MRI Results
 

Hello,
I just joined. Hope everyone is doing very well. I have a lot of symptoms that have been going on for about two years and are getting worse. Pins and needles down arm and in hands, constant tightness and soreness of neck and upper back and shoulders, going down triceps. Etc etc. it's gotten much worse just recently. The pain is often excruciating.

Got my MRI results report from last April (not sure why I waited this long; I just listened to the gist of it from my PCP). I don't know how to interpret them really and if someone is familiar with these results I'd appreciate any thoughts. I just want to be sure I'm not going crazy and that the pain is not partially psychological. I know it's there and that it's agonizing. But I don't see the words "severe" or "nerve" in the MRI, so I'd appreciate educated thoughts.

I'm looking into ADR with Dr Clavel who has amazing reviews. I can't take any more of this pain as it is debilitating.

History: neck/back pain and left shoulder/scapular pain.

Results:
There is a straightening and mild reversal of the normal cervical lordosis. Mild disc space narrowing is seen at C5-C6 and C6-C7 with associated endplate degenerative changes and marginal osteophytes. No fracture or suspicious marrow-replacing lesión is seen.

Slightly low-lying cerebellar tonsils are noted. The visualized posterior fossa and spinal cord are otherwise normal in signal.

By level:
C2-C3: Unremarkable
C3-C4: Unremarkable
C4-C5: Unremarkable
C5-C6: There is a mild left-eccentric posterior disc-osteophyte complex consisting of a minimal disc bulge and small greater than right uncovertebral osteophytes. This effaced the ventral thecal sac without central canal stenosis or foraminal narrowing.
C6-C7: There is a moderate left-eccentric posterior disc-osteophyte complex, including a moderate disc bulge and moderate left uncovertebral osteophyte. This effaces the ventral thecal sac without central canal stenosis. There is moderate left foraminal narrowing.
C7-T1: Unremarkable.

Impression:
Degenerative changes of the cervical spine at C5-C6 and C6-C7, as detailed above. At C6-C7, a left-eccentric posterior disc-osteophyte complex results in moderate left foraminal narrowing at that level.

What do you think? I'm kind of freaking out here.

Standard rule of thumb: your imaging results and your pain don't always match up. You might feel severe pain but look okay on an MRI image set or the reverse.

That said, it's clear that your images show that you have a real problem at C5-6 and maybe at C6-7. Does your pain match up with those levels? There's charts that show enervation pathways for each disc level. If it does, then your symptoms and your imaging match up. If not, it's worth your time to figure out what doesn't match. You can have a secondary effect: a nerve that is pinched causes a muscle to spasm which compresses a nerve that your imaging doesn't suggest should be irritated. If something like that is happening, the secondary effect should be temporarily lessened if you do a trigger point release or other means to reduce the spasming of the first muscle.

If you're asking if it's time to get an ADR, that's a different kind of question. I'd certainly say that your pain level indicates that it's time to start talking with surgeons and pick one you like. Whether you immediately pull the trigger on the surgery once you find one is a real personal decision and affected by how you perceive your pain level, worsening condition, and general quality of lfe.

annapurna,
Thank you so much for your response. I can say with 100% certainty that if Dr Clavel said he would do the 2-level ADR tomorrow, I'd be on the first flight to Spain. I hate to spend the money (over $30,000USD!) but this pain is ruining my life (not to sound melodramatic).

Does your left arm cause you more problems than the right? Notwithstanding what AP mentioned above, I see the C-6-7 left foraminal narrowing jumping out at me. But also like mentioned above, images and reality sometimes don't match. Have you tried PT and strengthening exercises? You might be able to open the space up enough for some relief.

My left arm is definitely bothering me more than the right. I'd do PT further than what I've been doing, but it doesn't help. I just want this fixed. It's been causing me many personal issues over the past 1.5 years. My wife is getting bored, which is not a good thing. I've sent my MRI and report to Dr Clavel, and I hope he can fix this. Do your think he can Fix this? Didn't you go to him, PhillyJoe?

I had actually used an inversion table, cervical traction collar, foam rollers, TENS unit and massage, and the pain has amplified significantly. It's my neck and upper back that are in just excruciating pain.

Failed trials of oral steroids? Gabapentin or other similar neuropathic pain meds?

Taking plaquenil but it is giving me excruciating migraines, so I'm stopping it.

Gabapentim i refuse to take because of the permanent damage I've heard it can do.

I've taken massive amounts of pain medication and I'm tired of needing it. Plus it doesn't stop the pain anyway.

Yes, he can fix "it". Just need to be sure you have completely identified what 'it' is. I am not married, but I'd venture a guess that wife getting bored isn't one of the top 5 reasons to risk your life in surgery!!