deciphering an mri scan of cervical spine

[anndylan]

Dear Doctor,

I have been suffering from pins and needles in my left arm and tingling and weakness in my index, thumb and second finger for about 4 week after having severe neck and shoulder pain for 3 days. I would be very grateful if you would decipher the results of my mri scan as I have to wait some time for an appointment with a neurosurgeon.

THERE IS A LOSS OF THE NORMAL CERVICAL LORDOSIS CONSEQUENT TO MODERATELY SEVERE DEGENERATIVE CHANGE AT C4-5, C5-6 AND C6-7. THERE IS MODERATELY SEVERE ANNULAR BULGING AT C4-5. MORE SIGNIFICANT CHANGE IS SEEN AT C5-6. AT THIS LEVEL THERE IS WELL MARKED POSTERIOR OSTEOPHYTE FORMATION ON THE RIGHT AND A SMALL CENTRAL DISK PROTRUSION WHICH INDENTS THE ANTERIOR ASPECT OF THE SPINAL CORD AT THIS LEVEL. AS A CONSEQUENCE OF THE RIGHT SIDED ABNORMALITY, THERE IS SIGNIFICANT NARROWING OF THE RIGHT SIDED EXIT FORAMEN AT THIS LEVE. LESSER DEGENERATIVE CHANGE IS SEEN AT C6-7 WHERE THERE IS AGAIN MARKED GENERALISED ANNULAR BULGING BUT THE LATERAL RECESSES ARE ADEQUATE AT THIS LEVEL. MINOR INDENTATION OF THE ANTERIOR ASPECT OF THE SMALL SPINAL CORD IS SEEN AT THE C5-6 LEVEL CONSEQUENT TO THE DISK PROTRUSION DESCRIBED. THE SPINAL CORD RETURNS A NORMAL SIGNAL AND THERE IS NO SIGNIFICANT CORD OEDEMA IDENTIFIED. THE AP DIAMETER THE SPINAL CANAL IS REDUCED AT C5-6 LEVEL AND MEASURES APPROXIMATELY 8 MILIMETRES IN ITS AP DIMENSION.

Many thanks for your help

Ann

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, and without reviewing your actual MRI images (which is not part of our role on this website) I can provide you with a definitive diagnosis, however I will try to provide you with useful information.

Your symptoms in your arm may be consistent with what is called a radiculopathy (often called a "pinched nerve"). This would be consistent with your MRI as well. The spinal cord is encased by bones called vertebra. Between these vertebral bones there is a jelly like substance, the disc. Nerves start to form as they come off the spinal cord and exit through holes (called foramina) formed between the vertebra. If a nerve is compressed on as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The causes of this compression would include arthritis or herniated discs.

Degenerative changes means arthritis. Annular buldging means there is a disc (the area between the vertebral bones) that is buldging out. Osteophytes, or bony spurs, are basically the result of prolonged arthritis.

I recommend continued follow-up with your neurologist. He/she can advise you further regarding the plan of action.

Thank you for using the forum, I hope you find this information useful, good luck.

[Lengo]

Basically, this report translates to

You have spinal degeneration at c4-c5, c5-c6, and c6-c7. In a nutshell, the diagnosis is c5-c6 radiculopathy (pain spreading down your arm). This is caused by the disks at c4-c5, mostly by c5-c6, and lesser by the disk at c6-c7.

At c5-c6, you have an osteophyte (a bone spur) at the right side, back of your neck, and the disk is compressed. The compression is forcing your spinal cord forward at this junction of vertebrae. The nerves that exit at c5-c6 are disturbed by the disk bulging, and they are causing the sensations in your arm. However, the nerve signals are mostly functioning well.

C4-C5 and C6-C7 also show problems, but the major culprit is C5-C6.

I am not a doctor, but I have had a similar MRI report and got myself educated. Since I am not a doctor, I will not advise you on a course of action, but I will tell you that you have options. Ask your neuro what those options are, then ask another neuro about your options. Get two opinions.