Question about Cervical AND Lumbar MRI

[WhatAHeadache]

I recently got a Cervical and a Lumbar MRI done. I was mailed the report for some reason and I'm wondering if there is someone out here who would (please) put this in plain English for me:

MRI-Cervical Spine

Findings:
There is slight straightening of the normal lordotic curvature of the cervical spine. The height of the cervical vertebral bodies is maintained and there is otherwise normal alignment. There is some loss of disc signal from the C2-3 through C6-7 levels consistent with desiccation discogenic change. The cervical cord is without signal abnormalities.

C5-6: There is mild disc bulging and osteophytic ridging. No significant central canal stenosis or neural canal narrowing is seen.

C6-7: There is a broad based disc osteophyte complex eccentric to the left which causes mass effect on the thecal sac, but no mass effect on the cord. There is mild central canal narrowing. There is some narrowing of the neural canals bilaterally secondaty to uncinate and facet hypertrophy.



MRI-Lumbar Spine

Findings:The height of the lumbar vertebral bodies is maintained and there is normal lardotic curvature and alignment. The lower cord and conus have a normal appearance.

L4-5: There is minimal disc bulging. No focal disc protrusion, central canal stenosis or neural canal compromise is seen.

L5-S1: There is diffuse annular disc bulging, which is either eccentric to the left or there is a small superimposed broad based left lateral disc protrusion. This causes left neural canal narrowing. Right neural canal remains patent.


I'd greatly appreciate any help I can get in translating this to layman's English and also possibly what it all means to my back.

Thank you all in advance!
-Christine

[Stephen Ryu, MD]

Good luck with the cervical injection. I think your best bet is to stick with pain management. You seem to have a lot of things going on. None that that really be explained by your scan reports, hence, no surgery required.

I think civilian and military doctors more or less train the same and many military doctors are just working off their educational debt. I good doctor is a good doctor and bad is bad whether in uniform or not. I think both have too much paperwork to do.

[WhatAHeadache]

Oh.
As far as other symptoms..
I can't walk for very long without aggravated pain and fatigue. I cannot sit or stand for more than 20 minutes without aggravated pain and extreme fatigue. My Doctor prescribed a wheelchair and a handicap tag for the car. Why? If I do try to walk/stand for too long, I collapse. EEG, EKG are normal. I have *severe* insomnia, sometimes going for one week consecutively without sleep. When I can sleep, I sleep for either very long periods of time (14+ hours) or very short periods (2 hours). Once I wake, I don't sleep again for days. I am constantly nauseated and have not had a moment free of a splitting headache for about 4 months now. My eyes are always very bright red, but my pupils are normal. I have "Dental Degenerative Disease" (Not sure if it is related) and Temporomandibular Joint Disorder. I have also been diagnosed with Arthritis/RA and all of the joints in my extremities and fingers snap and pop every time I move. You probably don't need all that info, but I'd rather be thorough :)
If you are at all interested in any of this, feel free to ask any questions you like and I will happily answer, even if to only satisfy personal curiosity. I'm not worried about the privacy of my symptoms, or I would not post them on the internet!  :)
Thanks again!
-Christine

[WhatAHeadache]

You're quite welcome and thank you so much for replying.
My pain is literally throughout my back. The center, or "focus" of my pain varies from hour to hour. Sometimes it is in my right shoulder blade.. Sometimes the center of my back. Sometimes my right arm, sometimes my left. (Shoulder to finger tips)
As far as the leg(s), I have severe warm, stabbing and generally aching pain that goes down *both* legs.
I've been diagnosed with severe Sciatica (about 4 years ago)
I've also had about 20 other diagnoses that encompass many diseases, syndromes and disorders. Every doctor tells me something different. Not to be cliche', but my current doctor calls me a "mystery diagnosis."

I've had every neurological test possible done, including nerve tests and a CT of my brain. Everything came out fine. Nothing in my body is actually *showing* as wrong, which is the mystery. My doctor and I have both been looking up rare diseases and the such. Why? He says "I don't want to pidgeon hole you." He is a good Doctor in that he is very interactive with me regarding my care. We're a team. My Pain Management Doctor has scheduled me for a CESI on Aug. 15th.
(Cervical Epidural Steroid Injection) and I will see how that goes. Do you think there is a difference between civilian and Military Doctors?
My husband is in the Army, so my PCM is a Military contracted Doctor. Do you think this will make a difference in my finally finding out what is definitively "wrong with me"? I apologize for rambling..
Also, I thank you so much for picking the Neurological field (in any form) for your specialization.
Again, thank you so much for the reply!
-Christine

[Stephen Ryu, MD]

Thanks for the vote of confidence!

Reading MRIs is like trying to describe a picture in words. Some people are good at it; some people are bad at it. It is nearly impossible to make a clinical decision on a spine matter by just reading an MRI report. MRI reports serve as a guide for the surgeon to try and correlate symptoms with findings. The decision of whether one needs surgery or not requires: talking to the patient, examining the patient, looking at the actual MRI/CT/X-rays, and then synthesizing the information to see if any surgically correctable lesion exists.

To answer your question though .... I'll try and simplify your scans reports.
MR - C spine
Your spine is straight but otherwise normal. There are some early degenerative changes. Spinal cord is normal. At C5-6 level there is enough early degenerative changes to comment on, but probably normal. At C6-7 there is more degeneration and bone spurs but not pressure on the spinal cord or nerves.
MR - Lspine
Your spine and spinal cord are normal. At L4-5 there is a very tiny disc bulge (most disc bulges are asymptomatic, not treated, and not important) At L5-S1 there is a bigger bulge more off to the left that narrows the canal a little.

If your symptoms are back pain and/or neck pain, the scans are fairly unimpressive and would not support the need for a major surgery. If you have left leg pain *ONLY* then it might be due to the disc, but the description on the report is not very suggestive of a big disc herniation.

Again, it is impossible to know *for sure* whether you need any surgery or not without you being seen by a doctor.

[WhatAHeadache]

Oh.. And my history is quite long, but I can list it if that would help.

[WhatAHeadache]

I also want to know if, barring a clean MRI, there is any sort of surgical solution to my possible problems. I ask here because I'd like to get as many educated answers as I can, and you just can't beat a Neurosurgeon. They are like the rocket scientists of medicine. Thanks again!