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MRI of cervical spine done. What does the report suggest? What cure should be done?

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Spine Surgeon
Practicing since : 1998
Answered : 116 Questions
Hello, I just received a report for my MRI C Spine and I would like help reading it before I go to my specialist. I would also like some advise as to what steps I should take. My Primary Doc wants me to go to a pain clinic. But I was wondering if I should see a neuro or ortho surgeon first....I need some guidance.
This is what is says:
Clinical History: Neck & left arm pain following injury.
Comparison: None available
Technique: Sagittal and axial T1, fast spin echo T2, STIR and T2* imaging of the cervical spine were performed.
The osseous structures of the cervical spine are intact. No focal malalignment identified. There are normal bilateral vertebral artery flow voids. Structures of the craniocervical junction are normal. Cervical cord is normal in signal characteristics. There are normal bilateral vertebral artery flow voids.
At the C2-C3 level there is mild left facet arthropathy. Spinal canal and neural foramen remain patent.
Athe the C3-C4 level there is a right paracentral disc osteophyte complex with extension into the right neural foramen causing sever right neural foraminal stenosis. There is facet arthropathy contributing to the foraminal stenosis. There is mild left neural foraminal stenosis. Spinal canal remains patent.
At the C4-C5 level there is a right paracentral disc osteophyte complex with uncovertebral hypertrophic change causing moderate to severe right neural foraminal stenosis. There is right facet arthropathy contributing to the foraminal stenosis. Spinal canal and left neural foramen remain patent.
At the C5-C6 level there is a broad disc osteophyte complex indenting the ventral margin of the thecal sac. This is slightly eccentric to the right. There is mild neural foraminal stenosis on the right. Spinal canal and left neural foramen are patent.
Athe C6-C7 level there is broad disc herniation indenting the ventral margin of the thecal sac. There is mild to moderate bilateral neural foraminal stenosis. Spinal canal is patent.
At the C7-T1 level spinal canal and neurall foramen remain patent.
Posted Wed, 15 Aug 2012 in Osteoporosis
Answered by Dr. S K Mishra 4 hours later

Your pain is in left arm but MRI report says disc bulges more on right side. Yes there are some noticeable changes on MRI. As a competent expert one should correlate these MRI finding with your physical symptoms.

Are you having any numbness or weakness in any of upper limbs.? You can consult a Neuro/spine surgeon. He will examine you to see any neurological sign like absent jerks/area of numbness and see whether if these are present and if present do they correlate to your MRI report.
What is your blood sugar level.? How severe is your pain.?

Steps are
1. To determine whether your symptoms are related to MRI findings or something else is cause
2. If the cause of your trouble is correlated with MRI then further treatment depends on severity of your pain, its response to conservative measures (exercise, posture modifications etc) and presence of neurological deficits.
Conservative measures include pain killers and collar. After relief of acute pain neck extension exercises may be continued.

The need for surgery is determined if the conservative measure fail or if some deficits are not on examination.

So you should first XXXXXXX the Spine Surgeon or Neurosurgeon.

I welcome any further queries.
Above answer was peer-reviewed by
Follow-up: MRI of cervical spine done. What does the report suggest? What cure should be done? 9 hours later

Thank you very much for your response. It's very helpful. Could you also explain some of the medical language to me? Such as; arthropothy, paracentral disc osteophyte complex, etc....

I would also like to give you a history of my situation in case it may be helpful when I have my first visit with a specialist to ask the right questions.

In 1998 I was in a car accident. We were rear-ended by a truck that was traveling at approx 55 miles per hour (he wasn't speeding, he just didn't see us). At the time of impact, we were in a stopped position waiting for a vehicle in front of us to turn left. Also at the time of impact we were thrust into the opposite XXXXXXX hitting a guard rail.

After getting out of the car I immediately noticed that my neck had a feeling of being on fire. I told the medics and they transported me to the local hospital for testing. It is my understanding they were not able to find anything in the images. I followed up with various Dr's and they gave me a diagnosis of Myfacial Pain Syndrome. I never did see a report and I don't know what type of testing they did. I was busy being a young mom of 3 :)

So, over the years I have experienced pain levels as low as about 4 to 10. If I am doing absolutely nothing I can keep it at a 4, but if I do things such as gardening, cleaning my house, etc my pain levels shoot to 8-10. I have tried different physical therapies, massages, chiropractors, but have had very little relief. I have a neck traction device and that does help a little bit.

Approx. 2 months ago I was doing yard work, gardening, mowing, lifting, etc and I noticed that my neck started to burn, crunch and ache so I stopped. The next day my neck, shoulders, wing, trapeziums and down my left arm ached, muscle spasm feelings and tingling in my left pinky and ring finger. Most of my aching and burning and weakness are in my neck, left and right delts, left and right upper arms and down the left arm as I stated above. I was at a level 9-10 and continued with that level until I saw my doc and she had my on Tramadol 50mg and Aleve 2xper day. The pain meds do work, but knock me right out. I'm not sure about the Aleve at this time. The weakness in the the areas above have been existent since the accident and as I said above from pain levels 4 - 10 depending on my activities.

In regard to my blood sugar. I have a physical every year and have not had any indications of problems. However, over the years I have gain approx 100 pounds due to my inability to exercise. I used to be an athlete and I so desperately would like to exercise and participate in sporting activities like I used to.

In summary:

My Blood Sugar is good.
My pain levels right now are 7/8 on pains meds 9/10 off pain meds.
I would like to understand the medical language
If you have any thoughts or questions I should ask/tell the specialist would be helpful.
Would it be proper or ok if I print this information and bring it to the Dr? Or would that not be advised. I don't want to go there and have them think I am a "know everything" kind of person. I just want them to understand that I want to participate as a team in my medical care and have them know that I will do my part.

Again, thank you very much for all of your assistance.


P.S. As a side note, in 1998/99 we did receive a small settlement from insurance. I do not plan to pursue any legal services, etc. This is strictly medical, so I can regain my quality of life.

Answered by Dr. S K Mishra 12 hours later

Thanks again for posting me this follow up. I am pleased to answer your queries.

Meaning of the medical words used in the scan is as follows:
1. Osteophyte is a result of long degenerative process in which small bony projections occurs from edges of vertebral body sometimes compressing neural structures (nerve root) - such compression is common if the osteophyte is located posteriorly.
2. Paracentral means on one side of centre either right or left. In your case, the osteophytes which I described above are located to the right adjacent to the centre.
3. Arthopathy refers to degenerative changes in the joint.

The pain seems significant, but again your pain is more on the left side and MRI report describes disc bulges are on right side. So when you consult neuro / spine surgeon discuss if there is something that is causing the immense left side pain. You may also discuss whether or not you have any neurological deficits - if yes, what deficits and how much.

Increased weight also contributes to the aforementioned degenerative changes. Please take adequate measures to maintain weight in the ideal limits.

I would wish you to consult the doctors without any documents from here. I always appreciate a doctor’s opinion without any influence from other doctors’ statements. You can post your queries after his initial opinion.

Hope this helps. Let me know if you have any more enquiries.

Above answer was peer-reviewed by
Follow-up: MRI of cervical spine done. What does the report suggest? What cure should be done? 5 hours later
Excellent Dr. Mishra! Thank you so much for you assistance :)
Answered by Dr. S K Mishra 22 hours later
Pleasure here. If you with to get answers directly from me in future post it through this link, WWW.WWWW.WW

For now I request you to close our discussion and rate my answer too.

Wish you Good Health.
Above answer was peer-reviewed by
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