Medical translation requested

[Bob78164]

I've been having numbness in my hands, starting to creep up my forearms, for about a month and a half. My doctor, suspecting nerve involvement, ordered an MRI. The report is in the spoiler below:

Long technical document

March 22, 2015

MRI OF THE CERVICAL SPINE:
HISTORY: neck pain with bilateral arm numbness/burning x 3 weeks
COMPARISON: None.
TECHNIQUE: On a 3 Tesla scanner, sagittal T1-weighted, T2-weighted and STIR images and axial T1-weighted and T2-weighted images were obtained.
FINDINGS:
There is reversal of the normal cervical lordosis. Vertebral body heights are normal except for mild degenerative height loss in the mid cervical spine. There is a grade 1 anterolisthesis at C3-C4 due to facet degeneration and mild degenerative retrolisthesis at C4-C5 and C5-C6 due to disc degeneration. Discogenic degenerative endplate changes are noted adjacent to multiple intervertebral discs.

There is moderate degenerative disc narrowing from C4-C5 through C6-C7 and mild degenerative disc narrowing in the upper cervical spine.

At C2-C3, there is mild disc bulging without significant spinal canal stenosis. There is moderate left foraminal narrowing due to left facet osteophytes. There is no significant right foraminal stenosis.

At C3-C4, there is circumferential disc bulging and ligamentum flavum/facet degeneration, causing moderate spinal canal stenosis and flattening of the dorsal and ventral surfaces of the spinal cord. There is moderate bilateral facet degeneration with multiple small subchondral cysts on the left. There are also edematous changes in the marrow of the articular processes. There is severe bilateral neural foraminal stenosis related to the anterolisthesis and disc/osteophyte complex.

At C4-C5, there is a circumferential disc bulge/osteophyte complex, mildly narrowing the spinal canal and flattening the ventral spinal cord. There is moderate bilateral foraminal narrowing due to the disc/osteophyte complex.

At C5-C6, there is a circumferential disc bulge/osteophyte complex, mildly narrowing the spinal canal. There is mild to moderate bilateral foraminal narrowing due to the disc/osteophyte complex.

At C6-C7, there is a small circumferential disc/osteophyte complex without significant spinal canal stenosis. There is mild bilateral foraminal narrowing due to the disc/osteophyte complex.

There is no mass or hematoma in the spinal canal. There is abnormal T2-weighted hyperintensity and likely volume loss in the spinal cord at the C3-C4 level.

The paraspinal soft tissues are within normal limits.

IMPRESSION:
Moderate multilevel disc and facet degeneration, as described above.

Moderate spinal canal stenosis at the C3-C4 level related to disc bulging, facet degeneration, and the resulting anterolisthesis. There is also abnormal T2-weighted hyperintensity in the spinal cord at this level that likely represents spinal cord myelomalacia.

Severe bilateral neural foraminal narrowing at C3-C4 and milder degrees of foraminal narrowing at multiple additional levels, as described above.

My doctor (actually, the doctor covering for him) was sufficiently concerned when she saw this report Thursday night to put in what she called an "urgent referral" to a surgeon, which she said I can expect to occur this week.

I'm pretty sure I get the gist of what's going on, but if one of the medical professionals would be kind enough to translate for me, I'd appreciate it. If someone can give me an idea of what to expect when I get my referral, that would be doubly appreciated.

Thanks in advance. --Bob

[Bob Juch]

As you know I'm not a doctor but: Damn! You're in bad shape! What that report says is that your cervical spine has severe degeneration to the point where the opening your spinal cord goes through has narrowed so much it's actually killing some of your spinal cord. You're going to need surgery to open that up and probably fuse two or more disks.

Good luck.

[ghostjmf]

I'm not a doctor either. You know that. But my cousin now has very limited mobility due to spinal cord damage at the top of the spine. Cous was warned for years this could happen but "surgery could leave you paralyzed". They will likely give you similar advice. My advice is to get surgery to widen the most severe stenoses before they do more damage. I know its a gamble but doing it as soon as you can is less of a gamble regarding paralysis. Cous was told *that* too but disregarded. Now Cous has movement but no proprioception, i.e. they're not getting nerve information, about where they're putting their feet. You don't want to be there or anywhere like it with your arms or any other body parts.

[themanintheseersuckersuit]

I am not a doctor but I play one in the courtroom. These are common signs of degenerative disc disease. The correlation with symptoms will tell if any are targets for surgery . As you get older the discs desiccate and the osteophytes begin to form. Sometimes more information is not helpful.

[bazodee]

Have the neurosurgeon explain the difference between stenosis of the spinal column versus foraminal stenosis.

Most spines exhibit a normal curvature in the cervical area- it's called lordosis. Your curvature has reversed- believe it's called kaiphosis (sp.?).

Stenosis of the spinal column (yours is mild), if severe enough, can lead to permanent nerve and function loss of extremities. In many ways, your report is pretty typical for guys of our age.

There are other tests which can give a more precise idea of what's going on with the hard structures of the cervical area. A cervical myleogram involves injecting radioactive dye into your spine and then putting you on a tilting table. It's considered the gold standard when a neurosurgeon is assessing whether surgery is necessary or warranted.

[Bob Juch]

Have the neurosurgeon explain the difference between stenosis of the spinal column versus foraminal stenosis.

Most spines exhibit a normal curvature in the cervical area- it's called lordosis. Your curvature has reversed- believe it's called kaiphosis (sp.?).

Stenosis of the spinal column (yours is mild), if severe enough, can lead to permanent nerve and function loss of extremities. In many ways, your report is pretty typical for guys of our age.

There are other tests which can give a more precise idea of what's going on with the hard structures of the cervical area. A cervical myleogram involves injecting radioactive dye into your spine and then putting you on a tilting table. It's considered the gold standard when a neurosurgeon is assessing whether surgery is necessary or warranted.

It's the spinal cord myelomalacia I find alarming.

[thguy65]

Here's a couple of images illustrating what is described in the report.

Side view


Top view


Parts of the spinal vertebrae have shifted slightly from their normal position, and some of the discs in-between the bony spinal vertebrae are bulging. At a certain point some of the narrowing is squeezing your spinal cord, leading to damage to the spinal cord and the symptoms you are experiencing in your hands and arms.
It does sound like surgical intervention is likely the main way to alleviate this problem, but the surgeon will tell you what your options are at this point.

- Tim H.

[BackInTex]

Here's a couple of images illustrating what is described in the report.

Side view


Top view


Parts of the spinal vertebrae have shifted slightly from their normal position, and some of the discs in-between the bony spinal vertebrae are bulging. At a certain point some of the narrowing is squeezing your spinal cord, leading to damage to the spinal cord and the symptoms you are experiencing in your hands and arms.
It does sound like surgical intervention is likely the main way to alleviate this problem, but the surgeon will tell you what your options are at this point.

- Tim H.

Interesting (and easily understood). thanks

[Bob78164]

Here's a couple of images illustrating what is described in the report.

Side view


Top view


Parts of the spinal vertebrae have shifted slightly from their normal position, and some of the discs in-between the bony spinal vertebrae are bulging. At a certain point some of the narrowing is squeezing your spinal cord, leading to damage to the spinal cord and the symptoms you are experiencing in your hands and arms.
It does sound like surgical intervention is likely the main way to alleviate this problem, but the surgeon will tell you what your options are at this point.

- Tim H.

Thanks very much. --Bob

[Bob78164]

I had my appointment with the surgeon today. Surgery is scheduled for May 8. The MRI looked remarkably like the image shown to me by thguy. It helped to have a clue what to expect. --Bob

[Bob Juch]

I had my appointment with the surgeon today. Surgery is scheduled for May 8. The MRI looked remarkably like the image shown to me by thguy. It helped to have a clue what to expect. --Bob

Good luck!

[kayrharris]

Dr Tim is the best!




kay

[Beebs52]

Seriously good luck with your surgery. It's not easy. Do what they tell you to or not do.

[mellytu74]

Good luck with everything. Boonie has this about seven years ago.

I cannot stress enough exactly what Beebs said. DO WHAT THEY TELL YOU. It makes a huge difference in the recovery. In both time and quality.

[BackInTex]

Best wishes for you. And do exactly as the Dr. orders. No more, no less.

Maybe they can fix that severe lean to the left while they're in there.

[ghostjmf]

Good luck. I know someone who (unlike cous) did have the op & as far as I know had good results.

They will probably be giving you steroids to keep swelling down after op; if you notice any new numbnesses after, tell them immediately so they can adjust dose, recheck your pics.

Cous also had probs after a fall where they didn't check for swelling in spine quickly.

[Bob78164]

Thanks. They're telling me that I'll be wearing a collar full time for a couple of weeks after surgery, and then I'll be able to take it off to sleep for two more weeks. Sounds like I'll get rid of it just in time to fly East for a family wedding. --Bob

[thguy65]

Good luck!

- Tim H.

[Vandal]

Thanks. They're telling me that I'll be wearing a collar full time for a couple of weeks after surgery, and then I'll be able to take it off to sleep for two more weeks.

It's for your own good:




Oh, you mean the other kind of collar...

[tlynn78]

Best of luck and wishing a quick recovery.

[Bob78164]

I'll be admitted at 9:30 a.m. PDT this morning with surgery scheduled to begin at 11:30. I'll have my iPad at the hospital so I hope I'm up to providing an update after they release me from the Recovery Room. --Bob

[ghostjmf]

Best of luck, doctors' skill & wishes.

[Bob Juch]

I'll be admitted at 9:30 a.m. PDT this morning with surgery scheduled to begin at 11:30. I'll have my iPad at the hospital so I hope I'm up to providing an update after they release me from the Recovery Room. --Bob

Break a ... something.

[Bob78164]

I'm up and (sort of) around, still on track to be released today. Thanks to all for the continued good wishes. --Bob

[thguy65]

I'm up and (sort of) around, still on track to be released today. Thanks to all for the continued good wishes. --Bob

Glad to hear you are on the road to recovery.

- Tim H.