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    What does this MRI report indicate?

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Posted on Sat, 22 Jul 2017 in Back Pain
Question: History: for about a year I have had the onset of numbness in both hands but that numbness has worsened over the past year so that now involves both pain and burning type of pain primarily in the fifth digit, began first on the right side but now it is involving the left hand also.
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Primary Doc thought I had a “pinch nerve" with the arm and possible ulnar neuropathy or median neuropathy
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Had MRI with report
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EXAMINATION: MRI Cervical Spine Without Contrast TECHNIQUE: Sagittal T1, T2 and STIR. Axial T2 and Gradient-Echo
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C4-C5 FINDINGS:
1- moderate disc space narrowing with moderate spur disc complex causing moderate central stenosis and cord compression.
2- Some high T2 signal in the cord on either side just below disc space level suggests myelomalacia.
3- Moderate left and moderate to severe right foraminal stenosis
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C5-C6 FINDINGS:
1-Moderate disc space narrowing with broad-based spur disc complex greater to left of midline causing moderate central stenosis
and cord compression worse to left of midline,
2- At the upper C6 level there is high T2 signal on either side of midline w/in the cord probably myelomalacia.
3- Mild left and moderate right foraminal stenosis.
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C6-C7 FINDINGS:
1- Moderate disc space narrowing and broad-based spur disc complex causing moderate central stenosis without cord compression.
2- Mild right and moderate left foraminal stenosis.
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C7-T1 FINDINGS:
1-mild degenerative disc & endplate change
2-mild bilateral foraminal stenosis. w/out significant central stenosis.
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30 Day Delay in Surgery Analysis
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Feb 1- Diagnosed with Cervical Spondylosis with Myelopathy (CSM) from compression of the spinal cord that caused me ONLY sensory dysfunction in my hands
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On March 1- “burning” nerve pain symptom’s location:
1- primarily in the Right hand’s “Pinky”
2- slight “burning” in the left hand’s “Pinky”
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Delay in surgery 30 days,
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On April 1 - “burning” nerve pain symptom’s location:
1-Same as Above with Increased level of “burning” pain
2- the ENTIRE dorsal ulnar cutaneous distribution in BOTH my left and right hands extending THRU-OUT the entire sensory territories of the ulnar portion of the posterior aspect with INTENSE “burning” nerve pain symptoms
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NO other part of my body was affected!
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QUESTION 1- From the MRI info, What possible reason(s) would explain this
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QUESTION 2- Can you explain the possible reason(s) for The Effects of wearing a "Hard Collar"
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From the moment I put it on and raised the chin support, each “click” of the adjustment “knob” raised my chin and “stretched” my neck upwards about one-quarter of an inch per “click.”
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Each “click” stretched my neck upwards; taking more of the weight of my head off my neck. Several “clicks” in effect “mimicked” what cervical decompression surgery with ”fusion” would do by what "could only(?) be explained as allowing the nerves to decompress.
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For 6 MONTHS, I could feel, a noticeable reduction of the burning nerve pain
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However, in that SAME ONE (1) MONTH
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I felt a dramatic REDUCTION in the collar's effectiveness to relieve the severity of my CSM symptoms
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With all due respect, Please NO copy and paste answers-
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Thanking you in advance

I grew up in Port XXXXXXX on Long Island for the first 18 years of my life, than I lived in Greenwich Village for 10 years during the 80s
doctor
Answered by Dr. Aashish Raghu 32 minutes later
Brief Answer:
Multiple disc prolapse

Detailed Answer:
Hi there

Thanks for the query

The reason for your symptoms is because of the compression of the cervical nerve roots by the prolapsed discs at various levels.

The hard collar helps to prevent flexion and thus effectively prevents reduction in the disc space thus reducing the compression of the nerves by a prolapsed disc. This isn't similar to fusion. Fusion immobilises a portion of the spine but also the disc is removed surgically as well.

It appears that you may need microdiscectomy to drive the prolapsed discs especially C6-C7 level. This will give you relief.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr.Aashish Raghu
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Aashish Raghu 24 hours later
YOU WROTE The hard collar helps to prevent flexion and thus effectively prevents reduction in the disc space thus reducing the compression of the nerves by a prolapsed disc.
This isn't similar to fusion. Fusion immobilizes a portion of the spine but also the disc is removed surgically as well.

FOLLOW UP QUESTION - Understanding that Fusion has the disc removed surgically as well. (FORGET that part)
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Can I make this statement as "true" :
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My hard collar had a chin adjustment that with Each “click” stretched my neck 1/4 inch upwards; each "click" taking more of the weight of my head off my neck.
Several “clicks” in effect “mimicked” what cervical decompression surgery with ”fusion” would do by allowing the nerves to decompress.
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THANKS
doctor
Answered by Dr. Aashish Raghu 7 hours later
Brief Answer:
Distraction/Traction vs Fusion

Detailed Answer:
There may be some similarities to distraction of spine as done in spinal traction.

It dioes not mimic fusion because you are still able to flex the neck sideways, thus giving movement from the joints.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Aashish Raghu 5 hours later
FOLLOW UP QUESTION: Distraction/Traction vs Fusion
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Apart from the fact that "you are still able to flex the neck sideways, thus giving movement from the joints." in a hard collar, Does the Hard Collar "mimic" spinal Fusion?
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THANKS
doctor
Answered by Dr. Aashish Raghu 45 minutes later
Brief Answer:
Hard cervical collar does not mimic spinal fusion

Detailed Answer:
Hard collar does not mimic fusion because the stability provided by spinal fusion is much much more than that of a hard cervical collar.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Aashish Raghu 5 hours later
THANKS -
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LAST SET OF QUESTIONS
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QUESTION 4: is spondylosis with myelopathy, A syndrome, condition or disease?,

QUESTION 5: Would this be a correct phraseology, "that on March 1 the "cumulative effect" from the "some-how" in "some-way" of my spondylosis with myelopathy (condition?) caused an intense burning nerve pain in my two pinkies >
and that during the month of March, there was a rapid deterioration in my spondylosis with myelopathy (condition?) such that
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on April 1 the "cumulative effect" from the "new" "some-how" in "some-way" effect from my spondylosis with myelopathy (condition?) was:
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1-the “burning” nerve pain symptom’s locations:
-Same as Above with Increased level of “burning” pain
- the ENTIRE dorsal ulnar cutaneous distribution in BOTH my left and right hands extending THRU-OUT the entire sensory territories of the ulnar portion of the posterior aspect with INTENSE “burning” nerve pain symptoms
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Additionally, the severity of my “numbness” symptom’s location were "now" 60% divided between being in my right and left outer palm that both had 100% numbness and 40% divided between being in my right and left wrists each had 100% numbness
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THANKS





doctor
Answered by Dr. Aashish Raghu 16 hours later
Brief Answer:
Answers

Detailed Answer:
Spondylosis with myelopathy is a condition.

Better to phrase it as

I have severe radiating pain from the neck to the outer aspect of my hand and palm with associated with burning sensation, tingling and numbness. The condition further progressed to involve the back and inner aspect of my forearm and hand. The numbness has increased considerably over both my palms.
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5197 Questions

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