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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Hi Freedog....I'm one of the MRI interpreting people so I'll see if I can help you.

1...straightening of lordosis due to positioning, muscle spasm or spondylosis. Our neck has a curve in it. If you look at the spine from the side, the neck curves inward toward the front of the neck then outward at the shoulder blades then inward again at the waist and then a small outward curve again at the very bottom. This is known as lordosis in the neck. It normally starts to go straight with age but can also look straight due to the position on the MRI machine or go straight due to muscle spasms pulling on the neck(and therefore may be fine when spasms stop) or go straight due to arthritis(spondylosis is the name for arthritis of the spine).

2....mild canal stenosis from C3-4 to C6-7. The spinal cord goes down through the vertebrae through an opening called the spinal canal in the back portion of the vertebrae. Diameter of the canal can differ so I won't give parameters but in general, radiologists list the amount of closing up of the canal by the words, minimal(1), mild(2), moderate(3) and severe(4). If you think of it as a number scale then a 2 out of 4 is not too bad but a 4 out of 4 is bad. So this relative has a problem but it is not significant as yet. Stenosis is the medical word for "closing up" whether it be the stenosis of the spinal canal or stenosis of an artery or valve in the heart. In the spinal canal, the closing up can come from being born with a narrow canal or from herniated disks filling it up or arthritic bone spurs building up or even a process where the canal itself begins to thicken.

3...this is where there is a problem. The "foramen" is the opening in the vertebral bone that allows the nerves to go out to the body. At each vertebra(except the first one) a pair of nerves peels off the cord and exits the bone by this foramen(foramen is medical for "opening") and in this case, there is foraminal stenosis...opening closing up. Again, they rate the degree of closing up with minimal(1), mild(2),moderate(3) and severe(4) and sometimes obliterated(5). So at C3-4, in the high neck, there is severe stenosis ...a 4 out of 4/5...bad. Moderate stenosis is listed for C5-6 and 6-7 a 3 out of 4/5 on the severity scale. The least amount of stenosis is at C4-5 where the right is moderate(3 out of 4/5) and mild on the left side(2 out of 4/5). Many things can cause the foramen to close up such as disk material and bone spurs.

All of this stenosis causes a lot of pain. It means a nerve is being compressed and that hurts like a son of a gun. But most spine docs will not operate until you reach that severe range(4 out of 4/5). At that point, they worry about the blood supply to the nerve being stopped by the compression and the death of the nerve. Nerve death means paralysis of the muscles fed by that nerve. So at that point, the pain may change to numbness, pins and needles sensation and muscle weakness....early signs of paralysis.

So I hope this explanation helps you pass along the info to your relative. I find using the number scale helps to get it across a little have a 4 out of 4 blockage says it pretty well.

Any questions, I am around.


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