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MRI -?severe left foraminal narrowing C5-6, disc-osteophyte complex - help plesae!

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Unread 10-31-2012, 05:06 AM   #1
Hartford
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Confused MRI -?severe left foraminal narrowing C5-6, disc-osteophyte complex - help plesae!

Another newbie looking for information, support and encouragement!

I am 59, long-time desk job with lots of computer, phone time, experiencing neck and radiating pain, at times debilitating, weakness in left shoulder and down left arm, for 5+ mos. Pain is aching, or stabbing, depending on position, activity. Seem to drop things more often. Some possible bladder, bowel symptoms, though I have put those down to just getting older.

MRI shows disc osteophyte complex C3-C6. Mild canal and foraminal stenosis, except for C5-C6, where radiologist notes severe left foraminal narrowing.

I assume that it is this is that is putting pressure on the nerve root, causing the pain and weakness through my shoulder, left arm (making left arm functionally fairly disabled - limited range of motion, no golf, swimming, yard work, sleeping on left side, etc, sigh..)? Using NSAIDs for pain, sometimes hydrocodone to be able to sleep at night (worse at night). My sleep is severely affected by the chronic pain.

My question is, with one nerve being impinged due to osteophyte, is surgery the most likely option for relief of pain, regaining function? It seems foraminotomy (?), at least, may be in my future, but do not want to jump to conclusions.

I will see a neurosurgeon in a few days, trying to schedule appt for a 2nd opinion as well, scheduled for epidural injection in a couple of weeks. Below are the results of my MRI - a lot of regular getting-old-rusty-neck-osteoarthritis stuff, but the pinched nerve, left arm pain and disfunction situation is debilitating.

Are there proactive non-surgical things I can do moving forward, to protect my neck from further deterioration? (stretch my neck?) Everything I know to date has been learned from this board - you all are an amazing resource. A few of you, who are so generous in sharing your time, accumulated expertise, and personal experiences have literally become my heroes - you know who you are. Thank you!

MRI:

FINDINGS: On the sagittal images, there is loss of the normal cervical lordosis. Vertebral bodies remain normal in height. Mild degenerative endplate marrow signal and contour changes are noted at C4-C5, C5-C6, and C6-C7, levels where there is also mild to moderate loss of normal intervertebral disc volume. The craniocervical junction is normal in appearance. The cervical spinal cord is normal in contour and signal intensity.

C2-C3: The disc contour remains normal and the central canal and neural foramina are widely patent.

C3-C4: There is disc osteophyte complex with a superimposed more focal left foraminal disc protrusion. This effaces the left ventral (SF space and in conjunction with facet arthrosis, leads to mild left foraminal narrowing.

C4-C5: Discosteophyte complex effaces the anterior CSF space and leads to mild canal stenosis (mid AP canal diameter of 8 mm). Uncovertebral hypertrophy more than facet arthrosis causes moderate narrowing of both neural foramina, left greater than right.

C5-C6: Disc osteophyte complex effaces the anterior (SF space and leads to mild canal stenosis. Uncovertebral hypertrophy and facet arthrosis contribute to mild right and severe left foraminal narrowing.

C6-C7: Disc osteophyte complex is eccentric to the right and results in mild canal stenosis. Uncovertebral hypertrophy contributes to mild to moderate narrowing of the right neural foramen.

C7-T1: The disc contour is probably normal and the canal and foramina appear patent.

IMPRESSION: Multilevel multifactorial degenerative changes as described above, with moderate C4-C5 and severe C5-C6 left foraminal stenosis.

For anyone that can share their impressions or thoughts, I am extremely grateful. I am used to being very active, and have needed both knees replaced for more than a year (also osteoarthritis). The development of the cervical problems as well leave me feeling pretty "old", but I am determined to regain my functionality and do what it takes to prevent further damage.

Bless you all!
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Unread 10-31-2012, 10:04 AM   #2
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Well there are several things going on there. As most here will tell you don't have the surgery for the pain. I have had multiple surgeries to my neck and the last was due to a severe herniation at C6-7 that caused complete stenosis of right foraminen and had significant canal/cord stenosis. I still have that same pain going into the shoulder and into the arm. I am still weak and drop things. Sometimes when a nerve is pinched the damage is permanent. Sometimes it will come back and heal with no symptoms.

Not sure what the approach would be from a surgical standpoint. The bony growth is definitely the cause of the major problems, but there is also at least on disc issue. Could be as simple as an ostephytectomy (sp) or they may do other more invasive procedures. When the nerves and cord are involved generally they like to get those free from what harms them. I would get several opinions on this one and make SURE they work at different companies.

Best of luck to you!
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Unread 10-31-2012, 10:55 AM   #3
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i have been experiencing the same thing guys.i to have problem with my disc'sc4thru7.they did surgery on my left shoulder.but later found that it was not just my shoulder but problem in my neck.suprisinly it was my lawyer who found the damage.doctor thought iwas faking.but anyway the surgeon said surgery on my neck would not get rid of the pain.so he sent me to a "nerve specialist".i get nerve block injections and nerve pills(gabapetin)
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Unread 10-31-2012, 01:56 PM   #4
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Does the dr think the pain and symptoms are related to the C3-C6 area?

Since you mentioned long time desk & phone work and with your symptoms, I just wanted to mention chronic RSI or even possible thoracic outlet syndrome TOS for short).
Or you could have both the c spine issues as well a some amount of TOS.
TOS is not well known and it takes a very skilled dr to sort out any spine vs TOS symptoms.

Have you had any kind of PT at all?
How is your upper body posture? head forward, shoulder forward?
If so that will close down the area where many nerves and blood flow goes thru, so that is some thing to work on.
Maybe lay on the floor in the yoga corpse pose a few times a day and see if that begins to help at all?

We have a thoracic outlet syndrome forum if you want to read a bit more about it.
sticky thread -Our Useful Links - Websites, Articles & Polls (TOS)
post #1 here has the basic starter info & links-
http://neurotalk.psychcentral.com/thread84.html

Our Symptoms of thoracic outlet syndrome -
http://neurotalk.psychcentral.com/showthread.php?t=5618
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Unread 10-31-2012, 06:39 PM   #5
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Default Hello Hartford

Helllo, and welcome to Neuro Talk. I read your MRI. What concerns me is that above the area of real trouble, C4-5 and C6-7 you have moderate problems with narrowing. There is something called the domino effect. If your neck is not strong enough to support the hardware with surgery, the ones above the site can fail. this is what happened to me. I was not told that the area above the first concern at C6-7 were damaged. I had fusion at C6-7 and then 6 years of misery later, I had that re-done with C3-7. This wasn't fun. Make sure that you do go for a second opinion to a neuro surgeon, and ask this specific question OK? I do want you to know the surgery can be successful. My second was good, and I don't have unbearable pain anymore. I wish you all the best as you go forward, and try to find a solution. ginnie
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Unread 06-18-2013, 04:14 PM   #6
jonlyn
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Default My MRI results.. what does this mean?

I have fusion C5,6,7 and L5,S1...
Reason for this MRI was numb left chest, arm underarm, wrist and thumb
I have MRI w/ contrast scheduled for August 20th.. waiting on EMG appointment to be scheduled.

RADIOLOGY REPORT

Report:
REPORT: MRI of the of the thoracic spine was performed. Exam was
done in the sagittal plane using a T1, T2 and STIR. Axial T2 is
were obtained from T1 down through T8.

FINDINGS: There is a mild scoliosis of the spine convexity to the
right. There are postsurgical changes seen in the visualized
portion of the lower cervical spine with an anterior fixation
device seen at C5 down to C7. There is a central CSF collection
seen within the cord extending from T3-T4 down through T5-T6. At
its widest its measuring 1.5 to 2 millimeters. The appearance be
consistent with a syrinx. Signal intensity from the visualized
portion of the cord otherwise appears unremarkable. No focal STIR
signal abnormality seen within the vertebral bodies. There's no
significant impression upon the thecal sac. It does appear to be
foraminal narrowing seen at C7-T1 bilaterally. There is
desiccation of the T10 T11-T12 disc. Is a minimal bulge without
evidence of a focal protrusion again no significant encroachment
seen of the central canal or foramina. Paraspinal soft tissues
appear unremarkable. There is a 1.5 cm focal area of bright
signal seen within anterior to the spine seen at the level of
T10. This is poorly evaluated on this study but I believe are
represents the hemangioma that had been crus evaluated with MRI
of the abdomen.





Impression:
There is a mild scoliosis of the thoracic spine convexity to the
right. There are postsurgical changes of the visualized lower
cervical spine. There does appear to be foraminal narrowing seen
at C7-T1 which I suspect is related to hypertrophic changes
involving the posterior elements. If this is of clinical concern
this could be more completely evaluated on the basis of MRI of
the cervical spine. Otherwise there is mild spondylitic changes
seen within the spine with no significant encroachment upon the
central canal foramina at remaining visualized levels.

There is syrinx seen within the cord from T 3 down to T6. I
suspect this is idiopathic with limited clinical significance.
However this should undergo further evaluation with an MRI of the
neural axis to include post gadolinium imaging
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Unread 06-19-2013, 06:26 PM   #7
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Dearheart, if you are having bowel and bladder problems this is SEVERE! ANY time those are effected, you could be in trouble!

I think you're looking at surgery, and probably the sooner the better. Cauda Equina syndrom is nothing to sneeze at. And you CERTAINLY don't want that to become permanent!!

MAKE SURE YOU TELL YOUR SURGEON about the bowel and bladder symptoms!!! He has GOT to know! Make that your FIRST STATEMENT! I want him to hear that first! And I'm not kidding! He's got to know that and i want him to remember that!

I wish you the very best my friend --- God bless you and PLEASE take care. Let us know what happens, okay? Hugs, Lee
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Unread 06-20-2013, 09:02 AM   #8
sfink
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Default don't minimize it

Hi! I think you are minimizing what's going on here. ( I'm now serving a life sentence for minimizing neurological problems.) I'm going to pick b2 phrases that are going to get you in trouble. "Just getting older" and "a lot of regular getting- old-rusty- neck-osteoarthritis stuff". What's saving you here is your desk job. If you were doing something more physical, you probably would have had the operation by now. I think your osteoarthritis is way more advanced than you realize. All the symptoms you describe are textbook progression of deterioration from spinal cord compression. Sadly, the last symptom before paralysis is incontinence. remember: surgery is not for pain relief or restoring function-it's about stopping further deterioration.. You are sailing dangerously close to the "island of misfit toys" (the place where a lot of us on this site live permanently). If you make landfall on the island, you will discover a "new normal". Regaining the old normal is over, it's all different now.(toto, I don't think we're in Kansas anymore!) Leesa is right on this, don't mess around- no matter how tough and determined you think you are, you can't overcome nerve destruction! I know I'm intense about it,but listen- it happened to me,so I have a pretty good idea of what your going through...take care,sfink
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Unread 06-20-2013, 12:49 PM   #9
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Quote:
Originally Posted by jonlyn View Post
I have fusion C5,6,7 and L5,S1...
Reason for this MRI was numb left chest, arm underarm, wrist and thumb
I have MRI w/ contrast scheduled for August 20th.. waiting on EMG appointment to be scheduled.

RADIOLOGY REPORT

Report:
REPORT: MRI of the of the thoracic spine was performed. Exam was
done in the sagittal plane using a T1, T2 and STIR. Axial T2 is
were obtained from T1 down through T8.

FINDINGS: There is a mild scoliosis of the spine convexity to the
right. There are postsurgical changes seen in the visualized
portion of the lower cervical spine with an anterior fixation
device seen at C5 down to C7. There is a central CSF collection
seen within the cord extending from T3-T4 down through T5-T6. At
its widest its measuring 1.5 to 2 millimeters. The appearance be
consistent with a syrinx. Signal intensity from the visualized
portion of the cord otherwise appears unremarkable. No focal STIR
signal abnormality seen within the vertebral bodies. There's no
significant impression upon the thecal sac. It does appear to be
foraminal narrowing seen at C7-T1 bilaterally. There is
desiccation of the T10 T11-T12 disc. Is a minimal bulge without
evidence of a focal protrusion again no significant encroachment
seen of the central canal or foramina. Paraspinal soft tissues
appear unremarkable. There is a 1.5 cm focal area of bright
signal seen within anterior to the spine seen at the level of
T10. This is poorly evaluated on this study but I believe are
represents the hemangioma that had been crus evaluated with MRI
of the abdomen.





Impression:
There is a mild scoliosis of the thoracic spine convexity to the
right. There are postsurgical changes of the visualized lower
cervical spine. There does appear to be foraminal narrowing seen
at C7-T1 which I suspect is related to hypertrophic changes
involving the posterior elements. If this is of clinical concern
this could be more completely evaluated on the basis of MRI of
the cervical spine. Otherwise there is mild spondylitic changes
seen within the spine with no significant encroachment upon the
central canal foramina at remaining visualized levels.

There is syrinx seen within the cord from T 3 down to T6. I
suspect this is idiopathic with limited clinical significance.
However this should undergo further evaluation with an MRI of the
neural axis to include post gadolinium imaging


Hello, jonlyn
You might make a new thread for yourself so replies on it will be for you only -
new thread link-- http://neurotalk.psychcentral.com/ne...newthread&f=22
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