Plain English?

[snugglepuss]

I would like help understanding these tests I had done in 2006/7.

The findings of my cervical spine MRI are:

"C4-5 level mild degenerative disc disease is present with posterolateral disc osteophyte complex resulting in mild bilateral neural forminal narrowing and minimal central canal stenosis with effacement of teh CSF anterior to the cord.  However no signal change is identified within the cord."

"At the C6-7 level, a tiny left central disc bulge is present which effaces the CSF anterior to the cord, but does not impinge on the cord"

"Impression:  Mild cervical spondylosis which is most prominent at the C4-5 level.  No evidence of nerve root impingement, cord compression, cord signal change, or significant disc herniation"

Here is the cervical spine CT report:

"The C3-4 level is unremarkable.  At C4-5 mild uncovertebral joint degenerative change is symmetrical.  The foramina are unremarkable.  The disk at this level shows a mild, symmetrical posterior bulge."

"At C5-6 the foramica and canal are normal.  Minimal right paramedian and posterior bulging of the disk is present."

"At C6-7 mild central posterior bulging of the disk is shown"

"At C7T1 no abnormality is seen"

"On bone window, canal dimensions and the Z-joints are normal.
Conclusion:  Cervical spondylosis, maximal at C4-5 without signs of root compression".

I am a white female, aged 36.  I was about 32 when I had the MRI and CT done. I have been in a couple of relatively minor car accidents, and have also had a couple of concussions as a result of playing sports.

[snugglepuss]

I should add, I am still having the same symptoms, which are pain, numbness/tingling in my hands, and a sensation I can only describe as feeling as though there are fibreglass slivers under my skin.  I get headaches very frequently, usually at least one per week, and they last anywhere from a day to 4 days.  Nothing really works to get rid of the headaches...I have tried Naproxen, ibuprofen, tylenol with codeine.  If it is a bad headache, I will end up in bed with an ice pack on my face.  

Since the MRI and CT scan, I have had an accident on my scooter, which resulted in me sliding along the pavement with the scooter on top of me.  I felt pretty banged up for about 2 weeks after that, and my neck was incredibly sore.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Your back shows evidence of chronic compression (either from posture, activities, etc) resulting in disc herniations. With time, the amount of disk that has herniated shrinks and may resolve with time. Therefore, for the majority of people, non-surgical treatment is the first option. This treatment may include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muscle relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications.

The osteophyte complexes are bony overgrowths, much like arthritis. Cord compression is usually commented on in spine imaging given the implications that it would have if found, i.e., surgery would likely be needed.

In a minority of patients, surgery needs to be done urgently. This often is the case when the herniated disc is pressing on the spinal cord itself (i.e,. cord compression which you don’t have in your reads). Surgery is emergent so that permanent spinal cord injury does not occur. Another indication for urgent surgery is if there is evidence that a nerve is being compressed on to the point that its function is impaired. Symptoms suggesting the need for urgent surgery include muscle weakness, loss of bowel or bladder control, loss of sensation, particularly in the pelvis and severe and progressive pain.

If you are symptomatic still, you should be seen by your primary care physician. He/she will need to decide if your symptoms warrant re-imaging and further workup.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.