MRI

[XFACTOR2009]

Symptoms   longstanding neckstiffness and pain over many years, longstanding cervical spondylosis
Last year of so, dizziness/balance issues, numbness in left  hand/tingling, some loss of strength in glute muscles


MRI  says   that  there isnt  a significant  change since last MRI   However it  does  say that  

"at  C6/7  There is intervertebral disk dessication with loss of  disk  height and c ircumferential irregular  osteophytes    The  disk bulge decreases the calibre of the exit  foramen bilaterallywith possible  C7.   root  compromise   The  disk  bulge  indents  the  theca  causing early  flattening of the cord at this level,with subtle increased  signal intensity

Although this is much like the previous MRI  the 'early  cord  flattening'  and  'possible  root  compromise'  and 'subtle increased cord  signal'  are different to previously    and to me sound like root  compromise and the beginning of mylopathy     Should I be  concerned  ?   There are a  few weeks before I see the neuro to discuss  results

Any  thoughts  on these  details ?

[ggreg]

I do not know if the MRI report of your cervical spine would mention if any of the arteries or blood vessels were being pushed on by the bones.  They ARE visible on an MRI.  But I can tell you that anytime your back is wrecked up, so too are all the nearby structures affected by the displacement of the bones, and could very well be that, like your dizziness can come from cervical abnormalities pushing on nerves or vessels, your throat may be receiving rather closer signals from, say, the carotid artery.

And I don't necessarily think the doc is going to talk about surgery at all.  As I said, when it comes to moderate treatments, I have no idea how those things work with a problem like a flattening of your spinal cord, so for all I know, the same things that make a bulging disc do better, like physical therapy, a brace, anti-inflammatories, and so forth, could also get the pressure off the spinal cord.  

I do want to say something else about you feeling this throbbing in your throat.  While it is possible your abnormally positioned neck could be pushing on an artery, I have to mention other possibilities.  I assume that each time you go to see your doc, they check your blood pressure and that sort of thing.  If your heart gets to thumping really hard, which happens when you're exercising, for example, you can hear it and feel it in a number of places in the body.  So, you may mention this to your regular doc AGAIN next time you see him, and also of course say this to the neuro.  In the meantime, whenever you feel that throbbing in your throat, you can take a very deep breath, hold it in for a couple seconds, blow it all out, breathe normal again a couple times, then repeat a few times, it will cause your heart to beat a little slower, so perhaps it's a way to make that particular annoyance stop sometimes.

As for your buttock muscles and upper legs feeling weak, it IS possible you also have some degeneration in the lumbar spine.  Also, since your spinal cord is being pushed somewhat, I suppose that could affect all things below that area, but I should think (altho I don't know) you would feel LESS rather than more.  My back is all goofed up, too, from a car wreck, and my lumbar spine has recently developed problems, so my rear end is sore all the time now.  So, that's how come I say could be arthritis is in your lower back too.

[XFACTOR2009]

Hi

Many  thanks,    that was most helpful
I suppose its  entirely  likely that  whether or not the neuro recommends intrervention yet  is hard to say but that definately it will need  to be closely  followed
The most worrying thing for me is a sense that my legs  do not have the same power,  almost the same but not the same, but my gait is OK.   I would say my glute muscles  have weakened.  
I  dont like the  throbbing episodes in my  throat,  that match my heartbeat, I beleive this may be a  blood vessel under  pressure.  My  Primary Care  doctor  (as  he  does with almost everything)  says  this  is simply  anxiety.   However,  the MRI  report says nothing about any  blood vessels under  pressure,  presumably  they look for that  ?

[ggreg]

Well, I don't know if concerned is exactly how I would describe the way I think about your recent MRI.  Fairly moderate things can be done to alleviate your symptoms, and as for the spinal cord, while it is not good for a disc bulge to push on the cord, this does happen to people and this can be corrected by either removing the disc and fusing the two vertebrae related to the disc, or replacing the disc with some of the newer types that move around less stiffly than the older ones, or your neurologist will know nonsurgical methods to prevent the disc from bulging further.  When it comes to disc bulges, I don't know so much about success of nonsurgical treatment of spinal cord impingement.

Now, the nerve root impingement and general worsening of your cervical spine is how come you've been feeling weakness and tingling down your arm to your hand.  The dizziness and balance issue can indeed come from a cervical spine problem, which has to do with either pressure on blood vessels or nerves that go up into the head.  As for myelopathy, not yet, rather I think of this more as myelitis, where your spine is inflammed rather than severely damaged.  Nevertheless, your cervical spine has experienced some expected worsening, and your neuro will know what to do, but he will likely not explain all the ins and outs or even prognosis, on account of his communications with you will be focused more on relief and prevention.