Cervical MRI :: Multilevel Degenerative Spondylotic Change
Aug 23, 2014
Clinical Notes: Radiculopathy.
Findings: Reversal of the cervical lordosis associated with a 2mm grade 1 degenerative anterolisthesis at C3/4. Multilevel disc desiccation, loss of disc height and degenerative anterior marginal end plate osteophytic spurring. Multilevel facet joint degenerative arthropathy. No suspicious bone marrow signal abnormality. No paravertebral soft tissue abnormality. The cervicomedullary junction is normally sited with the spinal cord of normal signal and volume down to the most visualised level at D4/5.
C2/3: Moderate left facet joint degenerative arthropathy with mild left foraminal narrowing.
C3/4: Anterolisthesis, a small superiorly pointing central disc extrusion, moderate bilateral uncovertebral and marked left plus mild right facet joint degenerative arthropathy, the latter associated with effusions bilaterally. Moderate canal stenosis with mild cord flattening. Severe left and moderate to severe right foraminal narrowing with impingement at both exciting C4 nerve roots.
C4/5: Broadbased disc bar, moderate right and mild left uncovertebral plus moderate canal stenosis with mild cord flattening on the right. Severe right and mild left foraminal narrowing with impingement of the exiting right C5 nerve root.
C5/6: Small broad based disc bar and moderate left uncovertebral joint degenerative arthropathy. Mild to moderate canal stenosis with mild cord flattening on the left. Severe left foraminal narrowing with impingement of the exiting left C6 nerve root.
C6/7: Small broad based disc bar and moderate bilateral uncovertebral joint degenerative arthropathy. Mild central canal stenosis. Severe bilateral foraminal narrowing with impingement at both exciting C7 nerve roots.
C7/T1 to T2/3: Posterior disc contour is normal.
T3/4 and T4/5: Moderate right facet joint degenerative arthropathy with moderate right foraminal narrowing and impingement of the exiting right T3 and T4 nerve roots.
Conclusion: Multilevel degenerative spondylotic change as described. Spinal canal stenosis associated with mild cord flattening between C4/5 and C6/7. Compressive foraminal narrowing seen bilaterally at C3/4, right at C4/5, left at C5/6, bilaterally at C6/7 and on the right at T3/4 and T4/5.
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CT c-spine Findings: There is postoperative change related to previous c5 c6 interiors fusion spacer with anterior retention hardware placement. There is no evidence of hardware fracture or loosening, alignment of the cervical spine is maintained. There is no findings of acute fracture or subluxation. Craniocervical junction is intact. C1-C2, C2-C3,C3-C4 no disc bulge or disc protrusion. No central canal stenosis or neural forAmina narrowing, within limitations of ct. C4-C5 small posterior disc osteophyte complex partially effaces the thecal sac without significant central canal or neural foraminal. C5-C6,C6-C7,C7-T1 no disc bulge or protrusion.
Impression, postoperative change at c5,c6 fusion. No evidence of hardware failure or acute fracture or subluxation of the cervical spine.
MRI findings: There is susceptibility artifact at C5-C6 related to intermediate fusion and cervical retention hardware placement.
C2-C3, C3-C4 , No disc bulge or disc protrusion. No canal stenosis or neural foraminal narrowing.
C4-C5 there is a 3 mm central disc protrusion with superimposed posterior endpapers osteophyte which partially enfaces the thecal sac. AP diameter the central canal measures 1.0cm. There is no significant central canal or neural foraminal narrowing.
C5-C6,C6-C7,C7-T1 no disc bulge or disc protrusion. No central stenosis or neural foraminal.
Impression: mild discogenic degenerative change at c4-c5. No significant central canal or neural foraminal seen at any level. Postoperative change c5-c6 anterior fusion.
I thought I was doing better from the first surgery. Pain, tingling, and numbness subsided, as well as migraines. Few months thst ago I get excruciating pain in my neck and shoulder with headaches again. I've seen my neurologist, but he says to go back to ortho. I go next thursday. I was hoping to get English what this means. My first mri and ct before surgery was quite obvious, and my pcp gave me the basics. The pain meds now im on aren't helping, in fact not even touching tje pain. Oxycodone 10/325 every 4-6 hours for breakthrough pain.
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I've been having pain and neck stiffness for years, and also have rheumatoid arthritis. Several months ago I started having "pins and needles" feeling in my left arm that became more and more intense from my shoulder down into my hand, mostly my thumb. I had an MRI, this is the result:
C2-3: There is a small posterior right lateral disc osteophyte complex as well as advanced facet arthropathy, particularly involving the right facet joint. This causes marked narrowing of the right neural foramen.
C3-4: There is moderate facet arthropathy, causing moderate narrowing of the left neural foramen. No evidence of canal stenosis. Right neural foramen appears patent.
C4-5: There is mild disc space narrowing and a right paracentral posterior disc/osteophyte complex causing minimal ventral impression on the thecal sac and mild narrowing of the right neural foramen. There is also moderate right facet arthropathy.
C5-6: There is advanced disc space narrowing, with prominent spurring both anteriorly and posteriorly. There is endplate sclerosis on both sides of the disc space. A prominent central posterior disc/osteophyte complex causes moderate to severe canal stenosis at this level with mild flattening of the cord. There is also moderate bilateral facet arthropathy. Neural foramina are significantly compromised at this level.
C6-7: There is a small posterior disc/osteophyte complex with minimal ventral impression on the thecal sac, but no significant canal stenosis or neural foraminal narrowing.
C7-T1: Normal.
OTHER: There is degeneration and narrowing at the C1-2 articulation with some irregularity of the dens.
CONCLUSION: Advanced degenerative disc disease involving the cervical spine, which is most severe at C5-6 with canal stenosis and bilateral neural foraminal narrowing at this level.
My doctor never called me, just sent me an email that said "no bulging disks, just arthritis", and he suggested I go see a pain management doctor. What should I do? I am having a really bad day today, my arm has been asleep more than it has been awake, and it's becoming more painful.
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Please help me understand this report:
There is a multilevel loss of t2 hyperintensity within the discs, compatible with disc degeneration.
C3-C-4, there is a small disc osteophyte complex. There is no central or foraminal stenosis.
C4-C5 and C5-C6 there is mild disc bulge
C6-C7, there is a small posterior disc osteophyte complex. There is no cental or foraminal stenosis.
The remainder of the visualized intervertebral disc levels are normal.
The cervical cord is normal in signal intensity and contour on all pulse sequences.
The cerebellar tonsils are low lying extending 5 mm below the plane of the formen magnum. Borderline for chiari 1 malformation. No evidence of cervical syrinx. No evidence of hydrocephalus in the visualized portion of the brain. He used brain MRI to compare for chiari diagnosis.
Impression: cerebellar tonsils extending 5 mm below the plane of the Forman magnum borderline for a chiari 1 malformation. C3-C4 and C6-C7 small posterior disc osteophyte complexes. At C-4-C-5 and C5-C6 mild disc bulges.
What does that loss of t2 hyper intensity mean?
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The doctor said the lung tissue is possible (mild) pneumonia. I'm less concerned about that, and I'm being treated with antibiotics. However, I have no idea what "degenerative change is present in the thoracic spine" means. He said nothing about that, but he's an allergy/asthma specialist, so it's not really his field...
Here's what the whole thing says:
"Minimal linear infiltrate is present in the left base. The lungs are otherwise clear. The cardiomediastinal silhouette is normal size and configuration. No pneumothorax or pleural effusion is identified. The pulmonary vascularity is normal. Minimal degenerative change is present in the thoracic spine."
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I'm 65 years old, male.
In Nov 2014 I found by casualty (MRI magnetic resonance imaging) that I have severe spondylotic cervical myelopathy (CSM) at C4-C5. I don't feel or show any neurological symptoms, like gait or radiculopathy. Neither feel any pain. One neurosurgeon strongly recommends surgery, because, he says, I'm in great danger and I will get symptoms soon. Another neurosurgeon strongly recommends not doing surgery, as long as I do not show any symptoms, because, he says, my case is clinical, not surgical, and recommends me to take care, don't walk in slippery floors and don't put my head to much backwards.
Does anyone has a similar condition that may help me to decide for surgery or "wait an see"? Is there any less invasive surgery that in spite not decompressing the spinal cord might at least delay progression, like ozone therapy or foraminotomy?
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This is my c-spine MRI. It may or may not be the cause of my symptoms according to my PCP, see the spine doc on Tuesday. Anyone have any opinions on what this means.
DATE: 07/16/13
MRI-CERVICAL SPINE
CLINICAL INFORMATION: 47-year-old female complains of neck pain radiating to the arms with clonus in the lower extremities.
TECHNIQUE: Sagittal T1, T2 and intermediate weighted imaging. Axial T1 and gradient echo sequence.
FINDINGS: There is no prior exam for comparative purposes at the present time. There is straightening of the normal cervical lordotic curve. degenerative changes to a varying degree are present throughout the cervical region.
The C2-C3 level is unremarkable.
At the C3-C4 level, there are mild spondylotic changes present where mixed hard and soft disc material mildly deforms the ventral subarachnoid space without cord deformity. There may be minimal osseous foraminal compromise on the right.
At the C4-C5 level, there are mild spondylotic changes, slightly eccentric towards the right, without cord encroachment. There may be minimal osseous foraminal compromise on the right.
At the C5-C6 level, there are mild to moderate spondylotic changes present where mixed hard and soft disc material approaches but does not deform the ventral surface of the cervical spinal cord. There is at least a mild degree of osseous foraminal encroachment, left greater than right.
There are also mild to moderate spondylotic changes at C6-C7 level without cord encroachment. There is at least a mild degree of osseous foraminal encroachment on the left neural foramen. The spinal cord demonstrates normal caliber and normal signal intensity pattern throughout its length. The region of the craniocervical junction is normal.
Unsigned transcriptions represent a preliminary report And do not reflect a medical or legal document
IMPRESSION: Degenerative changes involving the cervical region, as detailed above. There is at least a mild degree of foraminal encroachment multiple levels.
Followup as clinically warranted
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I'm 42 and i have just found out that i have this condition. The 1st doctor i saw after having an x ray didn't bother to tell me that i had this condition, and it was the next doctor that did. I have been having symptoms for the last year or so , which are dizziness, some numbness in my little finger and ring finger, neck ache, which is muscular and nerve extending to my shoulder and arm i have also been getting jaw ache, and i've had tension headaches for years.
i'm not sure if all these symptoms are due to having 2 ribs. i'm waiting to have an mri in october.
However i am seeing a 'sacral-cranial' osteopath who is really helping, and i am also having homeopathy which is also helping.
I'm not sure what is going to happen and it's comforting to know that there are others out there that will know what I'm talking about and who i can talk to.
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I have recently been told after 15 years of going to the doctors asking for help i have 2 cervical ribs and need to see a respiratory specialist.
I have been suffering with breathing problems which they did put down to asthma which might not be now, pains in my back, stomach, neck and arm. and sometimes get numbness in my arm and fingers.
I am cold and feel weak and tired all the time. I can sleep for days and still feel tired, the more i do the more i feel ill.
I have a large bone showing above my left collarbone which i can feel a large tube or vein above it going over the top of the bone which i measure to be about 2" wide.
Just wanted to know what the average size and width of cervical ribs.
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Have been suffering for 3 months with pain from cervical issues (diagnosed through MRI) - bulging discs, some stenosis, degenerative disk disease that is causing severe pain from neck through shoulder blade, underarm and down left arm. As I've had arthritis in my neck for a long time I know this pain came about from a stress injury to my neck. Have tried much conservative treatment (some physical therapy, chiropractic, and medication - currently 900 mg gabapentin and hydrocodone and ibuprofen and various others that I stopped.) I just had a Epidural Injection last week and thru this week experienced a bit of relief but not what I was hoping for. My question is has anyone gotten better with this type of problem doing these measures and had their problem resolve or at least get about 75% better without having any surgical intervention. My doctor thinks we can resolve this without surgery but also said surgery would be extensive as I have about 4/5 bad levels. I'm thinking of trying acupuncture and would appreciate anyone's input. Very tired of the pain and getting a bit depressed.
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I'm 48 suffered with cervical spondylosis for around 6 years, in the last two years it's got so painful. I have tried all meds, last year I had an op foraminotomy where they drilled the left side spurs C4 to C7. But the last year has been a nightmare the pain is worse. I have now had more MRI & CT scans more meds and having two injections next week. I asked the long term affect of my neck I was told I have a neck of a 70 year old. What dose this actually mean? Wheelchair what?? I am also on the list for a anterior cervical discectomy & fusion.
I have a fall time desk job which doesn't help at all but have a mortgage... holiday is taken as sick days.
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I am recovering from Anterior Cervical Discectomy, which became necessary to avoid drastic further deterioration.
I would like to tell you about my experience and what helped me. My problem started quite unexpectedly with a persistent back ache at work (I am an office worker). Within days it was so bad that I was vomiting with pain and had to stop working (I was commuting to London). I was on morphine within three weeks, but it did not help either. I won't list here all the various painkillers I was prescribed, which helped to certain extent, but the pain was so bad that I was suicidal. The doctors communicated with me hardly at all except writing another painkiller prescription. I felt totally abandoned by them. I tried osteopathy, ordinary physiotherapy and Bowen's therapy. Bowens worked the best but nothing would give more than a few hours relief from the extreme pain. My husband then hit on the Tens machine and that was the only thing that really helped. I would recommend it without hesitation. I dropped the morphine, which was a bit of nightmare for me anyway, and managed to live with the Tens machine.
Unfortunately my problem rapidly progressed to me losing strength from my arm and from my fingers and a neurologist recommended the dissection and fusion. It is not an easy fix, but to me it saved my life. I went back to work four months after the operation, seven months after first feeling the pain. I could not say I'm as good as new, but the pain has gone. My neck is stiff, gets tired very easily and a bit uncomfortable. I cannot lift, push or pull anything heavy. But I'm here, enjoying my family and grandchildren. I couldn't ask for more. I'm 63 and now feeling my age, that's all.
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I was diagnosed with cervical spondylitis when I was 27 ( had a severe fall when I was 16 yrs old...fell 2 stories), am 48 now and moved to Wales almost 2 yrs ago from South Africa and since being here, my pain has increased in intensity. Used to get steroid injections and am aware that I won't get that here in the U.K. I now suffer extreme nausea due to the pain and can only dry retch, as the valve below the oesophagus was tightened yrs ago and now prevents me from throwing up. I would appreciate if others with this condition could tell me what the maximum dosage of Ibuprofen one can take. Taking the normal dosage (2) does not alleviate the searing pain or spasms.
I am also very confused. After x-rays, all dr,s have said cervical spondylitis and not cervical spondylosis. Been told that I don't have arthritis and yet this is not ankylosing spondylitis, which 1 dr said it was..(he never saw the x-rays)...really confused even after numerous x-rays and dr,s. I am almost on the verge of giving up hope of getting effective painkillers from dr,s here. Do the exercises, use heated neck bags and nothing much helps, especially when I get a flare up.
Need to know if increased dosage of Ibuprofen would help.
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I have Bilateral Cervical Ribs. I also suffer Cervical headaches. Do the Cervical Headaches always come along with the ribs? Also, is it the Arthritis in the Cervical Ribs that are causing me so much agony? I have pain every single day. It gets so old, and boring. What does it take for them to remove them? I have a Kidney Disease as well, so I'm not able to take many pain meds, and the ones I have taken really don't do much of anything for me. I don't believe I have the TOS....think it would still be possible they would end up removing them WITHOUT having the TOS?
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I dont know i have cervical spondylosis , but MRI said i have a cervical spasm < now even after eating food my heart rate increase some times and there are weird feeling all day long in the chest ,pain in arm .. i feel tingling numbness, in legs ,arms , shouledrs some time. disbalance when i just stand up
Mty Doctors are sending me to neurologist,Cardio , Rheumatologist,Internal medicine .
nothing solved . Heart is ok , ECG is ok, x-ray of heart is ok.Blood test was ok ...
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I have finally found info on Forestier's disease!
When I was first diagnosed back in 1988 my doctor had no material on this subject. I was told to go home and find it on my computer, which I did. There was a researcher in Canada who hit the nail right on the head, Forestier's is no picnic! He was so right!
When I was first diagnosed with the disease, I was in a lot of back pain. I had x-rays done and this article is correct....my vertebral area looked as if I were leaking wax. I saw all sorts of bony hooks hanging from each and every vertebrate and I was in a lot of pain; but my doctor at that time said I couldn't be in pain, as it wasn't painful??? On the contrary, the article I was told to research stated that there is a great deal of pain associated with the disease and eventually it would be crippling and that is where I am, 20 years later.
At the first time I was diagnosed, I didn't know that my choking could be associated with the disease itself, I thought it was just asthma...after all "it isn't that bad." I was placed on many anti-inflammatory medications. I was place on one that I suddenly would loose my speech and get confused...I was told they might be TIA's. Later this particular drug was found to do just that. Since it wasn't helping, I was put on another anti-inflammatory and the doctor doubled the recommended dose and later I found that the sphincter muscle to my stomach and been burned away from too much of a good thing.
I was told not to see a chiropractor and for good reason! I had a complication from a surgery and they had to knock me out in order to go down my throat....while under someone turned my head further than I could myself and broke a facet in my neck; now I have plates in my neck and need more surgery....Once my neck was repaired, I didn't choke any longer. Right now, the disease has gotten so bad that I have many areas of stenosis and nerve root cut off. The neurosurgeon who performed my first neck surgery stated that every opening that allows the nerve roots to channel through my body was loaded with razor sharp spurs. This is just the spinal region of my body.
I am beginning to calcify at every ligament insertion site. I have bony over growth in my feet, which interfere with the articulation of my foot joints. I can feel the bones sticking out of my ankles and the tops of my feet; I'm beginning to fuse in my left foot. In three weeks I'm heading for a double knee replacement because my left knee can't support my knee cap; over growth of bone has pushed it away. It is getting more and more difficult to participate in daily activities as my range of motion is becoming limited. My elbows and my shoulders are affected as well...I can feel bony growth there as well. I'm losing feeling in my legs, as my nerves are being pinched; the pain shoots down to my feet and it is gripping. My hands can't grip a phone for any length of time.
I found if my pain can be controlled, I can function well, but too many doctors are not up on the pain this disease produces. Controlling the pain keeps me moving, and that is what you need to do, but the support isn't there for this. The disease is so rare that it is brushed off as regular osteoarthritis and it isn't, it's no where near the same.
I was diagnosed in my thirties and I have lived with chronic pain for over twenty years now. I was told that it affects mostly males over the age of 70....bunk! It is genetic, as my mother had it and wasn't properly diagnosed with the disease and my brother has it as well. My mother and I were deeply affected, she had it her feet as well and by the time she reached 70, she couldn't walk without crying in despair.
I had one doctor treat me with Suboxone and it was the only drug that gave me back the quality of life others enjoyed. He left for the north and I am back in severe pain once again. The problem with this disease, it's a square peg and everyone wants to fit into a round hole. I try to keep a smile on my face for my families sake, but the pain can be read all over my face. I'm still young, by today's standards and I just want to be a participant in this life, not stuck in some corner watching my life and the world go passed me.
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Hi, have been diagnosed with degenerative arthritis 2 years ago and had another CT scan yesterday after experiencing pain for the past 3 days in right lower back and hip
my ct results says:
L1/2: No significant disc protrusion. The central canal and exit foramina appear adequate
L2/3: Minor disc bulge. The central canal and exit foramina appear adequate. Early facet joint degenerative change
L3/4: Mild disc bulge and ligamentum flavum hypertrophy. Minor encroachment on the central canal. The exit foramina appear adequate
L4/5: Disc bulge. Ligamentum flavum hypertrophy. Mild central canal stenosis. Minor encroachment of both exit foramina
L5/S1: Marked disc space narrowing, endplate osteophytes, endplate sclerosis and vacuum phenomenon, consistent with degenerative disc disease. Disc bulge. Mild central canal stenosis. Abutment of the origins of both transiting S1 nerve roots. No overt evidence of nerve root displacement or flattening. Moderate left and mild right exit foraminal stenosis. Abutment of both existing L5 nerve roots. Mild Bilateral facet arthropathy.
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Degenerative discs and spondylolisthesis,had injections worked well for 5 days now all back ...
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Does norethisterone change your ovulation day? I was using the tablets for less than a week to delay my period and came off them and had unprotected intercourse a few days after. If that had been my fertile window before taking the tablets would that still be my window while I was taking them?
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I often find I am changing up to 8 times a day not because the bag is full but because my skin sweating causes the adhesive to break down and the leaks begin. This is worse in hot countries and when travelling as I will need to change to make sure I have an empty bag before queuing up for aircraft etc. I also need to change before driving any distance as the seat belt position can cause leaks. Is there anyone out there with a similar problem
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So now I feel like a complete hypochondriac. Ladybud (who is fabulous, btw) has helped me tremendously. I am wondering if any of you have had your ANA patterns change. I am having muscle aches, dx with small fiber neuropathy and Raynaud’s, my RBCs and C-reactive protein have been low throughout the last 3 years. I now have been dx with a reactivation of the Epstein Barr virus and alopecia due to “granulomatous Dermatitis” (getting 2nd opinion later this month).
These are my titers and patterns over the years:
10/2011 ANA Titer: 1:320 Pattern: Homogeneous
11/2011 ANA Titer: 1:320 Pattern: Homogeneous
10/2013 ANA Titer: 1:320 Pattern: Homogeneous
5/2014 ANA Titer: 1:160 Pattern: Homogeneous
AND NOW:
6/2014 (AVISE SLE 2.0 TESTING (1st time with this test) ANA Titer: 1:80 Pattern: Diffuse fine speckled
Negative on all markers. I am HLA-B27 Positive, but negative for ankylosing spondylitis (AS).
Now my rheumatologist stated all my blood work appears to be normal and I have ZERO autoimmune positivity.
Huh? I feel like such a hypochondriac.
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