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MRI Shows Cervical Spondylotic Myeloradiculopathy. Surgery Or Physiotherapy Required?
Dear Doc,
Below is my MRI Report. Do need surgery or just physio? I need immediate cure. Thanks.Enete, Nigeria
CERVICAL SPINE MRI SCAN
Indication: Cervical Spondylotic myeloradiculopathy.
Technique:
Sagittal SE T1-, FSE T2-, and axial SE T1-, GRE T2*- and FRFSE T2- weighted images of the cervical spine were obtained.
Findings:
Straightening of the cervical spine is seen indicating muscle spasm due to pain but the normal vertebral alignment is preserved.
Multiple levels (C3/4 – C6/C7) of anterior indentations are seen on the cervical spine caused by disc osteophyte complexes but this is most significant at C4/C5 and C6/C7 where the posterior disc osteophyte complexes have combined with posterior longitudinal ligament (PLL) hypertrophy to encroach on the spinal canal causing stenosis. They have also caused bilateral neural foramina compression and at C6/C7 impinged on the exiting left and right C6 spinal nerve roots.
All the cervical intervertebral discs show loss of T2 hyperintensity indicating dessication.
The spinal cord is free of compression and the cranio-cervical junction is normal.
Conclusion:
1. Cervical spondylosis.
2. Posterior disc herniation at multiple levels, but causing neural foramina and exiting spinal nerve roots compression at C6/C7.
3. Disc dessication at all the cervical intervertebral discs.
LUMBAR SPINE MRI SCAN
Indication: Lumbar Spondylotic radiculopathy.
Technique:
Sagittal SE T-1, FRFSE T2- and axial SE T-1, FRFSE T2- weighted images of the lumbar spine were obtained.
Findings:
Straightening of the lumbar spine is seen indicating muscle spasm due to pain, but the normal vertebral alignment is preserved.
Anterior thecal indentations are seen at L3/L4 and L4/L5 caused by posterior disc herniations. These have narrowed the neural foramina bilaterally and at L4/L5 impinged on the exiting spinal nerve roots (worse on the right).
The L3/L4 and L4/L5 discs show loss of T2 hyperintensity indicating dessication.
The spinal cord terminates normally at L1 and divides into its filaments.
Marginal osteophytes are seen on L3, L4 and L5 vertebral bodies indicating spondylosis.
No ligamentum flava hypertrophy is seen.
Conclusion:
1. Lumbar spondylosis.
2. Posterior disc herniation at L3/L4 and L4/L5 causing bilateral neural impingement (L4/L5 only).
3. Disc dessication at L3/L4 and L4/L5.
Below is my MRI Report. Do need surgery or just physio? I need immediate cure. Thanks.Enete, Nigeria
CERVICAL SPINE MRI SCAN
Indication: Cervical Spondylotic myeloradiculopathy.
Technique:
Sagittal SE T1-, FSE T2-, and axial SE T1-, GRE T2*- and FRFSE T2- weighted images of the cervical spine were obtained.
Findings:
Straightening of the cervical spine is seen indicating muscle spasm due to pain but the normal vertebral alignment is preserved.
Multiple levels (C3/4 – C6/C7) of anterior indentations are seen on the cervical spine caused by disc osteophyte complexes but this is most significant at C4/C5 and C6/C7 where the posterior disc osteophyte complexes have combined with posterior longitudinal ligament (PLL) hypertrophy to encroach on the spinal canal causing stenosis. They have also caused bilateral neural foramina compression and at C6/C7 impinged on the exiting left and right C6 spinal nerve roots.
All the cervical intervertebral discs show loss of T2 hyperintensity indicating dessication.
The spinal cord is free of compression and the cranio-cervical junction is normal.
Conclusion:
1. Cervical spondylosis.
2. Posterior disc herniation at multiple levels, but causing neural foramina and exiting spinal nerve roots compression at C6/C7.
3. Disc dessication at all the cervical intervertebral discs.
LUMBAR SPINE MRI SCAN
Indication: Lumbar Spondylotic radiculopathy.
Technique:
Sagittal SE T-1, FRFSE T2- and axial SE T-1, FRFSE T2- weighted images of the lumbar spine were obtained.
Findings:
Straightening of the lumbar spine is seen indicating muscle spasm due to pain, but the normal vertebral alignment is preserved.
Anterior thecal indentations are seen at L3/L4 and L4/L5 caused by posterior disc herniations. These have narrowed the neural foramina bilaterally and at L4/L5 impinged on the exiting spinal nerve roots (worse on the right).
The L3/L4 and L4/L5 discs show loss of T2 hyperintensity indicating dessication.
The spinal cord terminates normally at L1 and divides into its filaments.
Marginal osteophytes are seen on L3, L4 and L5 vertebral bodies indicating spondylosis.
No ligamentum flava hypertrophy is seen.
Conclusion:
1. Lumbar spondylosis.
2. Posterior disc herniation at L3/L4 and L4/L5 causing bilateral neural impingement (L4/L5 only).
3. Disc dessication at L3/L4 and L4/L5.
Sat, 17 Aug 2013
Hi, thanks for writing to HCM.
You can't expect immediate cure with so many problems both in your cervical & lumbar spine. Anyway, conservative management is always the first option for managing both the conditions and is as follows -
For Lumbar disc disease
* avoid lifting heavy weights as it imparts more strain on your back
* avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.
For cervical disc disease
Rest: A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.
Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.
Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.
Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful
Hope this information is helpful. Good day
You can't expect immediate cure with so many problems both in your cervical & lumbar spine. Anyway, conservative management is always the first option for managing both the conditions and is as follows -
For Lumbar disc disease
* avoid lifting heavy weights as it imparts more strain on your back
* avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants.
For cervical disc disease
Rest: A soft cervical collar is advisable. It should not be used for more than a week or two as it may worsen the condition with prolonged usage.
Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.
Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.
Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Moist heat can be useful
Hope this information is helpful. Good day
I find this answer helpful
Hello,
Thanks for writing to us
Your MRI report indicates that you might be suffering from degenerative disc disease at cervical and lumbar spine & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation & spinal canal stenosis.
There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.
If you don't get better with these treatment , another option is surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms
Hope this helps you. Let me know if you have any more concern.
Wishing you good health...
Regards.
Thanks for writing to us
Your MRI report indicates that you might be suffering from degenerative disc disease at cervical and lumbar spine & it occurs due to repetitive overload or stress to the disc & it increases the risk of disc herniation & spinal canal stenosis.
There are several treatment modalities with medicines, physiotherapy and with injections in the back called epidural injections and root/facet blocks.
If you don't get better with these treatment , another option is surgery, by which the nerves are decompressed by removing the protruded disc (discectomy), which would significantly improve your symptoms
Hope this helps you. Let me know if you have any more concern.
Wishing you good health...
Regards.
I find this answer helpful
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