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What Does This Cervical MRI Showing Degenerative Disc Changes Indicate?
Question: cervical MRI: Mild degenerative changes of cervical spine. Reversal of normal cervical lordosis with apex at C4-C5 with a broad disc osteophytic complex contacting the ventral surface spinal cord. Spinal canal is widely patent throughout. No significant neuroforaminal narrowing. Minor grade 1 anterolisthesis of C2 on C3 and mild grade 1 anterolisthesis of C3 on C4. No spinal cord signal abnormality. Small likely perineural cyst in the ostium of the left T1-T2 neural foramen. brain MRI: Minor burden of nonspecific hyperintense T2/FLAIR signal abnormality within the deep white matter of the frontal lobes. Numerous differential possibilities exist such as migraine sequela, demyelinating process, vasculitis, premature chronic small vessel ischemic changes, sequela of prior infection or
trauma. My question is what does it all mean? my current symptoms are: numbness bilat arms and legs, hands and feet often very cold and change colors to a blueish shade, inability to concentrate or finish tasks, insomnia, anxiety, depression, burning type pain on bilat arms and legs, head feels like it is too heavy for neck, neck spasms and tightening with severe pain at back of head (feels like someone is hitting back of head with a bat), memory lapses, abnormal gait, nausea, visual changes. medical hx: 2 stage IV staph/MRSA infections, one while being pregnant 4 yrs ago, anaphylactic shock/cardiogenic shock at age 12 (41 now), heart murmur, total abd hysterectomy and ooph., joint pain, migraines. What is wrong with me? currently on disability due to symptoms
trauma. My question is what does it all mean? my current symptoms are: numbness bilat arms and legs, hands and feet often very cold and change colors to a blueish shade, inability to concentrate or finish tasks, insomnia, anxiety, depression, burning type pain on bilat arms and legs, head feels like it is too heavy for neck, neck spasms and tightening with severe pain at back of head (feels like someone is hitting back of head with a bat), memory lapses, abnormal gait, nausea, visual changes. medical hx: 2 stage IV staph/MRSA infections, one while being pregnant 4 yrs ago, anaphylactic shock/cardiogenic shock at age 12 (41 now), heart murmur, total abd hysterectomy and ooph., joint pain, migraines. What is wrong with me? currently on disability due to symptoms
Brief Answer:
You have degenerative disc disease of spine.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
I have thoroughly gone through your findings in detail.
You have degenerative disc disease of cervical spine.
Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.
1.There is reversal of the cervical Lordosis means it has become opposite of normal curvature.
2.At C4-5 level there is broad disc osteophytic complex which is in contact with the ventral surface spinal cord.Spinal canal is normal.There is no narrowing of lateral neural canal.
3.There is minor grade 1 anterolisthesis of C2 on C3 and mild grade 1 anterolisthesis of C3 on C4 vertebra.
Majority of the cases of degenerative spine disease are benefited by physiotherapy.So,physiotherpay should be tried first.It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Treatment can be planned after consultation with neurosurgeon.
In MRI,FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic sequel etc should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.
You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.
You need follow up MRI scan to see its progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.
Majority of your problem are related to spine.you should start physiotherapy for cervical region.
You also have some psychiatric symptoms,so it is better to take psychiatrist opinion also.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
You have degenerative disc disease of spine.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
I have thoroughly gone through your findings in detail.
You have degenerative disc disease of cervical spine.
Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis.
1.There is reversal of the cervical Lordosis means it has become opposite of normal curvature.
2.At C4-5 level there is broad disc osteophytic complex which is in contact with the ventral surface spinal cord.Spinal canal is normal.There is no narrowing of lateral neural canal.
3.There is minor grade 1 anterolisthesis of C2 on C3 and mild grade 1 anterolisthesis of C3 on C4 vertebra.
Majority of the cases of degenerative spine disease are benefited by physiotherapy.So,physiotherpay should be tried first.It causes strengthening of Para spinal muscles and it prevents further changes.
Surgery should be the last option.
There are also medicines like capsule pregabalin available for pain relief.
Treatment can be planned after consultation with neurosurgeon.
In MRI,FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic sequel etc should also be ruled out with follow up scans.Diabetes mellitus also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.
You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.
You need follow up MRI scan to see its progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.
Majority of your problem are related to spine.you should start physiotherapy for cervical region.
You also have some psychiatric symptoms,so it is better to take psychiatrist opinion also.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response, I have been researching and studying on your answers. I do have a few follow-up questions if that is ok:
1) what would be the clinical reason for an abd US?
2) Just completed a CBC and shows I am slightly anemic. In the last couple yrs my B12 has gone from 804 to 400, so I wonder if that is the cause of the anemia.
3) I was in physical therapy and aqua therapy but it has stopped due to insurance issues. But I found especially the aqua to be very helpful.
4) I have frequent headaches and migraines. are those due to the ischemic vessel changes? I usually take imitrex or advil to help but the headaches lately, esp at the back of neck and base of head hurt so severely that meds do not help. Is this something more serious and should seek medical help if it happens again?
5) My PCP is ruling out MS as a possibility and d/t my other multiple symptoms but I have read that not all cases can be defined by an MRI, is that the case and is there a more solid test for MS?
Thank you again, XXXXXXX
1) what would be the clinical reason for an abd US?
2) Just completed a CBC and shows I am slightly anemic. In the last couple yrs my B12 has gone from 804 to 400, so I wonder if that is the cause of the anemia.
3) I was in physical therapy and aqua therapy but it has stopped due to insurance issues. But I found especially the aqua to be very helpful.
4) I have frequent headaches and migraines. are those due to the ischemic vessel changes? I usually take imitrex or advil to help but the headaches lately, esp at the back of neck and base of head hurt so severely that meds do not help. Is this something more serious and should seek medical help if it happens again?
5) My PCP is ruling out MS as a possibility and d/t my other multiple symptoms but I have read that not all cases can be defined by an MRI, is that the case and is there a more solid test for MS?
Thank you again, XXXXXXX
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
Abdominal ultrasound is advised as a routine investigation.It will screen abdominal viscera like liver,pancreas,kidney,spleen,pelvic organs etc.
You should take B12 supplement if it is deficient.
You can continue aqua therapy if it is helpful to you.
Headache may be due to ischemic vessel changes.Basically headache is due to underlying etiology of ischemic vessel changes like hypertension.Conditions which lead to ischemic vessel changes can be diagnosed by clinical examination and investigations as suggested earlier.In your case,degenerative changes in the cervical spine can be one of the reason for headache.
Follow up MRI (Brain) is important in your case.It can detect progression of lesions.
MS is associated with many neurological signs,you should consult neurologist for clinical correlation.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
Abdominal ultrasound is advised as a routine investigation.It will screen abdominal viscera like liver,pancreas,kidney,spleen,pelvic organs etc.
You should take B12 supplement if it is deficient.
You can continue aqua therapy if it is helpful to you.
Headache may be due to ischemic vessel changes.Basically headache is due to underlying etiology of ischemic vessel changes like hypertension.Conditions which lead to ischemic vessel changes can be diagnosed by clinical examination and investigations as suggested earlier.In your case,degenerative changes in the cervical spine can be one of the reason for headache.
Follow up MRI (Brain) is important in your case.It can detect progression of lesions.
MS is associated with many neurological signs,you should consult neurologist for clinical correlation.
Get well soon.
Hope i have answered your query.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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