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What Do These MRI Findings Indicate?
Question: I had an MRI and the Dr is recommending 3 level ACDF. I need to know based on the results if this is a practical diagnosis, or if there are alternatives.
Brief Answer:
Conservative treatment should be tried first.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
I examinated the MRI reports you uploaded too.
Since MRI results found moderate to advanced spinal cord compression at C4-C5 level ( near complete cerebrospinal fluid effacement ) and degenative changes at C5-C6, C6-C7 levels with compression effects on neural structures, the diagnosis is right.
A positive finding on MRI is that there are no changes into the spinal cord itself, or mielomalacia that indicates advanced stages of disease and difficulties with complete improvement.
Regarding to report, since there is a short symptomatic time ( 10 days right? ), there is no emergency in deciding to have surgery or not.
In my opinion, first conservative treatment should be started ( NSAID drugs, physical therapy with the aim of strengthening neck muscles and reducing joint loading ) and close follow up ( after one month eg. ) is needed.
If conservative treatment will not succeed in improving symptoms, surgery (ACDF) should be the next step.
Three levels of ACDF seems reasonable according to MRI findings, in order to prevent further progression of the condition and to avoid successive surgeries, but stabilization needed also.
Hope you found the answer helpful.
Let me know if I can assist you further.
Take care.
Conservative treatment should be tried first.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
I examinated the MRI reports you uploaded too.
Since MRI results found moderate to advanced spinal cord compression at C4-C5 level ( near complete cerebrospinal fluid effacement ) and degenative changes at C5-C6, C6-C7 levels with compression effects on neural structures, the diagnosis is right.
A positive finding on MRI is that there are no changes into the spinal cord itself, or mielomalacia that indicates advanced stages of disease and difficulties with complete improvement.
Regarding to report, since there is a short symptomatic time ( 10 days right? ), there is no emergency in deciding to have surgery or not.
In my opinion, first conservative treatment should be started ( NSAID drugs, physical therapy with the aim of strengthening neck muscles and reducing joint loading ) and close follow up ( after one month eg. ) is needed.
If conservative treatment will not succeed in improving symptoms, surgery (ACDF) should be the next step.
Three levels of ACDF seems reasonable according to MRI findings, in order to prevent further progression of the condition and to avoid successive surgeries, but stabilization needed also.
Hope you found the answer helpful.
Let me know if I can assist you further.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr. Spaho,
Thank you for your reply. The MRI was taken about two months ago. Since then I have had steroidal injections which have helped with pain in shoulder and forearm. The numbness in my left forefinger has continued and worsened. Now I am also having lower back pain as well.
If I do not have the surgery what is the prognosis? Also, is this type of surgery typically successful. Is there a long recovery time? Is this a genetic issue or is there something I may have done to cause this problem e.g. chiropractic adjustments.
Thank you,
XXXXXXX
Thank you for your reply. The MRI was taken about two months ago. Since then I have had steroidal injections which have helped with pain in shoulder and forearm. The numbness in my left forefinger has continued and worsened. Now I am also having lower back pain as well.
If I do not have the surgery what is the prognosis? Also, is this type of surgery typically successful. Is there a long recovery time? Is this a genetic issue or is there something I may have done to cause this problem e.g. chiropractic adjustments.
Thank you,
XXXXXXX
Brief Answer:
Surgery is indicated.
Detailed Answer:
Welcome back and thanks for the clarifications.
In this case, since there is worsening of symptoms and two months passed, surgery ( ACDF ) is indicated.
A genetic predisposition of this condition is found in a small number of cases, it is more an acquired condition.
Chiropractic manipulation is not indicated in your case and surgery (ACDF) is successful in about 95% of cases, with short recovery time.
If you don't have surgery, the condition may worsen by damaging spinal cord too and probably causing serious disability.
Hope I helped you.
Best regards.
Surgery is indicated.
Detailed Answer:
Welcome back and thanks for the clarifications.
In this case, since there is worsening of symptoms and two months passed, surgery ( ACDF ) is indicated.
A genetic predisposition of this condition is found in a small number of cases, it is more an acquired condition.
Chiropractic manipulation is not indicated in your case and surgery (ACDF) is successful in about 95% of cases, with short recovery time.
If you don't have surgery, the condition may worsen by damaging spinal cord too and probably causing serious disability.
Hope I helped you.
Best regards.
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Above answer was peer-reviewed by :
Dr. Yogesh D
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