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What Does This MRI Report Indicate?

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Posted on Tue, 16 Aug 2016
Question: s/p cervical disc replacement @ c5-6 (Oct 2015). Had updated MRI last week d/t increasing bilat UE sx (painful extremities, tingling & numbness that occurs intermittently but has steadily worsened since Jan).
Per radiology interpretation: c3-4 broad based posterior disc bulging that produces mild canal stenosis (AP 8-9mm) & mild ventral flattening without significant cord compression. Previous imaging showed disc bulging & osteocytes before at this level & canal stenosis (I believe @ 8mm). I f/u with my neurosurgeon next week to discuss but was just curious if this could potentially mean fusion? I would think my sx are explained by this finding. Theres also disc bulging @ c6-7 but without stenosis.
doctor
Answered by Dr. Mahaveer Patil (4 hours later)
Brief Answer:
Nothing to worry about

Detailed Answer:
Hi XXXX
Hope this message finds you in good health.
I have gone through your complaints and understand your concern.

From the details you have shared,it seems that you have got a disc bulge and flattening at c3-4 level.This is far away from being labelled as fusion.We call it a Fusion when the disc space between the vertebra is actually replaced by a thick fibrous tissue or bone.There don't seem to be such findings in your report. Its just an annular disc bulge,with canal recess narrowing.
Cord is not compressed- a good sign. Nerve is compressed causing the symptoms like tingling and radicular pain.
I would suggest you to avoid surgery as far as possible because in long term it will harm your spine as a whole.

Instead undergo a good physiotherapy, cervical traction, neck exercises,analgesics,rest,hot fomentation,neurotransmitter tablets, cervical collar.
Only if these don't help, then opt for surgery.

I JUST WONDER WHY YOU HAVE SO MANY DISC PROBLEMS AT SUCH A YOUNG AGE. Its rather unusual. Do put this point in front of your neurosurgeon when you consult him.

You should eventually get back to normal in coming few days.Nothing to worry about, as long as i am there to help you.
     
I hope your question has been answered.
If you have any follow-up queries,feel free to consult me anytime.
Thanks,Take care,God bless. Wish you a healthy life : )

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Mahaveer Patil (1 hour later)
Thank you for your input. Sadly there are no great stories to explain this. Good 'ol degenerative disc disease. In addition to what I've mentioned, per radiology reports: c5-6 is an artificial disc, c3-4 broad based posterior disc bulging that produces canal stenosis (AP 8) with mild central cord flattening without significant cord compression, c6-7 suspected posterior disc bulge without severe cord compression, l2-3 minimal broad based posterior disc bulging without protrusion, l3-4 posterior central disc protrusion & associated annular fissure indent the ventral thecal sac and results in stenosis (AP 8-9) & partial effacement of the subarticular recesses bilaterally, l5-s1 disc desiccation, loss of disc space height and there's mild broad based posterior disc bulging with annular fissure & lft sided facet arthropathy. Bone spurs/osteophyte complexes noted in many areas of cervical region.
This has all been years in the making. I've done PT, systemic steroids, use hot and cold for sx management, TENS unit marginally helpful. I've increased activities and notice an increase in sx. My initial question was asking if a fusion could be a potentiAl fix to the c3-4 level.
doctor
Answered by Dr. Mahaveer Patil (7 minutes later)
Brief Answer:
query answered

Detailed Answer:
Hi XXXX
Welcome back
You seem to have so many discs that have been under stress.
Fusions are best to be avoided as they result in loss of movements at that level causing stifness. Long term effects are then seen on the adjoining discs.
But if you consider pain,the factor, fusion offers the best relief.
If activities are increasing the symptoms, do try curtailing them down

I hope your question has been answered.
If you have any follow-up queries,feel free to consult me anytime.

If you do not have any clarifications,you can close the discussion. Wish you a good health.Have a great day : )
Take care,God bless.
YOUR RATING FOR THIS ANSWER MATTERS A LOT AND WILL BE HIGHLY APPRECIATED.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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What Does This MRI Report Indicate?

Brief Answer: Nothing to worry about Detailed Answer: Hi XXXX Hope this message finds you in good health. I have gone through your complaints and understand your concern. From the details you have shared,it seems that you have got a disc bulge and flattening at c3-4 level.This is far away from being labelled as fusion.We call it a Fusion when the disc space between the vertebra is actually replaced by a thick fibrous tissue or bone.There don't seem to be such findings in your report. Its just an annular disc bulge,with canal recess narrowing. Cord is not compressed- a good sign. Nerve is compressed causing the symptoms like tingling and radicular pain. I would suggest you to avoid surgery as far as possible because in long term it will harm your spine as a whole. Instead undergo a good physiotherapy, cervical traction, neck exercises,analgesics,rest,hot fomentation,neurotransmitter tablets, cervical collar. Only if these don't help, then opt for surgery. I JUST WONDER WHY YOU HAVE SO MANY DISC PROBLEMS AT SUCH A YOUNG AGE. Its rather unusual. Do put this point in front of your neurosurgeon when you consult him. You should eventually get back to normal in coming few days.Nothing to worry about, as long as i am there to help you. I hope your question has been answered. If you have any follow-up queries,feel free to consult me anytime. Thanks,Take care,God bless. Wish you a healthy life : )