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Thanks for your reply. For me I feel the need(ed) to extinguish all other non-invasive treatments before going under the knife. And in my mind I have tried almost everything and I am closing in on decision time.

This MRI was performed in 2012. I had one done the other day. I have yet to receive the report but my doctor did. He did say that it has deteriorated a little more.

Any thoughts on the MRI would be great.


MRI -

Technique 1.5 Tesla MRI was utilized. Sagittal T1, STIR, and T2- weighted images were performed through the cervical spine.


FINDINGS: Vertebral bodies are normal in height. There is no evidence of spondylolisthesis. There is straightening of the normal cervical lordosis. No evidence of vertebral fracture. No evidence of destructive bony lesion. The visualized portion of the posterior fossa is unremarkable without evidence of Chiari I. The visualized spinal cord is normal in signal. Facet joints appear unremarkable throughout the cervical spine except C7-T1.


C2-C3: Normal

C3-C4: Mild disc desiccation with normal disc height. There is a diffuse disc bulge with left greater than the right unconvertebral osteophytes and left posterior endplate osteophytes. AP diameter of the thecal sac measures 8.5mm in the midline with mild left ventral cord flattening. There is mild left foraminal narrowing. No right foraminal stenosis.

C4-C5: Mild disc desiccation with normal disc height. There is a diffuse disc bulge with superimposed central disc protrusion. There is additional left foraminal disc protrusion. AP diameter of the thecal sac measured 8mm in the midline with mild left ventral cord flattening. There is moderate left foraminal narrowing. No right foraminal stenosis.

C5-C6: Mild disc desiccation with normal disc height. There is a diffuse disc bulge with superimposed central disc protrusion. There is additional left foraminal disc protrusion. AP diameter of the thecal sac measured 8mm in the midline with left greater than right ventral cord flattening. There is severe right and moderate left foraminal narrowing.

C6-C7: Mild disc desiccation with normal disc height. There is a diffuse disc bulge. AP diameter of the thecal sac measured 8.5mm in the midline with mild ventral cord flattening. There is mild to moderate right and mild left foraminal narrowing.

C7-T1: Normal disc signal and height. minimal disc bulge. Moderate right and mild left facet arthropathy. No stenosis.

T1-T2: Normal

IMPRESSION:

1. there are disc bulges/osteophytes and protrusions at C3-4 through C6-7. This results in Mild C3-4 and C6-7 and mild to moderate c4-5 and c5-6 central canal narrowing with cord flattening.

2. There is mild left C3-4, moderate left c4-5, severe right and moderate left c5-6, and mild to moderate right and mild left c6-7 foraminal narrowing.

3. there is facet arthropathy at C7-T1.

4. Straightening of the normal cervical lordosis.
OK, to start with the adjectives:

Moderate = clearly there, and possibly borderline problematic

Severe = likely problematic

straightening of the normal cervical lordosis = your cervical spine reverses the forward lean of the thoracic spine at shoulder level - this change to (relatively) backward-bending is called lordosis. The radiologist is saying you're not as lordotic as you "ought" to be. However, this is so common that it's almost boilerplate, at least for people who are 45+. For you, it MAY be a little worrisome, but I really don't know. Besides, he did not indicate that he thought it's problematic.

Mild disc desiccation with normal disc height. = your disks are starting to dry out, but haven't compressed yet. As you get older, they will compress, if you don't take care of them by stretching and by avoiding bad posture.

superimposed central disc protrusion = My guess is that he's saying the disk is herniated, that the soft inner filling has broken through the tough outer layer. I'm not sure that's what he means, but since he uses "protrusion" in ADDITION to "bulge", that's what I'd guess. If the disks are only slightly dessicated and still of normal height, but they're STILL herniating, then perhaps that's due more to trauma than to decades of wear and tear.

unconvertebral osteophytes and left posterior endplate osteophytes = Extra bone ("spurs") is being laid on to the interfaces between the disks and the vertebrae

AP diameter of the thecal sac measured 8mm in the midline = The spinal canal, measured down the middle from front to back is 8mm. This is narrow, but not terribly so. I've seen 4mm several times.

with mild left ventral cord flattening = Whatever is pressing back into the spinal canal (disk bulge + protrusion) is pressing on the spinal cord a little and flattening the front of it. Not "indenting", which would be the next step, but just flattening.

There is mild left foraminal narrowing = the foramina - the holes in the front/side of the spinal cage through which pass the nerves as they go from the cord down into your arms - are being narrowed by the disk bulges, and possibly also by the osteophytes.

Believe it or not, only one thing definitely looks bad here, which is the right foraminal narrowing at C5-6. If the foramen is narrowed enough, the nerve will be pinched (radiculopathy), which could cause neck pain, but also a variety of symptoms from your right shoulder down to your thumb... everywhere the C6 nerve goes.

It's a little odd that if you had a 7mm herniation in 2009, as the radiologist in 2012 only refers to "superimposed disk protrusions".

I'd be interested to see the report from the most recent MRI. I suspect things are noticeably worse, particularly at C7-T1, as the C8 nerve that leaves from that level goes to your pinky and ring fingers.

I don't see anything in your report that would correlate to jaw pain. As for the hyperactive patellar reflexes, that could be an indication of cord damage. (I still have hyperative patellar reflex from damage that occurred seventeen years ago.) That's a little strange, in your case, because the report doesn't seem to indicate enough pressure on the cord to cause damage. Maybe the latest one does...





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