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AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:39 AM in Neck Pain: Cervical
Update: Just got off the phone with my doctor's admin. My doc is out of town today and the radiology report is still not available. (They no doubt do that so that patients don’t read the report and misinterpret it before the neuro has a chance to translate it to English, while I’m advanced and can misinterpret the pictures without the report, I say with dry humor.)

My MRI from the 13th of November looks like a hot mess. Unless I am mistaken, and I don't have a radiology report, just pictures, I've got a dural tear at C4-C5 which was not fused at the time of the last surgery. I can't tell whether the disc is the culprit or a screw from the fused disc below it; either way, there is no dura visible at that level (either on the lateral view or the axial view) which leads me to believe I'm in danger of a cord transection, especially if it's a screw that punctured the dura.

Wish me luck and hope I'm wrong!!



  • I understand you reading your MRI and comming up with your own interpetation. I was sent by my surgeon to a neurologist on Thursday, he said that he was going to wait for the "official" reading on the MRI, which will be available today, he said that he didn't want to go by the unafficial report, which would have been his interpetation of the films when I spoke to him on Friday. It' so hard having to wait, let us know when you speak to your doctor.

  • Does it worry anyone other than me that the neurologist can't read the films or is dependent on the radiologist? I'd like to think that the guy with the knife knew where he was cutting. Thanks for the hand-hold, Ilene. I'm needing it today!!!

  • Are you certain he is a neurologist? Neurologists are not surgeons and generally have a difficult time reading MRI's to the level a neurosurgeon would. If he is waiting on an official report instead of reading the films himself, I would be concerned unless he requested they be read by a neuroradiologist.

  • TitanNeck said:
    Does it worry anyone other than me that the neurologist can't read the films or is dependent on the radiologist? I'd like to think that the guy with the knife knew where he was cutting. Thanks for the hand-hold, Ilene. I'm needing it today!!!

    Howdy TitanNeck,

    First I hope what you are seeing is wrong, and it is not torn! My Neurologist was a "great troubleshooter" and too stunk when it came to "reading" the MRI. My Neurosurgeon on the other hand takes in account what the Radiologist has to say, but he reviews and "reads" the MRI for his own interpretation. On my last one he had a lot of things that the Radiologist *did not* even touch! I hope you get "Good luck" on the official read!! :-)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • "C"

    I was actually commenting on Ilene's doctor waiting for the radiology report, and you're correct on all counts. As it happens I have both a neurologist for chronic daily headaches and a neurosurgeon for my titanneck. I happened to have an appointment with the neurologist right after I ran through the pothole, so I asked her to order the MRI. She coincidentally ordered the one three years ago that sent me to the surgeon. The surgeon has since changed practices and hospital affiliations so he doesn't know yet that I've even got a new problem. I'll probably run the CD by the surgeon's office tomorrow, since I still don't have the radiology report and I'm running out of valium.

    They will hopefully fax me the radiology report in the morning, as I do know it's finished. As it happened, my last client of the day was a nurse with back trouble; she couldn't see any dura at the C4-C5 level either, nor can my aunt, who was an x-ray tech and also has a fusion at C5-C6. As I said to my neuro's admin this morning, I’m hoping you’ll lean on Dr. T. to look at the report early so I can either stop panicking about what I don’t know or know what I should be panicky about. The doctor is out of town today.

    Someone keep sending up good thoughts, OK? I can deal with another surgery and even the results of that, but not so much on the risk of transecting my spinal cord that high.

  • Here's my experience with MRIs and doctors. I had three neck MRIs because in the first one the radiologist said I had a herniated disk that was at the edge of the study and he recommended a follow-up. Of course when I went for the second MRI I told them what the first one said and why I was back but no one listened and they did the wrong area. SO the they did a third at the correct area and issued an addendum to the first report confirming the herniation.

    Well the orthopedist sent me to an orthosurgeon. He said he didn't see that herniation and sent me to the neurologist. After 3 months with the neurologist and no improvement I went back to the ortho who sent me to a neurosurgeon.

    Thank God for an honest surgeon. He looked at the films and missed the herniation the first time. Then he read the reports and said the radiologist was excellent. He said he would never have found that on his own but once it was pointed out it was very clear.

    Sometimes I think doctors have so much ego they are unable to admit their mistakes. I am so lucky to have found someone like this.

    As far as reading the MRI leave that to a professional. I have alot of respect for the doctor who admits their limits instead of the ones who give you a load of crap.
  • I just posted on this very topic.


    All the way at the bottom.

    I haven't ever met a neurogsurgeon who didn't already know everything in the world; same for pulmonologists. And I agree with what you said; it's amazingly human when they admit they don't know everything. That said, it was frightening when my cardiologist said "I've never had a patient not respond to this combination of medication. I don't know what to do now." But it was amusing when my neurologist looked at those films from three years ago with giant, expressive Italian eyes and said "Oh, I'm notta gonna be treatin' you! I gotta no pills for this!" Maybe she'll havea some pills tomorrow.

  • All these days waiting for radiology to get their act together and I'm now not sure whose act they got together. The person dictating and approving this report is certainly not the same person who did the last one, and I am positive that the second group never read the first group's report and maybe didn't even look at the older films. I read of this happening on another board - the radiologist actually miscounting the discs and attributing all the problems to a disc above the problematic one.

    2008 Anterior cervical diskectomy and fusion C5-7 with artifact at this level from hardware.

    2009 There has been prior cervical fusion at C5-7. Artifact from hardware obscures the surrounding soft tissues.

    (Nothing obscured last year? And the surgeon says he fused C5-T1, which is what is on the films. Clearly.)

    2008 No mention of C3-4 in 2008 report.

    2009 Broad based dorsal disc osteophyte complex at C3-C4 results in mild canal narrowing, unchanged

    (How is it unchanged if it wasn’t even IN the 2008 report?)

    2008 There is a dorsal central C4-5 disk
    herniation with effacement of the anterior subarachnoid space. There is no evidence of cord compression.

    2009 The focal central disc extrusion at C4-C5 (level above the fusion) contacts, and mildly distorts the cord centrally, and is also stable.

    (How can it be stable if there was no evidence of cord compression last year and this year there is, especially if the hardware artifacts are obscuring the surrounding soft tissue? Last year the subarachnoid space was effaced; this year the subdural cavity is effaced. I don't feel all that stable.)

    2008 There is no alignment abnormality.

    2009 There is no alignment abnormality.

    (Except that my c-spine has no curve. I think that’s abnormal alignment.)

    2008 The craniocervical junction is unremarkable.

    2009 The craniocervical junction is unremarkable.

    2008 The spinal cord is of normal diameter and the neuroforamina are not narrowed.
    2009 Neural foramina are patent without cervical stenosis.

    2008 The other intravertebral disc and facet joints are unremarkable

    2008 Status post anterior cervical diskectomy and fusion C5-7 with a new disc herniation at C4-5. No evidence of spinal cord compression.

    2009 Prior fusion of C5-7. Focal disc extrusion at the level above contacts and mildly distorts the cord, unchanged from prior.

    (How is it unchanged if last year there was no evidence of spinal cord compression and this year C4-C5 is “distorting” the cord? And again, can they COUNT?)

    In 2008, the osteophyte at C3-4 was already causing distortion, but it was not mentioned in the radiology report and appears unchanged in 2009. C4-5 is described as herniated.
    What is all the detritus where the subdural cavity should be at C4-5 and even at C3-4?

    I wish I could post the pics. This is me....

    TitanNeck frustrated is.

  • Titan, I feel your frustration... Really I do. This spine stuff eats up your life.

    I am having sharp Thoracic pain on and off again (feels like some one is stabbing me in the lung) and freaking out a little because I can clearly see a very large herniation on my cervical mri towards the bottom, where appears to be t3/4. No one has mentioned this problem except my PT and my PCP.

    Too bad that Radiology is not an exact science. When my low back was bad and my NS sent me for flex/ext xrays the radiologist didn't even mention the retrololisthis (almost completely dislocated).

    I had to point it out to my NS who thankfully is nice and open minded but very hard to get in with and see.

    My NS said "we spine sufferes" are probably more qualified to look at the xrays and mris because we are constantly looking for answers and there are lots of examples to compare on line. We study ours when we can and we should come prepared to the appt with any and all information we can find.

    Patience is a comodotity for me. Pain is a standard. I try to balance the two :O)

    Hang in there (as if you have a choice).


  • Great Story Titan. I completely agree- I would now probably say the same thing... LOL

    I used to sell Hot Tubs. Now I sell Food.... Same idiot people everywhere. I just dont understand why people have to be so lame.

    As I lay on my heating pad with my Tens Unit on high debating how much I really want to clean my house.... I work from home and busted out all my reports early. We are getting new handme down barely used furniture (including a new recliner- I have A$$ed out the other 2)....

    I have people coming to look at my old furniture after PT today... So I asked one lady for her name so I could schedule her time and she didn't want to give it to me either.... Like I am going to call and harrass her.... :O)

    Hanging on or around.... Keep the humor bone going.

  • I wonder if I actually hanged myself would it stretch my neck enough to resolve my issues. #o

    I certainly agree with your NS, and for another reason as well. We care about it more. They glance at the radiology report or race through the images, and we sit at our computers and study each image as though it was the Sacred Heart of the Saviour. I get mine on a disc which has a small review software program on it, allowing me to change the sizes, contrast, compare the images side by side from different sets or from different years, even. This particular MRI must have been done by what we used to call a nurse's aide, or maybe the night watchman at the hospital, it is so dark. I actually copied a slice into a photoshop program to see if I could enhance it without ruining the resolution. No, I couldn't.

    As for patience, I have way more than I used to. Working in retail has that effect; I'm MUCH nicer to the people working at Walmart than I used to be. In fact, I've got a retail patience story that will make you laugh.

    As I've said, I work as a kitchen designer in a big box retail environment and have been in the same store for nearly nine years. (The industry standard for big box kitchen designers is nine MONTHS.) It was my very first Saturday in the store, having done the requisite training elsewhere, and we were having a big appliance clearance. We are the backup for the appliance department, and there was a big crowd. 2 gentlemen came to my desk wanting to buy two identical upright freezers on the clearance aisle. So I walked up and got the item number and the price, came back to my desk and started to enter the information. When it came time to save the sale so the customer could go up front to pay for it, I asked him for his phone number. You would have thought I'd asked to see his private parts, and argued about why I needed that. No way to save the sale otherwise, and he didn't want to carry it with him, he wanted to pick it up later. Then I asked for his name and got the same song and dance. I was already stressing - big first Saturday, complicated discounted sale, irritable customer... and then he turns to the customer next to him who is waiting for me to sell him the other freezer and he says "That's what's wrong with places like this. They get more and more computers so they can hire stupider and stupider people." Oh yes, he did.

    Well, I'd only been with the company for three weeks, so I didn't say the words which sprang to my mind immediately. Today, I would: "Why don't we see if that refrigerator will fit up your A** so you can carry it out of here with you."

    Sorry, mods, I know this is off-topic and I won't let it happen again.

    Pain is a standard for me as well, though until the pothole incident it was headaches rather than neck and arms.
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