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Trying to understand certain terms...

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:31 AM in Neck Pain: Cervical
Hello to all. I had an ACDF c5,c6 in 2004. Everything went beautifully.

A couple of months ago I started to have neck pain that was different than in the past. The doctor called for an mri.

I am going to see him in a couple of days, but am confused about a couple of things I see on the report. 1) Broad based disc osteophyte c4-c5 complex indenting the ventral epidural space with minimal flattening of the cord. 2) Multilevel uncovertebral and facet hypertrophy with resulatant neural foraminal narrowing most severe at c3-c4 with moderaate bilateral narrowing impinging the exiting nerve roots, lesser findings at the other levels.

My hands, especially the left feel clumsy and weak. Can that happen w/out full on cord compression? Do you know if cord flattening is ever a precursor to compression? I had a cord compression the last time.

I really want this to be a big nothing that resolves with time.

Thanks for reading!


  • Hi Josie,

    Welcome to spine-health. There is a search feature at the top of the page which you can use to search alot of the terms you are looking at on your MRI report. In my experience a disc can buldge and place pressure on the thecal sac and it is the thecal sac which places the pressure on the spinal cord. All though there is still plenty of fluid around the cord this can cause radicular type pain. Looks as though you have some other issues going on as well. I would be afraid to speculate as to what your surgeon would say though. Did you have issues at those levels at the time of the surgery, and they weren't bad enough to operate on or weren't symptomatic. When is your appointment with the surgeon?

    Anyway wanted to say welcome to spine-health and look forward to reading more of your post. Let us know what the surgeon says.
  • Hi Tam,

    Thanks for responding. This experience is pretty different than before my ACDF. In 2004 the pain and progression was like a runaway train. This time around, I have good days and bad days. I started with pain in my neck and between my shoulder blades. And then I realized the headaches I am getting everyday were neck related. Then the weakness/numbness started. I saw an ortho surgeon b/c I didn't immediately think my symptoms were nerve related. The ortho ordered the mri. I will see him tomorrow. I am seeing the NS who did the acdf on Tuesday. I like both of them very much. In 2004, my mri was clear of everything except for the ruptured disc and cord compression. I remember the doctor being happy about that. So I guess these things are all new. I wonder if my past history will affect the treatment plan.

    Thanks again!

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  • I think what might be affecting your hands could be the nueral foraminal narrowing affecting the exiting nerve roots. The foramin have holes in them, like a donut. As the facets narrow, it leaves a smaller hole, thus pressing on the exiting nerves. That's probably as clear as mud :D Kind of like a garden hose that's filling up with silt, leaving less room for water to go thru, increasing the pressure in the hose. Good luck at your appt tomorrow. Please let us know what you find out. And welcome to the "spiney" forum.

  • Hi.

    The doctor prescribed PT for 4 weeks and an anti-inflammatory. Which sounds like my dream come true.

    The only problem is they couldn't get the computer working to pull up my MRI. He said (basically) "remember last time on your x-ray how there was a loss of height at c4-c5. that can compress the disc causing pain. Do PT and take this medication." He only talked about the last appt.

    I had the weirdest feeling that he didn't have written notes on my MRI or didn't remember it thoroughly. And he didn't do any physical tests for weakness/numbness. I am weak and numb at this point. That hadn't even started at my last appt. I told him my symptoms, but no physical tests. I know this sounds paranoid.

    And I know MRI's can be read differently by different doctors, but I don't think my MRI report even said the word 'disc.' It said a lot of bony stuff like 'osteophyte' and 'facet joint.' It's just a gut. I felt like he gave one size fits all advice.

    ON the other hand, I'm seeing the NS who did my surgery on Tues. So if he confirms this diagnosis and treatment and feels it will work in that 4 week space, I'm the happiest girl in the world!

    Thanks for reading!
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