Significant central canal stenosis at C3-4, 4-5, 5-6 due to a combination of soft disc bulge and disc osteophyte complex. There is complete effacement of the ventral CSF with deformity of the cord consistent with moderate central canal stenosis at each of these levels. No cord signal abnormality is clearly identified. Foraminal stenosis and exiting impingement is present at each of these levels to varying degrees.
Cervical Myelography performed in standard fashion with puncture at the L3 level. There is stenosis at C5-C6 with bilateral C6 nerve root impingement and widening of the cord. Only minimal contrast opacification is present more cephalad. There is partial opacification of the left lateral subarachnoid space at C3 and C4. Almost no opacification is present in the right lateral subarachnoid space at these levels.
Impression: Spondylosis and stenosis C5-C6 with bilateral C6 nerve root compression. Poor further cephalad contrast opacification.
CT Scan Findings: Axial CT images of the cervical spine were obtained. Sagittal and coronal reconstructions were obtained. At C7-T1, there is slight spondylosis with normal central canal size and no C8 nerve root impingement. There is mild spondylosis and central canal stenosis at C6-C7. Neither C7 nerve root is impinged. Spondylosis and marked central canal stenosis are present. At C5-C6, there is bilateral C6 nerve root impingement. Spondylosis and moderate central canal stenosis are present at C4-C5. There is spondylitic compression of the left C5 nerve root. There is slight spondylitic compression of the right C5 nerve root, but the nerve root sleeve fills with contrast. At C3-C4, there is spondylosis and prominent broad central disc protrusion. There is moderate central canal stenosis. No left C4 nerve root compression is present. Right-sided spur at C3-C4 compresses the right C4 nerve root however. At C2-C3, there is satisfactory central canal size with minimal spondylosis.
It is wise to consult a qualified spine surgeon in this case so he/ she can perform a thorough physical examination and correlate with your imaging listed above. Only then can a doctor determine if you need surgery.
I left out I am 57 years old. My question is should I have surgery and if so which one first or can both cervical and lumbar be done at same time? I constantly in some pain from a 4 to a 9 on a scale of 1 to 10. I no longer cut my grass because I have to rest too often and it take too much time. My forearm, hand and fingers are always numb to varying degrees and my hand fingers are often in pain ranging from a 4 to a 9.
Here is the lumbar part from the MRI Lumbar Spine W/O 3/8/2007
Indication: back pain radiating to foot. Coronal localizer shows no evidence of significant scoliosis. The visualized portions of the sacrum and iliac wings are unremarkable. Sagittal images show no evidence of subluxation or dislocation. There is hypointense signal noted at the L4-L5, L3-L4, and L1-L2 interspaces consistent with multilevel generative disc disease. Parasagittal images show neural foramina to be patent bilaterally. Axial oblique images were obtained from T12-L1.
T12-L1 Bilateral degenerative facet changes are noted. A mild diffuse disc bulge is present. L1-L2 Bilateral degenerative facet disease with ligamentum hypertrophy is present. There is a mild disc bulge present. L2-L3 Bilateral degenerative facet changes with ligamentum flavum hypertrophy is present. Spinal canal and neural foramina are patent, however. L4-L5 Bilateral degenerative facet changes with ligamentum flavum hypertrophy is present. There is a mild diffuse disc bulge with slight flattening ofthe ventral aspect of the thecal sac. L5-S1 Spinal canal and neural foramina are patent. Bilateral degenerative facet disease is present.
Impression: Lumbar spondylosis with multilevel degenerative disc and facet disease.
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