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What Does This MRI Report Indicate?

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Posted on Mon, 11 Jul 2016
Question: I had an MRI in 2009 that read central extruded disc at C-5 and 6, flattens the anterior margin of the dural sac and mildly flattens the cervical cord. I have had chronic headaches and migraines for years. I was told then that this wasn't causing my headaches/migraines.
Last month I repeated my MRI because I feel as though the headaches/migraines are almost daily. This MRI reads At C5-6 there is posterior marginal osteophyte and prominent central disc bulge abutting the cord without canal stenosis or foraminal encroachment. (Impression: At C5-6 prominent central disc bulge superimposed on marginal osteophyte abuts the spinal cord. Otherwise unremarkable.)
I wanted the results explained a little. Is there a chance it is now the cause of my headaches or not related at all like before...?
doctor
Answered by Dr. Olsi Taka (25 minutes later)
Brief Answer:
Still doesn't explain migraines.

Detailed Answer:
I read your question carefully and I understand your concern.

The MRI report is more or less similar to the previous one. Again it speaks of a bulging disc which goes as far as touching the spinal cord, but stenosis (narrowing of the spinal canal), no cord compression. There is also an osteophyte, a bony spur, they are often formed over the years with the wear and tear of the spine (though a little early for your age).

From a practical point of view, spinal changes such as disc bulges and osteophytes cause symptoms either due to spinal cord compression (would cause weakness of the limbs) or due to compression of nerve root as they exit through the foramina, the canal where the nerve passes (main symptom is pain along the nerve trajectory). At times nerve root pain may radiate somewhat in the head, but apart from it being recognizable, there is the fact that the MRI states clearly there is no stenosis and no foraminal encroachment, so that MRI report doesn't explain your headaches, doesn't add much on that regard.

Considering your young age, for which these changes are a little premature (may be due to trauma, heavy physical work or simply genetic factors), I would say you need to pay some attention to prevent these changes from progressing and causing spinal or nerve root compression in the future, physical therapy exercises to strengthen your muscles would be advised on that regard.

As for migraines, preventive treatment is necessary. Beta blockers are a good first choice, but there are other options which could be tried such as antidepressants or antiepileptics, which are also first line treatments in migraine prevention.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (17 hours later)
Is there any pain associated with this injury? If I was diagnosed with Juvenile Rhematoid arthritis when I was 10 could that be a factor in the bone spur developing?
doctor
Answered by Dr. Olsi Taka (6 hours later)
Brief Answer:
Yes it is a factor

Detailed Answer:
Hello again and welcome back!

Regarding your question, the pain depends on what structures it compresses, when there is nerve root compression there is pain, but in the MRI report no such compression is seen, so if you mean any pain associated with the "abutting on the spinal cord" no that in itself shouldn't cause any pain. Arthritis in itself on the other hand, since it is a joint inflammation may cause some neck pain due to local inflammation, muscle spasms etc, but not that disc bulging in itself.

The juvenile arthritis issue may well explain the bone spur developing, bone spurs are a result of inflammation, so it can well explain why you have developed such changes at a young age.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3673 Questions

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What Does This MRI Report Indicate?

Brief Answer: Still doesn't explain migraines. Detailed Answer: I read your question carefully and I understand your concern. The MRI report is more or less similar to the previous one. Again it speaks of a bulging disc which goes as far as touching the spinal cord, but stenosis (narrowing of the spinal canal), no cord compression. There is also an osteophyte, a bony spur, they are often formed over the years with the wear and tear of the spine (though a little early for your age). From a practical point of view, spinal changes such as disc bulges and osteophytes cause symptoms either due to spinal cord compression (would cause weakness of the limbs) or due to compression of nerve root as they exit through the foramina, the canal where the nerve passes (main symptom is pain along the nerve trajectory). At times nerve root pain may radiate somewhat in the head, but apart from it being recognizable, there is the fact that the MRI states clearly there is no stenosis and no foraminal encroachment, so that MRI report doesn't explain your headaches, doesn't add much on that regard. Considering your young age, for which these changes are a little premature (may be due to trauma, heavy physical work or simply genetic factors), I would say you need to pay some attention to prevent these changes from progressing and causing spinal or nerve root compression in the future, physical therapy exercises to strengthen your muscles would be advised on that regard. As for migraines, preventive treatment is necessary. Beta blockers are a good first choice, but there are other options which could be tried such as antidepressants or antiepileptics, which are also first line treatments in migraine prevention. I hope to have been of help.