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Can someone translate my cervical MRI

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Unread 04-15-2012, 06:58 PM   #1
edensvision
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Default Can someone translate my cervical MRI

Been about a week since it was done but have not recieved a call from my doctor to come in for the report. So i picked it up myself and waiting to hear from them. I am 7 years post opt 2 surgeries/2 cervcal fusions c5/c6 & c6/c7.

There is evidence of fusion c5-c6. Good alignment. The hardware and vertibral bodies could not be optimally evaluated due to the magnectic susceptibility artifactacts.

There is loss of disc height & signal at level c3-c4, c4-c5, & c7-t1 representing degeneration/desiccation of the discs.

The bone marrow signal of the vertebral bodies & posterior elements appear normal with no evidence of focal enhancement.
c2-3 unremarkable
c3-4 Moderate sized disc osteophyte complexes seen without a significant compression on the thecal sac or the nerve roots. The facet joints appear normal. No evidence of sinal stenosis.
c4-5 There is prominant uncinate spur assymmetrically more towards the rights & moderate facetal arthropathy. There is narrowing of the right neural foramen c4-5 which was also notes in the previous study 1/2011. The left nerual fomrmina appear normal, no evidence of spinal stenosis.
c5-6 There is diffuse enlargement of the right nerve roo c6 whch shows contrast enhancement & a small surrounding fluid in the right neural foramen. This may represent neuropathy /neuritis. This was not notes in the previous study. There is a 5.5 x3.7 MM extradural meningeal cyst in the latter part of the left neural foramen c5-c6 displacing the left nerve root c6 anteriorly. This is unchanged since the previous study. No evidence of spinal stenosis at this level.
c6-7 No evidence of neural foraminal or spinal canal stenosis. the facet joints appear unremarkable.
c7-t1 Unremarkable

The size & signal of the cervical spinal cord appear normal. There are some serpiginous areas of signal void seen in the cervical spinal cord which i believe represent imaging artifacts. Remote possibility of these representing tortuous spinal dural veins? May not be excluded. Images obtained after contrast enhancement do not show any areas of focal abnormal enhancement in the cervical spinal cord, vertebral bodies or the poseriror elements.

Impression:
1) Moderate severe right neural foraminal stenosis c4-5 which was also noted in the previous study 1/2011 & is unchanged in the interval
2) Moderate thickening of the right nerve root c6 with a surrounding fluid may represent neurapathy./. This waas not visualized in the previous study.
3) A small extradural meningeal cyst posterior to the left nerve root c6 with displacing the nerve root anteriorly.
4) Anterior spinal fusion c5-c7. Good alignment of the vertebral bodies.
5) Degeneration/desiccation of the intervertebral discs level c3-4, c4-5,c7-t1
6) other findings as above.

Can any translate or decifer any of this for me please????
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Unread 04-15-2012, 11:27 PM   #2
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Quote:
Originally Posted by edensvision View Post
Been about a week since it was done but have not recieved a call from my doctor to come in for the report. So i picked it up myself and waiting to hear from them. I am 7 years post opt 2 surgeries/2 cervcal fusions c5/c6 & c6/c7.

There is evidence of fusion c5-c6. Good alignment. The hardware and vertibral bodies could not be optimally evaluated due to the magnectic susceptibility artifactacts.

There is loss of disc height & signal at level c3-c4, c4-c5, & c7-t1 representing degeneration/desiccation of the discs.

The bone marrow signal of the vertebral bodies & posterior elements appear normal with no evidence of focal enhancement.
c2-3 unremarkable
c3-4 Moderate sized disc osteophyte complexes seen without a significant compression on the thecal sac or the nerve roots. The facet joints appear normal. No evidence of sinal stenosis.
c4-5 There is prominant uncinate spur assymmetrically more towards the rights & moderate facetal arthropathy. There is narrowing of the right neural foramen c4-5 which was also notes in the previous study 1/2011. The left nerual fomrmina appear normal, no evidence of spinal stenosis.
c5-6 There is diffuse enlargement of the right nerve roo c6 whch shows contrast enhancement & a small surrounding fluid in the right neural foramen. This may represent neuropathy /neuritis. This was not notes in the previous study. There is a 5.5 x3.7 MM extradural meningeal cyst in the latter part of the left neural foramen c5-c6 displacing the left nerve root c6 anteriorly. This is unchanged since the previous study. No evidence of spinal stenosis at this level.
c6-7 No evidence of neural foraminal or spinal canal stenosis. the facet joints appear unremarkable.
c7-t1 Unremarkable

The size & signal of the cervical spinal cord appear normal. There are some serpiginous areas of signal void seen in the cervical spinal cord which i believe represent imaging artifacts. Remote possibility of these representing tortuous spinal dural veins? May not be excluded. Images obtained after contrast enhancement do not show any areas of focal abnormal enhancement in the cervical spinal cord, vertebral bodies or the poseriror elements.

Impression:
1) Moderate severe right neural foraminal stenosis c4-5 which was also noted in the previous study 1/2011 & is unchanged in the interval
2) Moderate thickening of the right nerve root c6 with a surrounding fluid may represent neurapathy./. This waas not visualized in the previous study.
3) A small extradural meningeal cyst posterior to the left nerve root c6 with displacing the nerve root anteriorly.
4) Anterior spinal fusion c5-c7. Good alignment of the vertebral bodies.
5) Degeneration/desiccation of the intervertebral discs level c3-4, c4-5,c7-t1
6) other findings as above.

Can any translate or decifer any of this for me please????
Yes....you need help....go see a spine specialist!
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Unread 04-16-2012, 12:18 AM   #3
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Originally Posted by Dubious View Post
Yes....you need help....go see a spine specialist!
I thank you. I understand no one is a Doctor here. I was just wondering if anyone knew about what any of this meant as a whole picture or in pieces.

I have been through this for 7 years now. The last neurosurgeon I saw based on last years MRI said oretty much that there wasn't anything they could do for me. Am I worse now? I feel worse, having a lot of arm weakness and hurting more. Just not sure on the medical jargon as to why....
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Unread 04-16-2012, 01:51 AM   #4
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Here you go edensvision. I've tried to simplify the findings and added some great references that explain things better than I can. I hope it helps.

Impression:
1) Moderate severe right neural foraminal stenosis c4-5 which was also noted in the previous study 1/2011 & is unchanged in the interval


There is a narrowing in the spine, (can be the result of a bulging disc, torn disc, osteophyte, or many other conditions) in the neck at level C4-5 (around the middle of your neck), but it was there on your last check and hasn't changed since then.

2) Moderate thickening of the right nerve root c6 with a surrounding fluid may represent neuropathy. This waas not visualized in the previous study.

The nerve roots arise from the spinal cord and pass out between the discs of your spinal column. Your's has thickened at C6, which is a new finding. They say it might be caused by neuropathy, which is a collection of disorders that occurs when nerves of the peripheral nervous system (the part of the nervous system outside of the brain and spinal cord) are damaged.

3) A small extradural meningeal cyst posterior to the left nerve root c6 with displacing the nerve root anteriorly.

extradural means outside of the spinal canal

meningeal refers to the membrane around the spinal canal

There is a small cyst almost at the bottom of your neck (C6) sitting on the spinal canal's external membrane, close to where the nerve exits between the dics. It's not pressing on the nerve from the front view.

4) Anterior spinal fusion c5-c7. Good alignment of the vertebral bodies.

Your spinal fusion is evident and looks good.

5) Degeneration/desiccation of the intervertebral discs level c3-4, c4-5,c7-t1

There's disc wear visible in most of your neck. Degeneration is usually caused by arthritis

6) other findings as above.

References:
http://www.orthogate.org/patient-edu...e-anatomy.html
http://www.netdoctor.co.uk/ate/muscl...ts/203244.html
http://www.medicalnewstoday.com/articles/147963.php
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Unread 04-16-2012, 02:08 AM   #5
edensvision
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I THANK YOU YOU SOOOOOO MUCH!!!!! FOR YOUR TIME, YOUR KNOWLEDGE AND YOUR COMPASSION.

I had a recent emg that stated I had a new problem at c5c6, and this explains it, bt you have helped me understand the jargon.

I live on my meds, i can't do too much without hurting my shoulder and arm, so I have to limit myself or it hurts worse than the daily pain.

It's nice to at least get a peak into what the report means. Thank you so much I will go to your links and check things out more. I appreciate it very much!!!!
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Unread 04-16-2012, 08:11 PM   #6
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the only link that i could get to work was the last one unfortunately....If you or anyoe else can send me new one's or more input that would be wonderful
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Unread 04-16-2012, 09:33 PM   #7
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Gosh, I don't know why those links don't work, especially when I checked them prior to posting, but they won't work for me now either.

The first link is this this one : http://www.orthogate.org/patient-edu...neck-pain.html

...but sadly I've been unable to get the second link back but I've added these instead.

http://www.ajronline.org/content/178/1/201.long
http://www.nature.com/sc/journal/v44.../3101848a.html
http://www.arscerebri.com/ucsd/usefu...4/13-4-cp1.pdf
http://www.pagepress.org/journals/in....2009.e17/1353

The last 2 might have too much medical jargon for you to understand, but hopefully you'll find something useful in at least one of the links.

My own knowledge of this condition is rather limited, but hopefully some-one else will be able to tell you more.
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Unread 07-08-2012, 12:36 AM   #8
edensvision
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Question UPDATE to Translate MRI

I have been to the Dr. Was confusing but told I have neuritis c5c6. Don't know why, and told if conservative measures didn't work i was a candidate for a Frominotomy.

I have grave concerns about the cyst and opening me up at all due to already having two cervical fusions at two different times in 7 years.

I am concerned they don;t know why I have nueritis, and when offered a forminotomy verbally, it was said...."we can give you a forminotmy and get in there and see what's going on"....I said "I'd prefer more testing to know why wouldn't you?" He didn;t feel it was neccesary at this time.

I have done a 6 weeks conservative measure of a weeks worth of a streoid pack and increased my bacolfin, nuerotin. Had one trigger pint injection
On the second round of 6 weeks conservative measure with the same, and fixing to go for my seconf trigger pint injection. I am three weeks through this.

My forarms are really bad and it hurts to outstretch my arms due to extreme elbow pain and the nerve that runs into my forarms. Still have arm weakness and sharp pains in my shoulders.

I am unsure as the Dr said he believed the neuritis could be from everything i have had done in 7years, two surgeries, several trigger pint injections epidural injections. I'm just not getting better but worse now. But believe I have tried all that I can.

Was told in December based on 2011 old MRI nothing could be done for me. Now in May told I might be a candidate for a forminotomy with the updated MRI and EMG results. I am conflcited. I'm relieved i might be able to get some relief, but scared to have another surgery. I desperatly need the relief but not so sure I won;t need another fusion later in life and don;t want to be opened up a third time let alone a fourth. So I'm conflicted as you can tell. I want relief and hope no further permament damge is being done, but not sure it isn;t and not sure how long a forminotomy lasts and does it resolve the issues once and for all....ugh

Any advice, translation defining understanding or future prognosis based on experience would be very helpful and is much needed from you or anyone else on this board
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Unread 07-08-2012, 11:12 AM   #9
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Default edensvision,

I have to tell it like it is. While we all (patients and surgeons) hope for the best, and it can happen, no surgical procedure is or can be guaranteed to resolve issues once and for all. Surgery releases are like investment disclosures in that past performance (others' experience) is no guarantee, or even an indicator, of future results or expectations. Prognosis, like diagnosis, is a fancy term for an educated guess. Each patient/situation is unique.

The translation may be kind of vague, but sometimes that's the best that can be done/hoped for. Doctors/surgeons usually don't know as much as we think/believe or would expect/like them to know. There's a lot of trial & error -- that's how surgeons learn. Much of medicine is an empirical science.

Neuritis means an inflamation of a nerve or nerves. When it's not the optical nerve, neuritis is often equated with peripheral neuropathy (seems odd/vague to me too). They very well may not know why, and are making the best guess they can, regardless of how many tests they perform. They just can't ask your nerve why it's angry/cussed off, but that's what it means.

Foraminotomy can be a minimally invasive procedure -- perhaps even a microsurgery -- done with small incisions, cameras, and instrumentation, to carefully cut away portions of the foramen to relieve pressure on the nerves branching out from the spinal cord. If done that way, it should have minimal effect on your previous surgeries.

Personally, I think stress, in all its forms (physical from surgeries, injections, pressure, tightening up from pain/worry, etc. and emotional/psychological from fear & worry) is exacerbating everything, and I think your doctors would agree (and please feel free to ask them). I don't know if you have or haven't tried all that can be tried.

To be told different things by different doctors is common. There's an old saying that if you ask ten doctors the same question, you'll get ten different answers, because doctors give medical opinions (albeit based on whatever facts can be garnered). This is just one reason (there are more) to get multiple opinions regarding any surgery.

The folks on this board didn't learn what they know solely from their own experiences and/or by osmosis. Most of us found ourselves in the same situation as you in that we were confused by the doctors and not understanding the jargon, conditions, and procedures being discussed. What we've all had to do is a LOT of HOMEWORK. Fortunately this has become much easier than it used to be due to the internet's vast resources (including this group and others like it).

My advice/suggestion is to dig-in and research all you can about anything/everything related to your past and current conditions & procedures, so that you'll at least be able to keep up and question your doctors intelligently, and in the end, be able to make the best informed decision(s) you can for you about your future care. We'll be here to help where we can, but we are not doctors; we're all patients -- more like you than you may think(?)

Doc
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Last edited by Dr. Smith; 07-08-2012 at 11:45 AM. Reason: added thought
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Unread 07-08-2012, 11:21 AM   #10
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Default Hi Edensbvision

The post expaining your cervical neck was really good. The only thing I could add to that, is to look up each individual word on google, to get familiar with the terms. The more you know, the more this cervical issue will make sense.
When you have nerve compression due to a cyst, or damage, do seek your neurologist again and see what he says. Hope when you get your appointment that he can tell you if something can be done to help. Don't be afraid to quiz your doctor. I wrote down all the questions I had so I wouldn't forget. I wish you all the best. ginnie
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