New MRI results

fernwhisper · 05-16-2011, 08:58 AM

Hiyas, I had a 2 level ACDF w/ corpectomy almost a year and 2 months ago. I ended up with a numb left arm and since then I am feeling numbness in my right arm now. My primary doc sent me back for another MRI w/ contrast and an EMG and I am waiting to go back to my Nuerologist. When I initially went to my Nuero I was blindsided and ill prepared. I want to be more informed this time wtih my results. I would appreciate any insight and opinions although I know diagnosis is a big no no on forums. Below is my MRI results.

MRI of the cervical spine without and with contrast
Clinical information: Upper neck pain. Prior surgical intervention on 3/2010. Comparison:MRI from 12/08/ 2009 which was prior to the surgical intervention. Technique:multiplana multisequence MRI of the cervical spine without and with contrat. Axial imaging is performed throughout the cervical spine. Findings:imaged posterior fossa is unremarkable. Craniocervical junction is intact. There is normal alignement without acute fracture or subluxation. INterval anterior cervical fusion from C4-C7. Localized susceptibility artifact degrades imaging. There is a question of partial fusion of the C2 and C3 vertebrae posteriorly. Heterogeneous marrow signal of the C4 vertebrae which demonstrates patchy areas of abnormal hypoattenuation on the T1- weighted imaging and mixed signal on T2 weighted imaging with patchy abnormal enhancement. Cervical and thoracic junctions are intact. Cervical cord is in anatomic location. On T2-weighted imaging at the level of the C6 vertebrae there is a persistent focal area of abnormal T2 signal intensity involving the cord substance. This measures approzimately 6-7mm. This was not clearly seen on T1 weighted imaging. There is abnormal enhancement at this level on postcontrast imaging. Multilevel ligamentum flavum hypertropy and facet anthropathy.
Degenerative disease is present as follows:
C3/4: Posterior disc osteophyte complex with a central disc protrusion. Effacement of ventral CSF
C4/5: Posterior disc osteophyte complex. Small uncovertebral osteophytes.
C5/6: Posterior disc osteophyte complex with a greater right-sided component. Moderate to marked right neural foraminal stenosis. Effacement of ventral CSF. No fefinitive cord impingement.
C6/7: Posterior disc osteophyte complex with a large broad-based disc bulge involving the right aspect. Impingement on the ventral cord is suspectected. Multiple moderate canal stenosis. Moderate to marked right -sided neural foraminal stenosis.
Impression : Interval surgical intervention in comparison with prior MRI. There has been stabilization anteriorly from C4- C7. There is abnormal marrow signal involving the C4 vertebrae which demonstrate abnormal enhancement. Etiology is uncertain. Neoplastic process cannot be excluded. Persistent abnormal signal intensity of the cord at the C6 vertebral body level which demonstrates abnormal enhancement. Etiology of this signal abnormality is uncertain. If the patient has a primary carcinoma secondary neoplastic process cannot be excluded. Since this was previously identified addition lessions such as ependymoma cannot be excluded. Multilevel cervical spondylosis without significant change more pronounced at the lower cervical spine as described above. Clinical correlation is essential

Please someone, give me some input and rest my mind lol!

ginnie · 05-16-2011, 09:28 AM

I am ten months post. C3-7. My second after a failed surgery on C6-7. I also had spondiolosis where my vertrebre, were rolling on top of each other. I think your worst problem seems to be at C6-7, and it includes a disk buldge. Other vertrebre seem to have measures of difficulity. Get all the tests you can, and seek a second opinion if you can. I have no real negative things to tell you other than my surgery though painful, did help. I had my first 6 years ago, I continued to degenerate until I was in a sad sad shape. Then they did a big surgery, 6 years later when I was much much worse. If I had been told, I was going to degenerate on all the rest of my cervical spine, I would have asked my neuro, why he didn't correct it all to begin with. If your pain is really bad with the NP you mention, if Possible, i hope your surgeon and neuro can correct it. This sounds like a fixable thing. Have you talked to your neuro about all options yet? Please try to be calm, gosh I know how hard that is too. I believe there can be a solution with the right neuro. This took me several doctors to find my answer.. I truely wish you all the best. Others will be along that may address the individual aspects of your MRI results. Read all you can and look up words that your don't know.

ginnie

fernwhisper · 05-16-2011, 09:41 AM

Hey Ginnie, and thanks for a quick reply! My ACDF was C5/ thru C/7 so I am surprised to see more problems there. I think they difference was mine was Anterior and now my new results are Posterior. It was my understanding that C6 was done with a donor vertebrae too, so again I"m surprised. I am awaiting my apt with the Neuro so I haven't had the opportunity to discuss options and all that good stuff lol! I have been researching and tryin to be more informed this time around, what a daunting thing this research is lol! From the begining of my journey, I"m amazed at how quickly things progress, and what we overlook through the years, hindsight is a boogie isn't it? I think I will get more Neuro opinions this time around, maybe a new Neuro this time around will have more options and a fresh opinion. I wish you the best as we all go through our neckie tribulations lol!

Leesa · 05-17-2011, 06:42 AM

Ferwhisper ~ You need to talk with your surgeon ASAP, as there is mention of a carcinoma. Either talk with your doctor or your surgeon. But please call them. God bless. Hugs, Lee

ginnie · 05-17-2011, 08:00 AM

Lisa is right. If there is mention of an carcinoma, even more important you get that other opinion. Keep strong and find that doctor that will help you. You should be very comfortable with your doctor, and he should explain every detail to you, even after you look up the information. By the time my surgery rolled around, I was prepared, as I came to this site, did the research and found out exactly what was going on before I went to the appt. to dicuss the acutual proceedure. Scared, absolutely, but I did get alot of encouragement from this site. good luck and I wish you no pain in your future. ginnie

Dubious · 05-17-2011, 01:53 PM

Quote:

Originally Posted by ginnie

I am ten months post. C3-7. My second after a failed surgery on C6-7. I also had spondiolosis where my vertrebre, were rolling on top of each other. I think your worst problem seems to be at C6-7, and it includes a disk buldge. Other vertrebre seem to have measures of difficulity. Get all the tests you can, and seek a second opinion if you can. I have no real negative things to tell you other than my surgery though painful, did help. I had my first 6 years ago, I continued to degenerate until I was in a sad sad shape. Then they did a big surgery, 6 years later when I was much much worse. If I had been told, I was going to degenerate on all the rest of my cervical spine, I would have asked my neuro, why he didn't correct it all to begin with. If your pain is really bad with the NP you mention, if Possible, i hope your surgeon and neuro can correct it. This sounds like a fixable thing. Have you talked to your neuro about all options yet? Please try to be calm, gosh I know how hard that is too. I believe there can be a solution with the right neuro. This took me several doctors to find my answer.. I truely wish you all the best. Others will be along that may address the individual aspects of your MRI results. Read all you can and look up words that your don't know.

ginnie

In short, your report does not say you have bad things. It says things are not normal and what is seen could be bad but is not identifyable or conclusive. What it does say is to follow up with your doc to clarify the problem.