Myelopathy Symptoms with no cord compression

[shadyrn]

neck spasms started and I put this together with shakiness going down stairs, incontinence issues, and hyperreflexia(my reflexes are so brisk it's like clonus) and wanted to see NS again...of course had to go through proper channels and see PCP first...he ordered steroids and a STAT Mri....I am a nurse so I'm at either an advantage or disadvantage in thinking too much about this! MRI findings:

There is mild stranding of the cervical lordosis which could be secondary to the patient positioning or muscle spasm.

The cervical spinal cord is normal in signal and caliber.

The is no focal disc herniation, central stenosis or neural foraminal narrowing in C2-3, C3-4, or C4-5.

At C5-6 there is mild disc space narrrowing. There is diffuse disc osteophyte complex which abuts the spinal cord without evidence for cord compression. There is mild central narrowing at this level. There is mild-to-moderate left and mild right neural foraminal narrowing at this level. The disc osteophyte complex appears to have slightly increased in size since 2005.

The C6-7 and C7-T1 levels are within normal limits.

IMPRESSION:
Degenerative disc disease at C5-6. The disc osteophyte complex at C5-6 may have slightly increased in size and abuts the spinal cord. However, there is no evidence for cord compression at this level. There is bilateral neural foraminal narrowing at C5-6 as described.

So it sounds not too bad from the MRI....my understanding though is that there may need to be intervention with signs of myelopathy?!?!? I remember 4.5 yrs ago the NS commenting that my symptoms present as indicating cord compression with the myelopathy, yet the findings don't indicate this degree.....so I'm waiting for my appointment 12/10/09- I feel like I will be wasting my time along with the NS if there is really nothing going on with the spinal cord, yet I show the signs of myelopathy?!?!

[Abhijeet Ghosh]

Dear Shadyn,
If there are S/S of hyper-reflexia/clonus, then this shows Upper Motor Neuron Lesion (UMN). Being a nurse, you can understand the medical terminologies in a better way. I am sure that it can be either myelopathy or CNS related.I agree there is a neural foraminal compression, but myelopathy is the main suspect.
Please consult the Neurosurgeon or Orthopaedician who specializes in Spine.
Feel free to ask more......
Regards,

[shadyrn]

A related discussion, Hyperreflexia and MRI findings was started.

[shadyrn]

Any specific diagnostics that should be done? The rest of the spine? Can you be more specific about Upper Motor Neuron Lesion possibilities?  Thank you for your response