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Spine and Back Health

Information on MRI

02/28/2010

Question:

I have been seeking information on what the lower mri results mean. I am in severe pain and have very little resources can someone please tell me what this test shows and should I seek a surgeon?

STUDY: MRI CERVICAL SPINE WITHOUT CONTRAST

TECHNIQUE: 1. Sagittal STIR, T1 and T2. 2. Axial T1 and T2* Findings: The Coronal localizer demonstrates a mild detro-convex scoliosis centered at the cervicothoracic junction. In the sagittal plane, there is mild retrolisthesis of C5 on C6. Alignment is otherwise essentially normal.

Degenrative spondylotic change is demonstrated at all levels from C2-C3 to C6-C7. The degenerative changes are most pronounced at the C5-C6 and C6-C7 disks, with moderate disk space narrowing at both levels. Cervical disk space heights are otherwise relatively preserved.

Marrow signal intensity is unremarkable.

Noted is dorsal angulation of the odontoid process. This can be seen as a normal anatomical variant or this represents an acute injury.

AXIAL IMAGES: C2-C3: Normal.

C3-C4: Small posterior spondylotic bar eccentric to the left. No significant spinal stenosis. Facet and uncoverterbral hypertrophy give rise to formaninal narrowing that is mild-to-severe on the left. Right neural foramen is patent.

C4-C5: Small posterior spondylotic bar. No spinal stenosis. Uncoverterbral and facet hypertrophy cause mild-to-moderate right formaninal narrowing. Left neural foramen is widely patent.

C5-C6: Retrolisthesis and relatively concentric, posterior spondylotic bar. There is associated mass effect on the thecal sac. AP dimension of the thecal sac in the midline is reduced to about 6 mm. This normalle equates to significant spinal stenosis. However, in this patient, although the CSF ventral to the cord is effaced, there appears to be a tiny amount of CFS along the dorsal aspect of the cord. In addition, there is no flattening or deformity of the cord to suggest impingement. Uncoverterbral and facet hypertrophy give rise to moderate formaninal narrowing bilaterally.

C6-C7: Concentric posterior spondylotic bar. There appears to be a small superimposed, central/right central protrusion. There is a mass effect the ventral aspect of the thecal sac without significant appearing spinal stenosis. Mild foraminal stenoses are demonstrated bilaterally.

C7-T1: No significant findings.

Of note, at T2-T3, there is a small, right-sided disk herniation laterally that causes slight mass effect on the thecal sac. There is no associated spinal stenosis or spinal cord impingement. The spinal cord has normal caliber, contour, and signal intensity throughout.

IMPRESSION: 1. MULTILEVEL SPONDYLOTIC CHANGE GIVES RISE TO SPINAL STENOSIS AT C5-C6 AS DESCRIBED. THERE IS NEAR ENTRAPMENT OF THE CORD AT THIS LEVEL. HOWEVERE, NO FINDINGS TO SUGGEST IMPINGMENT. 2. ACQUIRED BONY FORMINAL STENOSES ARE NOTED AT MULTIPLE LEVELS FROM CHRONIC DEGENRATIVE FACET AND UNCOVERTEBRAL HYPERTROPHY. FORMINAL NARROWING APPEARS TO BE PRONOUNCED AT C3-C4 ON THE LEFT WHERE DEGREE OF STENOSIS IS CONSIDERED MODERATE TO SEVERE. THERE COULD POTENTIALL BE IMPINGMENT OF EXITING LEFTC4 NERVE ROOT. CLINICAL CORRELATION FOR LEFT C4 RAICULOPATHY RECOMMENDED.

Answer:

Thank you for visiting NetWellness. On this site, NetWellness experts try to answer general questions about health. Only a health professional performing a thorough clinical exam is able to evaluate your symptoms. You appear to have some very, very specific questions about your MRI results, which can only be answered properly by a physician who is familiar with your history, physical exam, and test results. The significance of the findings depend entirely on your clinical symptoms and physical exam. You should see a spine specialist.  However, NetWellness may have some general information available that you can access through our search feature. Feel free to write back if you still have questions or need an explanation.

For more information:

Go to the Spine and Back Health health topic, where you can:

Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University