Severe pain - Cervical MRI Report, thoughts/suggestions?
 

Below is my recent MRI report. I've had moderate to severe neck pain for quite some time now. Chiropractor visits yielded minimal relief. Doctor recommends surgery to remove portions of the 2 discs impinging on the nerves. Thoughts and recommendations are greatly appreciated. Currently on my 2nd 10 day prescription of vicodin which does work, but only 4 hours at a time, as I was told it would. I work at a dual-screen computer setup 10 hours a day and it is very painful by the time the afternoon rolls around. My quality of life is greatly impacted due to the pain and inability to do things like baseball and football with my 2 sons. Help!

MRI- CERVICAL

Clinical Indication: Chronic neck pain

Technique: Using a Hitachi 0.3 tesla open air magnet sagittal T1, T2, and axial T2 sequences were performed of the cervical spine, No contrast was administered for this exam.

No previous studies are available for comparison.

FINDINGS: There is mild reversal of the normal cervical lordosis. The vertebral body heights are maintained. There is no signal abnormality within the cervical spinal cord. The paraspinal soft tissues are unremarkable. The patient has slightly shorter pedicles then average which does diffusely narrow AP diameter of the canal.

C2-C3: There is no significant disc displacement, central canal stenosis, or neural foraminal narrowing. There is prominent asymmetric right-sided uncovertebral joint hypertrophy (see sagittal image 5).

C3-C4: There is no significant disc displacement, central canal stenosis, or left neural foraminal narrowing. There is asymmetric right-sided uncovertebral joint hypertrophy which combines with disc material to mildly attenuate the proximal neural foramen. There is minimal left uncovertebral joint hypertrophy.

C4-C5: There is no significant disc displacement, central canal stenosis, or left neural foraminal narrowing, There is mild right uncovertebral joint hypertrophy which mildly attenuates the right neural foramen.

C5-C6: There is mild loss of disc space height. There is a broad-based posterior disc bulge which is eccentric to the left minimally indenting the left ventral cord. There is also a left foraminal disc herniation with mild to moderate left foraminal narrowing. Disc osteophyte formation mild to moderately attenuates the right neural foramen.

C6-C7: There is a moderate to large left posterior paracentral disc extrusion with severe impingement on the left anterior lateral recess (see sagittal image 8 and axial image 19). Disc osteophyte formation moderate to severely attenuates the left neural foramen. There is moderate right foraminal attenuation with a suspected tiny right foraminal disc extrusion.

C7-T1: There is no significant disc displacement or central canal stenosis. There is bilateral uncovertebral joint hypertrophy. The foramina are not well evaluated.

IMPRESSION: Loss of mild reversal of the normal cervical lordosis

At C6/C7 there is a moderate to large left posterior paracentral disc extrusion with significant impingement on left anterolateral recess. Moderate to severe foraminal attenuation is also noted. .

At C5/C6 there is a small left. foraminal disc extrusion/herniation and bilateral mild to moderate foraminal attenuation

At C2/C3 and C3/C4 there is asymmetric right-sided uncovertebral joint hypertrophy

Hi,
My thoughts are you remind me of myself before i had my cervical fusion . I also had electric shock like symptoms pretty frequently when i turned my head. I too was at a chiropractor first and he recommended i see a spine surgeon, i already had one for my lower back, and show him the x-rays. My spine surgeon took one look and said forget your lower back, you are headed for cervical surgery soon. We did try physical therapy for a short time. It did nothing and at that point my left arm was weak so he would not let it go any longer.

Is your doctor talking about a fusion?
I would go ahead and have the surgery as i do not like being in pain. Will your job be impacted at all?
Sorry you are in this position.
Judy

Thanks Judy. I get the shock/burst of pain on the left side of my neck when I turn left. I also have constant pain in my left arm and tingling from my mid forearm to my fingers. Head mobility isn't really limited, just hurts from the time I wake up until bed. The surgeon I saw recommended a see a neck/spine specialist as he was a more joint/sports injury specialist which I didn't know when I made the appointment. He said the surgery we basically by going in thru the front of my neck and using a little "pac man" type tool to cut away the parts of the discs that are herniated. They are clear as day on the MRI (wish I had the film electronically to show people). I feel there should be a way to get the neck back to it's natural curve since he said mine is more or less straight and that's what's forcing the discs to bulge out and pinch the nerves. I plan to see a pain management office asap. I'm not a fan of PT unless it's from an injury which this apparently is not as I've had no traumatic injury or anything. My mom has chronic back pain and suffers from scoliosis so I have a feeling this is hereditary. Does cutting away parts of the 2 discs sound like a good idea? It seems like a quick-fix surgery to me.

Hi
I really don't know anything about a surgery to cut away part of the discs only. I hope others who do know more chime in.
Yes i also had the tingling down to the fingers, but my surgeon, who is a spine only orthopedist , said when it was obviously weak, he operates.
I wasn't yet in pain management then, but have been for the last 3 years. When vicodin stopped working i was bumped up to percocet.
I am having some issues now with the fact that i have built up a tolerance to it and was taking 20mg for one dose. I recently got myself on 10mg per dose. AFter my most recent surgery , but at my post op my surgeon wanted me to go down to 10mg every 6 hours. For the first week it was 10 every 3 hours. I think i am not progressing to walking as much do to the pain i still have with only the low for me dose. He did refer me to a new pain management doc who i will see in a few weeks
judy

The only thing i was just thinking about (lots of time to think, my last surgery was only 3 weeks ago) is if your spine is unstable or made unstable by the surgery then either a fusion or artificial disk replacement must be done to truly stop the pain.
Do to my poor bone density , i have never been a candidate for an artificial disc but certainly lots of people on this forum have had them.
Judy

I am really new to this site and came across this by trying to find information on this Asymmetric uncovertebral hypertrophy thing. I have had two different spine doctors, the first was not so great. In total I have had a lumbar herniated disc trim, forget medical term, two cervical fusions at c6-7 and c5-6. I continue to have issues with numbness, pain, weakness and lack of control (my hands do not listen to the brain all the time if you know what I mean). The pain is bearable, for now, but the numbness and other things are starting to get worse by the day. My last MRI showed that the Asymmetric uncovertebral hypertrophy is showing up at c2-3, with degeneration at all other levels. I thank you for the info on the hypertrophy it helped a lot. The radiologist has a hard time reading some of my MRI's because of movement by is caused by my movement, when I am in the donut I feel pretty much the entire thing to the point I can tell you were they are scanning. When they get to the bad spots I feel like I am being ripped apart, anyone else go through that?

caz, welcome to the forum, sorry you need to be here.

Note that this thread was started more than 1.5 years ago... I have sent an email to turbokid asking if he/she can post an update.

I don't know about your 'feeling ripped apart' sensation in the MRI, but I have felt warmed by the MRI... pretty disconcerting feeling like you are being cooked.

Take care,

Mark