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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does C4-5 Mild Diffuse Disc Bulge In The X Ray Result Suggest?

Hi. I was wondering if someone can explain what my results mean in normal terms. I strained my neck about a year ago and went through a month of PT and got better. But I work alone at night in x-ray and hurt it again last month moving a patient who was fighting me moving him. I tried to deal with it but broke down and went to company health. I am 34 and supposed to leave for National Guard boot camp July 15th. Now I am not sure I will go at all. Anyways... I am having pain in my neck, between my shoulder blades and tingling, numbness, and pain down my right arm. Mainly on the little finger side. but also from my middle finger to the little finger. The PA at company health said I have arthritic changes (which I know is normal) and a minor bulge at C4-5. However I got a copy of the results and she seemed to miss what the radiologist said about C5-6 and C6-7. This is what my results say. Sorry it s a lot. I will only post what is not normal... Cord: the visualized cord is within normal limits of signal intensity but is compressed as outlined below C4-5: Mild diffuse disc bulge without significant spinal canal narrowing. Facet and uncinate hypertrophy result in mild right neural foramina narrowing. Left neural foramen is patent. C5-6: Diffuse disc bulge with superimposed central protrusion results in effacement of the anterior theca sac with mild flattening of the cord ventrally. Neural foramen are patent bilaterally. C6-7: Diffuse disc bulge with superimposed right paracentral /Foraminal disc extrusion results in eccentric to the right effacement of the theca sac anteriorly with flattening of the ventral cord on the right. Disc protrusion combined with facet and uncinate hypertrophy result in mild right neural foramina narrowing. Left neural foramen is patent. Impression: DEGENERATIVE CHANGES OF THE LOWER LUMBAR SPINE (this should say cervical spine) ARE MOST PRONOUNCED AT C5-6 AND C6-7 LEVELS WITH DISC EXTRUSIONS RESULTING IN VENTRAL CORD FLATTENING AND NEURAL FORAMINAL NARROWING AS DETAILED ABOVE. Thank you for your help. I am trying to get an appointment the an Otho Dr to follow up.
Thu, 11 Sep 2014
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Radiologist,  's  Response
Hi,
Thanks for writing in.

There are 7 small bones in the neck part of spine with spongy discs between them. These discs should be aligned in a normal fashion to allow various movements in the spine and also provide cushioning. In your upper neck the discs at levels C 4 -5, C 5 - C 6 and C 6 - C 7 is displaced backwards and this is due to degeneration. As the nerve roots pass in between vertebrae and hence it is under pressure and the symptoms you are having are due to nerve root compression. At C 4 - C 5 the disc is displaced to right and nerve root is compressed. At C 5 - C 6 the nerve roots are free because the disc is extending backwards and not to any particular side. At C 6 - C 7 the nerve roots are affected on the right side.

Treatment is conservative by medications in the beginning and includes pain killers which work on nerve related pain. You may try doing physiotherapy and avoid lifting heavy weights. This problem will not heal completely but if you take precautions, the progress of the problem will be slow and you will still be able to continue with your daily activities without much troubles.

You should not do sudden neck and hand movements to avoid severe pain.
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What Does C4-5 Mild Diffuse Disc Bulge In The X Ray Result Suggest?

Hi, Thanks for writing in. There are 7 small bones in the neck part of spine with spongy discs between them. These discs should be aligned in a normal fashion to allow various movements in the spine and also provide cushioning. In your upper neck the discs at levels C 4 -5, C 5 - C 6 and C 6 - C 7 is displaced backwards and this is due to degeneration. As the nerve roots pass in between vertebrae and hence it is under pressure and the symptoms you are having are due to nerve root compression. At C 4 - C 5 the disc is displaced to right and nerve root is compressed. At C 5 - C 6 the nerve roots are free because the disc is extending backwards and not to any particular side. At C 6 - C 7 the nerve roots are affected on the right side. Treatment is conservative by medications in the beginning and includes pain killers which work on nerve related pain. You may try doing physiotherapy and avoid lifting heavy weights. This problem will not heal completely but if you take precautions, the progress of the problem will be slow and you will still be able to continue with your daily activities without much troubles. You should not do sudden neck and hand movements to avoid severe pain.