New MRI shows dramatic reduction in problems!

[KL Aguilar]

I had a new MRI at Cedar Sinai and received the radiology report.

Bad news is that there are problems from C2 thru T1 (but many are fairly minor, things like "minimal posterior disk bulge with no spinal stenosis or neural foraminal narrowing)." For the first time, the MRI identifies "narrowing of the neural foramen" and "facet hypertrophy" at C5/6--not good.

Good news is that all the severe and moderate adjectives have been replaced with minimal and mild! Previous moderate and severe displacement and compression of the spinal cord is now "impression but not compression" of the spinal cord.

So I guess I have reason to celebrate, huh?

A question...the facet hypertrophy at C5/6 rules out ADR at that level, right?

[mmglobal]

What you may be seeing is a difference in radiologists or interpretations. I suppose it's possible that things have improved, but it would be interesting to ask a doctor to explain the difference.

What you can do is ask the radiologist to compare against previous MRI. Yesterday, I called to speak the to radiologist to ask a question about a very unusual anomoloy on a client's MRI. He explained at length... then called the surgeon. Today, the surgeon requested more testing that will either shed light on the existing diagnosis or change the surgical plan.

Also remember that the MRI is a static image.... things can change and things can also be different in motion, than they appear on MRI.

Mark

[mmglobal]

Regarding facet hypertrophy, you'll want to ask the ADR surgeon about the condition of the facets... could be in early stages and not significant in ADR decision... could be borderline... could be too far gone. You may also get different opinions from different ADR surgeons.

[KL Aguilar]

Mark, we saw the Cedar Sinai surgeon yesterday. They have their MRI films in some kind of computer system that makes them available on demand. He "ran the film" and went up and down the spine, concentrating on the most problematic areas. He drew a computer line across the spinal cord space at C5-6 and prompted the system for the measurement: 7.9 mm, still very much a concern, but much better than a year ago when it was 5.7. He agreed that films are only a snapshot, but pointed out that many of last year's worst symptoms (the problems swallowing, the constant feeling of something stuck in my throat, the coughing, the panic when I would wake up from a sound sleep feeling I couldn't breathe, the wrist drop, the claw hand, the inability to use my left hand at all) have resolved or been greatly reduced, suggesting that my improvement in symptoms match the improved MRI.

His surgical recommendations and concerns about ADR for my particular situation were almost a word by word repeat of Dr. Lauryssen, the first time I have had any agreement from non-related surgeons (well other than the first two surgeons who said four-level fusion ASAP; one of these surgeons wasn't even a spine specialist). This particular surgeon does not know I had a consultation with Dr. L, or otherwise it would have seemed too coincidental that they said almost exactly the same thing.

He said that my best bet for C6-7 which bulges to the left and compresses the nerves was a posterior foraminotomy, but that my only possibility for C5-6 was a anterior fusion so he is recommending a two-level fusion rather than two separate surgeries. He said that the other levels should be left alone for now, that ADR was a possibility for some of these levels in the future, but that such treatment now is unnecessary and "off label." He said that nothing is going to solve all my spine problems and that I will be dealing with this the rest of my life.

He is sending me to a sports rehab type doctor prior to any surgical decision to see if this type of therapy helps and to build up my neck and back muscles.