Cerivcal Spine MRI - C4 C5 complexity

[louiep]

Condition: I am a 29 year old male with light to moderate pains in my left hand for the past year or so. Pains are very irregular and may come once in a day or so and last for anywhere between 5 minutes to an hour.

After consultation with a physician and an MRI later, I was referred to a Neurosurgeon who advised immediate disc replacement for 3 disc sections. The results as given to me from the MRI are posted below. Request an expert to let me know whether the surgery is absolutely imminent or whether the condition can be bettered with any alternative other than disc replacement OR Fusing.

EXAMINATION: MRI Cerival Spine
TECHNIQUE: Multisequence, MultiPlanar Imaging
FINDINGS:
Posterior Fossa in view appears normal.
Cranio-vertibral junction appaears normal.


Posterior fossa in view appears normal.

Cranio-vertebral junction appears normal.

Central spinal canal AP dimensions ( cms) = C2 - 1.60cms, C3 - 1.10cms, C4 - 1.10cms, C5 - 1.10cms, C6 - 1.15cms, C7 - 1.15cms.

C2 - C3: No significant discal contoural abnormality. Cervical cord at this level appears normal. Central spinal canal and nerve root canals are of adequate dimensions.

**** C3 - C4: Small sized focal bright para central disc protrusion with osteophytes seen indenting the right exiting nerve root with mild foraminal compromise. No cord compression.

**** C4 - C5: Moderate to fairly large focal left para central disc protrusion is seen indenting the left side of the cord and the root entry zone of the exiting nerve root. Cord shows mild hyperintensity on the T2W images - Suggestive of cord edema / myelomalacia.

**** C5 - C6: Tiny focal right para central disc protrusion indenting the thecal sac. No cord compression / foraminal compromise.

**** C6 - C7: Tiny focal posterio central disc protrusion indenting the thecal sac. No cord compression / foraminal compromise.

C7 - T1: No significant discal contoural abnormality. Cervical cord at this level appears normal. Central spinal canal and nerve root canals are of adequate dimensions.


Vertebral body heights are maintained.

Paraspinal soft tissues in view normal.

**IMPORTANT FINDINGS / IMPRESSIONS**

IMPRESSION:

1. Moderate to fairly large focal left para central disc protrusion is seen at C4 - C5 level indenting the left side of the cord and the root entry zone of the exiting nerve root. Cord shows mild hyperintensity on the T2W images - Suggestive of cord edema / myelomalacia.

2. Small sized focal bright para central disc protrusion with osteophytes seen at C3 - C4 level indenting the right exiting nerve root with mild foraminal compromise. No cord compression.

Is there anyway i can correct this problem WITHOUT disc replacement or fusing Surgery?

[JainMD]

Hi Louie,
You said you are having mild to moderate pains in your left hand for the past year or so.
How have you managed this from past 1 year?
Have you consulted anybody so far or is it that first time you are consulting a doctor?
What treatment has been done so far?
If all conservative management like physiotherapy, pain-killers, Transcutaneous Electrical Stimulation of nerve has failed to generate any results then you can go for surgery.
Any neurosurgeon would exhaust all his conservative management and then refer you for surgery.
Keep me informed if you have any queries.
Bye.

[louiep]

Till date i have been applying pain killer ointments mostly... i had been to a few doctors previously and they've all been worried whether it was a heart condition.. on a few occasions (less than 10 in the past one year, i have taken a pain killer tablet.

This is the first time the pain has been diagnosed as being related to the cervical spine condition.  The pain is mostly for relatively mild with tingling in the left arm.

Doctors tested my arm strength and they were quiet satisfied with the same as there is no weakness.

This was my first consultation with a neuro surgeon. He straightaway suggested replacement of the disc as the MRI image shows a protrusion which has eroded the white stuff surrounding the spine on the c4-c5 section.

[JainMD]

Hi Louie,
I suggest you, to see an orthopaedician at earliest. Firstly, to get a opinion on your condition. Secondly, to evaluate his line of management and I recommend you should also see a physiotherapist to start mild exercises and strengthen your back muscles.
Good Luck,
Keep me informed,
Bye.

[JainMD]

Hi Louie,
You can also try Transcutaneous Cutaneous Nerve Stimulation.
You can try a Transcutaneous Electrical Nerve Stimulator, which is an electronic device that produces electrical signals used to stimulate nerves through unbroken skin. The unit is usually connected to the skin using two or more electrodes. TENS works to decrease pain perception and may be used to control acute and chronic pain. It helps in regenerating nerve.
Nerves regenerate, or heal, at a rate 1 millimeter/day. The only nerves that can regenerate are the nerves outside of the spinal cord, or peripheral nerves. The nerves in the spinal cord, once damaged, cannot regenerate. However, if the peripheral nerve is severely damaged or stretched it may never heal.
Hope this helps.
Bye.