I had an MRI for my Lumbar spine without contrast and MRI spine cervical without contrast.
1)The Lumbar spine impression says that mild degenerative changes seen within the lumbar spine.
2) diffuse low signal is seen on the sagittal T1 images of the visualized bone marrow. While this could just be related to red marrow a diffuse infiltrative process in the bone marrow could not be excluded. Correlate clinically. Patient may need bone marrow biopsy
The cervical spine MRI impressions say
1) moderate sized left paracentral disc protrusion is seen at the C5-6 level causing moderate spinal canal stenosis and moderate left sided neural foraminal narrowing. pROTRUSION IS 7mm by 4mm by 10mm in craniocaudal, AP, and transverse dimension. Disc extrusion extends into the left lateral recess. It is causing some displacement of the left sided nerve root at this level. Mild flattening of the cervical spinal cord is seen. Moderate spinal canal stenosis is seen with the thecal sac measuring 7mm in AP dimension.
2) small central disc protrusion is seen at the C8-7 level causing mild central canal narrowing
3) heterogeneous bone marrow signal is seen within the vertabral bodies of the cervical spine.
I am scared to death. Does this mean I will need surgery? What does the abnormal bone marrow results mean? My doctor said he didn't know and is sending my results to another radiologist. He referred me to orthopedic doctor for spinal issues. I just really haven't been given any real picture of what the problems are. Thanks for any input!
Don't get surgery! That is the last resort. There are allot of treatment options before you would resort to surgery.
I am assuming you're experiencing some discomfort, the question is how much. The doctor you need to see is a neurologist, orthopedists like to perform surgery then send you to a neurologist when you can't walk anymore.
The problem is even if you have the best surgeon in the world your nerves could build up scar tissue from the operation. That would mean pain. That doesn't mean surgery doesn't work for allot of people, just that you need to try everything else first.
The 7mm stenosis is a problem. The typical canal is 12mm with 10mm being narrow.
Experiencing some discomfort? Yes! My neck has been painful and causes shoulder pain frequently. Howver it's been chronic for so long I can deal with it. Naproxen 800 usually makes it manageable. I insisted on the MRI (thank god) because of the horrendous pain in my right upper buttock and hip. It was bad two weeks ago, but seems to worsen daily. It's pretty awful right now. The weird thing is, the neck appears to be where my main problem is. Is it possible that the neck issue is exacerbating the problems in the lower lumbar area?
So what can be done about the 7mm stenosis? My PCP referred me to an orthopedic surgeon for my back, and a different radiologist for the abnormal bone marrow results. Any help for pain management? I've been taking a hydrocodone 5mg once daily for about a week now. Since the pain is worsening they are not helping anymore.
You need to see a neurologist and a physical therapist. The pain is coming from two locations and will continue to get worse. The stenosis can cause all kinds of problems, from foot pain to bladder problems and everything in between. My foot feels like it's on fire at times.
Find a good neurologist, not from the phone book. Some are pill pushers or too eager to cut you open to pay for their next trip to Europe.
Look for doctors connected to teaching hospitals.
They can operate and open the spine around the spinal cord. This is major surgery, the spinal cord is very fragile and the nerves can get damaged easily. I know too many people that rushed into surgery and ended up in a wheelchair for the rest of their lives. The doctor will be sure to have you sign forms acknowledging the risks.
I am not trying to scare you, I just want you to find the best solution for this major problem.
A canal diameter of 7mm would possibly be considered severe, not moderate, in some radiologists' opinions. It depends on how much it compresses your spinal cord and the severity of your symptoms.
If it's a lumbar spine issue, avoiding or delaying surgery might be an option. But if it's your C-spine, you may have little choice about the need for surgery. Severe spinal stenosis in the C-spine puts you at risk for paralysis, with or without surgery. The surgery is probably the safer option, if you can find a good, highly experienced spine surgeon. If there are no docs you trust, in your region, find one in another part of the state or even further away. Confidence in your doctor can alleviate some of the fear.
Some indications that you need C-spine surgery include lots of pain and other symptoms such as difficulty using your hands and coordinating your feet when walking. Very red flags are urinary incontinence or retention, and/or bowel incontinence. Similar symptoms, along with sciatica pain in your legs, can make you a candidate for lumbar surgery, too.
For neck surgery, I prefer a neurosurgeon, not an orthopedic surgeon, and I suggest you speak to your doctors and people who've had spine surgery, to find out which surgeon they'd recommend.
Spine surgery is a scary thought, but neck surgery is less horrible than you'd imagine and can cure a lot of your symptoms. But some kinds of lumbar surgery can unfortunately be pretty difficult to endure, so you should spend time deciding whether or not to have it.
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