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What Do These MRI Results Indicate?

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Posted on Mon, 22 Jun 2015
Question: I just got MRI results. I had an auto accident in Nov. 2014 (rear-ended). I had similar accidents in 2001 & 2005. I never had numbness or tingling in my right hand, sometimes my left. Both get numb daily now since my accident. Results show: At the C4-5 level, left paracentral disc ridge complex effacing the left lateral recess, contacts the spinal cord which is flattened. Uncovertebral osteophyte and facet degenerative cause severe left neural foraminal narrowing, mild on the right. There is mild spinal canal stenosis at this level. At the C5-6 level, prominent disc ridge complex, uncovertebral osteophyte flattening the ventral segment of the spinal cord. There is mild spinal canal stenosis. Uncovertebral osteophyte cause bilateral moderate to severe neural foraminal narrowing, left greater than right.
At the C6-7 level, paracentral disc ridge complex flattening the thecal sac with uncovertebral osteophyte
effacing the left lateral recess with severe left neural foraminal narrowing. The right neural foramen is
slightly narrowed. There is mild spinal canal stenosis. At the C7-Tllevel, no focal disc herniation. No spinal canal stenosis identified.
Below is result from March 2005 MRI of my cervical spine. Can you determine the changes and could my car accident in Nov., 2014 have contributed to the worsened symptoms and constant pain I am in? I have been in pain daily since the accident; prior to the accident I had occasional pain.
IMPRESSION: Degenerative changes present to a variable degree throughout the
cervical spine, most prominently at C4-5 to C6-7. Disc material and spondylosis are noted asymmetrically to the right of midline at C4-5 and to the left of midline at C5-6 and C6-7. There is a small right paramedian disc protrusion at C4-5. The disc protrusion appears more prominent than on the previous study dated 07/18/03 and now appears to cause mild impingement of the cord. There is impingement of the cord to the left of midline at C5-6 and C6-7. The changes at these levels appear stable. The remainder of the examination is as described above.
doctor
Answered by Dr. Dr. Erion Spaho (52 minutes later)
Brief Answer:
There is worsening of spine condition regarding to stenosis.

Detailed Answer:
Welcome to HCM.

I have read your query and understand your concerns.

It could have been easier for me if you could upload MRI pictures.

After examining carefully two different times MRI reports, in my opinion, there is worsening of cervical condition observed by imaging too, besides your symptoms.

This is true particularly at C4-C5 level when now is instituted spinal canal stenosis.

There is degenative spine disease of cervical column too, this makes your spine more susceptible to traumatic damage.

I think the November accident worsened, predisposed worsening of your condition.

Another imaging study is needed in order to evaluate instability of your cervical spine. There's need for plain radiography films on flexed and extended position of your cervical spine.

Conservative treatment is tried first. This includes NSAID drugs and physical therapy and exercises designed to increase muscle strength and relieve joint loading.

When conservative measures fail to improve your symptoms, decompressive surgery with/without stabilization of cervical spine is indicated, this always related to your symptoms.

Hope I helped you. I remain at your disposal for further questions and clarifications.
Best regards.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (16 hours later)
I did not know how to upload the entire MRI CD - I took a photo on my computer and have attached it for your review. Thank you for your response.
doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
There's stenosis at C4-C5, C5-C6, and C6-C7 levels.

Detailed Answer:
Welcome back and thanks for the picture.

Even there is just one view of your cervical MRI, it is obvious that there is spinal cord stenosis at levels C4-C5, C5-C6, and C6-C7.

There seems to be degenative spine disease too.

As I said before, treatment about this condition consists on conservative measures first ( NSAID drugs, physical therapy with the scope of reducing joint load and strengthening neck muscles ).

If these measures fail to improve your symptoms, decompressive spine surgery is indicated, in order to stop progression of symptoms and relieve actual ones.

In my opinion, if it comes to surgery, in your case posterior cervical laminectomy at C4-C5, C5-C6, and C6-C7 levels is the best solution.

Regarding to conservative treatment that should be tried first, I recommend a soft cervical collar for two months during the day or when standing.

Hope I helped you. Best regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4501 Questions

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What Do These MRI Results Indicate?

Brief Answer: There is worsening of spine condition regarding to stenosis. Detailed Answer: Welcome to HCM. I have read your query and understand your concerns. It could have been easier for me if you could upload MRI pictures. After examining carefully two different times MRI reports, in my opinion, there is worsening of cervical condition observed by imaging too, besides your symptoms. This is true particularly at C4-C5 level when now is instituted spinal canal stenosis. There is degenative spine disease of cervical column too, this makes your spine more susceptible to traumatic damage. I think the November accident worsened, predisposed worsening of your condition. Another imaging study is needed in order to evaluate instability of your cervical spine. There's need for plain radiography films on flexed and extended position of your cervical spine. Conservative treatment is tried first. This includes NSAID drugs and physical therapy and exercises designed to increase muscle strength and relieve joint loading. When conservative measures fail to improve your symptoms, decompressive surgery with/without stabilization of cervical spine is indicated, this always related to your symptoms. Hope I helped you. I remain at your disposal for further questions and clarifications. Best regards.