help understanding my cervical spine MRI

[julleea]

Im 46, I had an MRI in 2012 that was normal..I'm losing the use of my left arm, am now starting to have sporatic loss of control of bladder/ bowels and now shortness of breathe...I had an MRI done again this month and I'm out of town and just got my MRI results and am a 28 hour drive from home..I'm trying to figure out if my situation is one that needs surgery ASAP? Here is my MRI /EMG results , sorry for the legnth.

At C2-3 there is severe right and moderate left facet spondylosis with mild to moderate right neural foraminal narrowing.
At C3-4 there is a small posterior buldge indenting the ventral thecal sac causing mild narrowing of the spinal canal without spinal cord deformity or compression.There is facet spondylosis on the left with a small facet joint effusion and increased signal in the facet suggesting facet joint inflammation. Mild neural foraminal narrowing.
At C4-5 there is mild retrolisthesis and a small posterior bulge or protrusion causes moderate narrowing of the spinal canal eccentric towards the right mildly flattening the right anterior surface of the spinal cord and indenting the right lateral recess with osteophytes narrowing the right lateral recess. There is severe narrowing of the right neural fora men due to uncovertebral spondylosis.
At C5-6 there is moderate vertebral spondylosis with mild tetrolisthesis and a small posterior bulge/ osteophyte complex indenting the ventral thecal sac slightly eccentric towards the right causing mild narrowing of the spinal canal. There is severe right neural foraminal stenosis due to uncovertebral spondylosis. There is mild left neural foraminal narrowing.
At C6-7 there is minimal tetrolosthesis and a minimal bilge of the posterior disc annuls without spinal canal stenosis or spinal cord contact / deformity
At C7+T1 there is mild facet spondylosis. No spinal canal stenosis

My EMG impression of C4-5 thru C8-T1 says:
Abnormal exam. There is electrodiagnostic evidence of a C5-6 cervical radiculopathy in the right upper extremity. There is severe early chronic and active denervation in the C-6 myotome with milder chronic denervation in the C5 myotome as well.

Any help or guidance understanding this as soon as possible would be greatly appreciated as I said I'm out of town and pretty confused.
Thank you

[sblythe]

I am a little confused by all this - your MRI seems to show most severe changes on the right, but your left arm is the one with the neurological problem. And you don't seem to have spinal stenosis to the extent that you should have bladder problems and shortness of breath.  Have you had a brain MRI also?  Certainly if you have neural foraminal stenosis pinching a nerve to the point of decreasing muscle strength in an arm, you need surgery to relieve the pressure on that nerve - you need your situation evaluated thoroughly. But from your MRI as I look at it, I don't see a cause for bladder dysfunction and shortness of breath. I would want to see a brain MRI also to make sure there isn't something like MS going on. Best wishes.

[philnoir]

Some terms:

C3, C4, C5, C6, etc. - the cervical spine has 7 cervical vertebrae, named C1 - C7.

thecal sac - the fibrous covering of the spinal cord.

facet joint - each vertebrae is joined by 2 facet joints (left and right) that allow you to flex and bend your neck and back. The facet joints and the disc create 3 point stability at each level between vertebrae to support your neck and back.

spondylosis - inflamation and disease of the facet joint.

retrolisthesis -- one disc slipping backwards over another. This indicates disease of the facet joint and associated ligaments. (Treatment is stabilization (fusion) of the two vertebrae involved.)

neural foramina - space between two vertabrae where the nerve root exists the cord. Cervical nerve roots branch to innervate the head, face, neck, shoulders, arms, and upper back.

foraminal stenosis - narrowing of the foramenal space.

spinal canal stenosis  -- narrowing of the spinal canal, (usually classified as mild, moderate, and severe.)

Because of your symptoms, you would be wise to consult with an experienced orthopaedic surgeon.

[Caryopteris]

No such thing as "tetrolisthesis."  Probably retrolisthesis or anterolisthesis.  

I believe surgery will be strongly recommended for these problems.  Diskectomy with fusion.

Get a highly rated surgeon and make sure somebody is there to assist you after surgery for a few days.  

Surgery of the cervical spine can go very well with very good outcomes if you get a good surgeon.  

If you are overweight, reduce calories to lose weight as it will help you.  

Neck spine surgery is much more successful generally than low back surgery.