain doesn't feel pain but those spinal nerves hurt like he!!. But those nerves and the tiny holes they go through are okay for you...that is good.

And along with the arthritis you have, the disks are slowly getting smaller as they do with age(everything shrinks with age, doesn't it..except the medical bills).

But the last thing they added was a first for here...the lordotic curve in your neck is getting deeper, instead of straightening. Lordosis refers to that inward curve we have in our necks and it normally gets straighter as we age...yours is getting a bigger curve to it...and the same goes for your lower back too.

As for the hemangioma...I'm hoping Feelbad will come along and explain them...she had one in her actual spinal cord that had to be removed. They are benign and so can stay there unless they cause a problem with your spinal cord. It may hurt a lot but there is not a lot they can do for it as far as I know. Eventually, they will probably have to remove the damaged bone and fuse the area from either side.

Now your lumbar spine......the situation is somewhat the same but here, the vertebrae are much, much bigger but the cord is much smaller as so many nerves have peeled off and even the holes where the nerves go out to the body(foramina or neuroforamina)are twice as big as in the neck.

At L3-4 and L4-5, again you have that bulging disk that has bulged backwards enough to hit the thecal sac of the cord and is pressing on the "peel off" nerves on both sides....those side nerves can cause pain and/or numbness above and below the knees and the back inside of the calves. At L5-S1, the bulge is even worse and is hitting the fat that is around the vertebra, the thecal sac and both the nerves going out to the body. This would cause pain/numbness in the feet(top and bottom) and the outside aspects of the calves. And you have arthritis in the vertebrae all the way down. Although the nerves are being hit, it says the holes where those nerve go out are all open so the bulges may be like mine are...hitting the nerves outside of the canal area on the sides...hard to explain but picture a doughnut that had squished out to both the sides and back and it's hitting things all over the place. I've got the same thing and until they show it to you on the MRI, it's hard to picture...but disks can bulge anywhere around the circumference and the nerves come out from the back of the bone and wrap around to the front so they can be hit in lots of places.

As above, the disks show loss of height and "signal intensity"...think losing a shadow gets lighter as the disks shrink up they look lighter on the MRI.

And as I said above, your back is developing a deeper curve to it.

So I hope this helps you understand what is going on. The arthritis alone can cause tons of pain. The nerve compression in your lower back can cause pain, numbness, tingling, pins and needles...all sorts of stuff. They didn't put in what they classified the amount of compression as. If you see the words "minimal, mild, moderate, or severe" in the report, that is how the list the amount of compression to the nerves or the cord.

Oddly enough, the one thing that probably worries you the most is where the disk bulges are hitting the spinal cord and thecal sac. When that happens slowly over time, it is not a big problem and the cord can take a lot of compression. The normal cord is about 12mms...mine was down to 5-6mms at 4 different levels before I had surgery. It's only when it happens suddenly that you have a big problem. With time, as it worsens, you end up with problems walking and numbness anywhere from the level of compression on down as well as others.

Anatomy lesson over...questions?????


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