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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

First off, your cervical spine encompasses the first 7 vertebrae c1 at the base of your skull through c7 roughly at the bottom of your neck. Each pair of these vertebrae are separated by spongy discs made of about 90% water. Over time, the moisture content lowers (called dessication), and the disc height lowers. When that reaches a certain point, the pairs of vertebrae start to rub on one another which causes bone spurs to form. You have that in most areas of your c-spine. That isnt a big deal on its own. It really depends on where and how much the spurs grow. If they grow too much centrally they can impact the spinal cord and laterally they can affect the nerve roots. The distinction is important as cord symptoms can affect anywhere below the area of the impacted cord (a c6 cord compression can cause symptoms in your legs for instance). Compression of a nerve root will only cause symptoms where that nerve root delivers sensory or motor messages (c6 right nerve root compression may cause pain in your right shoulder but not in your legs).

Now for specific areas of concern on your mri.

C5/C6 - this is the area of most concern because the bonespurs at this level are pressing on the spinal cord (mass effect). It doesn't give the actual canal diameter or an idea of the extent of the compression but it does say moderate narrowing.

C4/c5 - here the big issue is the bone spurs causing severe narrowing of the area for the right nerve root to exit. The scale is usually minimal, mild, moderate, severe, so you cant get much worse there according to the reading. Note there is some narrowing of the cord space as well but that is not at a point where it is likely to cause symptoms.

C3/c4 - similar to c4/c5 but left nerve root exit moderate/severe compromised.

What does this mean:
It is *possible* the tingling in your leg, gait trouble and dropping things are due to the compression of your spinal cord at c5/c6. If that is the case, you have something called cervical spondylitic myelopathy (CSM)1. Other symptoms to look for are twitching/spasms, bowel or bladder issues, possibly weakness in limbs. It is possible your symptoms are caused by some other process as well. You'll need a good spine specialist to help sort that out.

The pain in arm/shoulders is most likely due to the nerve roots being compressed at c4/c5 and or c3/c4. It's seems like a pretty classic case of radiculopathy (or pain radiating through the dermatome of the spinal nerve that is compressed. You can look up dermatome maps online to see how that works).

I would get an evaluation from a spine specialist as soon as possible. This is a neurosurgeon or orhthopedic surgeon with specialized training in the spine that limts their practice to spine issues only. If it is CSM, the course is difficult to predict and there is some evidence that the longer compression remains the more likely there will be long lasting damage. They will be able to help manage the radicular symptoms and evaluate the other spinal canal narrowing as well.

I'm amazed that the insurance company put up a fuss with your symptoms, especially with a clear head mri.

Good luck and let us know how things go...

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