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Is Signal Change On My MRI An Indication Of Spinal Cord Damage?
Question: Hi, I was just talking with another person who has cord compression without signal change. He said the fact that I have signal change is worrisome to him. He said signal change on my MRI is an indication that spinal cord damage has already occurred and that further deterioration is more likely than if I did not have signal change. He said I am even at risk for paralysis. He said he has CSM, without signal change and is still having surgery in the near future. He is not a doctor. Given my lack of neurological/motor impairment do you agree with his commentary? Thank you
Brief Answer:
Scans are less useful than Symptoms
Detailed Answer:
Hey! Thanks for coming back!
I would not put too much stock in what he is saying. A signal change just shows that that segment of the cord has developed some swelling and inflammation. That's certainly NOT a good thing. But it doesn't increase your risks for paralysis unless it progresses.
The most effective way of finding out if the cord compression is worsening is to look at the SYMPTOMS. You are at a higher risk of worsening spinal injury than a person who has NO neck issues. But from the history you have (injury happened a long time ago), i do not think this injury is progressing that much.
I do think it would be a good idea to get another MRI, about a year from the date of the last one and make sure visually that the signal intensity is not changing. But i don't think you have to worry about scans any more than that.
Whenever you consider elective surgery (as in your friends situation), you have to weigh potential upsides (will this surgery improve quality of life) with the potential downsides (could the complications of this surgery hurt that patient in the long term)
In your case, even if we operate.. you will not see ANY benefit neurologically. But I would be exposing you to alot of surgical and anesthesia risks. That's not a good risk assessment. Clinically if the muscle issues get worse or if the cord signal changes on the next MRI.. then i can justify surgery.
I hope that made sense. Feel free to ask me anything chief. Take care.
Vin
Scans are less useful than Symptoms
Detailed Answer:
Hey! Thanks for coming back!
I would not put too much stock in what he is saying. A signal change just shows that that segment of the cord has developed some swelling and inflammation. That's certainly NOT a good thing. But it doesn't increase your risks for paralysis unless it progresses.
The most effective way of finding out if the cord compression is worsening is to look at the SYMPTOMS. You are at a higher risk of worsening spinal injury than a person who has NO neck issues. But from the history you have (injury happened a long time ago), i do not think this injury is progressing that much.
I do think it would be a good idea to get another MRI, about a year from the date of the last one and make sure visually that the signal intensity is not changing. But i don't think you have to worry about scans any more than that.
Whenever you consider elective surgery (as in your friends situation), you have to weigh potential upsides (will this surgery improve quality of life) with the potential downsides (could the complications of this surgery hurt that patient in the long term)
In your case, even if we operate.. you will not see ANY benefit neurologically. But I would be exposing you to alot of surgical and anesthesia risks. That's not a good risk assessment. Clinically if the muscle issues get worse or if the cord signal changes on the next MRI.. then i can justify surgery.
I hope that made sense. Feel free to ask me anything chief. Take care.
Vin
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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