New Cervical MRI images -- opinions?

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cogito
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   Posted 5/24/2012 1:48 PM (GMT -6)   
I realize I'm not asking MD's, but many of you have seen your own MRI's and I'm wondering about mine.

Here's a composite of four images:
i50.tinypic.com/ayvdk3.jpg

The left top is normal, the left bottom identifies the level for the left top image.
The right top shows a compressed cord, the right bottom identifies the level for the right top image.
The right bottom also shows a few locations where there are disk issues, the worst being C4/C5 (as well as above and below).
The MD said that the C5 vertebrae is also putting pressure on the column, but it doesn't seem as pronounced to me -- nor do I see more than a slight signal increase in the cord in that area (the left it a T2 image, where inflammation causes signal change)


I wish I had an MRI report, but the MD didn't order one and though he said he would call back after consulting with some neurologists (about what are supposed to me some rare issues he saw), he hasn't called back (and I've called his office).
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 5/24/2012 2:37 PM (GMT -6)   
For now it's best to just wait, it's easy to over analyze things and then worry, so just wait and see
what a neurologist has to say and then see if you can get a copy of the results...many Prayers
and well wishes to you...others will come by...keep us posted when you do hear back from the neurologists...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

cogito
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Date Joined Oct 2010
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   Posted 5/24/2012 2:58 PM (GMT -6)   
Well,

I was scanning through the images and I think I've come to a diagnosis. Apparently, I have a small Greek man with a large mustache in my spine:

i50.tinypic.com/2uszqjq.jpg

tongue
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

cogito
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   Posted 5/24/2012 6:39 PM (GMT -6)   
I have pain through upper-mid left back -- burning stabbing in various points, cramping/aching in neck, burning shooting down left arm.

According to the MD who ordered the MRI's, the C5 vertibrae has a large bone spur that is pressing on spinal cord. But I don't see it to be as pronounced as the disk bulges. Another MD (from prior MRI) said that I have two disks that are not just bulging but herniated. I, though, am not sure how to distinguish between bulges and herniations on the MRI.

I also wonder how severe the bulges from C3-C6 are. From other MRI's I've seen online, they are I think just "moderate" so I remain curious about other factors, such as foramenal issues. If I don't hear back from the MD who ordered them, I'll go to my GP or ask friends for some favors (who have friends who are MD's) and get some who are properly trained to read them.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

straydog
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Date Joined Feb 2003
Total Posts : 16795
   Posted 5/24/2012 6:50 PM (GMT -6)   
I am sure there is a written report ready at the facility where the MRI was done. It was read my a radiologist, I would call them and let them know you need to come by and pick up a copy of the written report.

Beats sitting there trying to figure it out and guessing. Let us know when you get the written report.

Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Blessedx8
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Date Joined Aug 2008
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   Posted 5/24/2012 7:17 PM (GMT -6)   
I'm w/ Susie... the facility should have the written report, which you are entitled to pick up. I would call and get a copy. That way - you'll know for sure what is going on.

Did you figure anything else out about your medications? I think on one of your last posts you were going to talk to one of your docs about figuring out a better plan in regards to your meds (BT and LA).

Take care --Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 5/24/2012 11:20 PM (GMT -6)   
Actually, the MD didn't order a report -- he just reads them himself. Unfortunately, I'm still getting nothing from his office -- same place as the MRI, university teaching hospital.

Tina, as for my meds, I have a little less than 3 weeks before my next PM appointment and don't know what to do. The additional hydrocodone has been both good and bad -- too low a dose and not enough help, too high and (a) I use up my day's quota too quickly and (b) I seem to get headaches from it (or at least there is a correlation). I'm trying out various permutations, but don't see taking the hydrocodone daily as a viable long-term scenario. Its efficacy is dropping, especially the duration. As a result, I've been using more oxycodone in the evening (7.5mg usually is enough) or some old Opana the PM wanted me to try a few years ago.

I've been keeping a pain log, log of meds and side effects and, really, just don't know what to do. Next, I'm going to try putting tzatziki sauce on my neck. That may make the greek man with the large moustache happy ;)
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

Blessedx8
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Date Joined Aug 2008
Total Posts : 3193
   Posted 5/24/2012 11:44 PM (GMT -6)   
Cogito,

haha.... I could see the small greek man w/ the large moustache.... and, yum, tzatziki sauce sounds good (I love that stuff!).

Will be curious to see what your PM says at your appt.... I agree that you need to figure out something for long-term.

Take good care. --Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 5/30/2012 2:21 PM (GMT -6)   
I finally heard back from the doctor yesterday -- at least from his nurse.

She told me (a) my MRIs are so fascinating (little Greek man?) that the doctor brought them to a spine conference last week; (b) the consensus was that the condition wasn't operable; (c) that I need a neurological consult.

I asked her about each of the three, and she had no answers for me. She didn't know what specifically the images showed, why it wasn't operable, or why I need a neuro consult. Gee thanks!

So, I asked that the doctor actually contact me so I can know the answers to the above. I thought as well to ask my GP for a report from him, but it turns out that my GP is away on vacation this week.


Very Frustrated!
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 5/30/2012 2:43 PM (GMT -6)   
I can understand your frustrations, call your gp's office and make an
appointment as soon as your doctor gets back from vacation..or
keep calling them until they do give you an appointment, and do
make an appointmnt with a neurosurgeon for a consult..
Keep us posted, prayers and well wishes...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 5/30/2012 2:53 PM (GMT -6)   
It is frustrating when you have to chase down your results and try to get answers...

The good news is that you don't need surgery!!! So that is something to celebrate...

I'm guessing that your appt. with the Neuro will be to talk about PT, injections, and other non surgical ways to help alleviate the pain.

Did they already give you an appt. date with Neuro? Hopefully you will be able to talk with your GP when he returns to get some more answers in the interim...

Keep us posted!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

Blessedx8
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Date Joined Aug 2008
Total Posts : 3193
   Posted 5/30/2012 3:02 PM (GMT -6)   
Cogito...

I've been down this path... where one thing leads to more unanswered questions. I'm sorry for your frustrations, really.

While I don't want anyone to have surgery... in some ways, it would be easier if some of our issues could be operated on and dealt with. I'm not saying surgery solves all, by any means... but it's frustrating to hear something is inoperable, too. It throws that choice out the window.

You would think that if she brought the images to a conference - someone would have had some input as to "what" it could be... besides a little Greek man, lol.

Hope you can get in to the neuro quickly... that your GP gets back from vacation and maybe has some input... and that you will get some answers as to what is going on - so that you can work on trying to get proper treatment.

--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 5/30/2012 3:40 PM (GMT -6)   
Tina....I do agree that if there was a way that surgery would fix everything...that would be the best option!. I was just trying to look on the bright side with not needing major surgery....but I do understand what you mean...
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 5/30/2012 4:24 PM (GMT -6)   
I'm pretty sure that even if surgery were an option, I wouldn't go for it (at least now). Discectomies too often lead to greater pain -- and from my original impressions, my problem also includes a vertibrae that is pressing on the spinal column.

I made an appt to see my GP Monday and left a note asking that he contact the Ortho who ordered the MRI in order to get a written report. I also have 2 weeks until my next PM appointment and, hopefully, he'll agree to something new. I can't take as many hydrocodones as he has been prescribing without getting headaches.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 5/30/2012 4:45 PM (GMT -6)   
Glad you are seeing your other doctors... and, I agree, hopefully your PM will agree to some other medications.

Take good care.

--Tina
Moderator - Chronic Pain Forum

My faith and family sustain me even on my worst days... as well as my wonderful friends here at HW.

Health/Pain Issues - too many to list; feel free to ask

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9664
   Posted 5/31/2012 4:44 PM (GMT -6)   
I hope you can get the much need medication changes you need or at least something different to try...
Prayers and well wishes...
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16795
   Posted 6/1/2012 8:04 AM (GMT -6)   
Cogito, have you considered having a consult with a neurosurgeon, take the films and let another set of eyes look at the MRI? May be something to consider. I have always seen better things with a neurosurgeon when the neck is involved and they have no problem telling a patient whether or not surgery will help or if even needed. I have done the ortho bit with my neck and ended up with two neurosurgeons. In fact the ortho referred me to one of the neurosurgeons. Just a thought. Susie
Moderator, Chronic Pain Forum & Psoriasis Forum

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 6/1/2012 8:13 AM (GMT -6)   
Good point Stray! I was wrongly assuming it was a Neuro...

So I absolutely agree....A Board Certified Neurosurgeon is the highest trained and most knowledgeable Dr. on cervical spine issues. So I would definitely go and get another opinion on all of this...
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 6/1/2012 10:34 AM (GMT -6)   
A neurosurgical consult does make sense, and I definitely need more information. The Ortho said that one vertibrae in particular is pressing on the spinal column -- so it might be that even with discetomies, the pressure won't be resolved.

As for which neurosurgeon to see, that's a problem where I live. 80% of MD's (or more) are idiots and/or greedy in my experience and I waste a lot of time and money navigating through the mire.

So, I need to find someone who isn't likely to see something just so he can make some money (or have fun with the scalpel), nor someone who is woefully lacking in diagnostic skills.

My PT is great and well connected with some of the best doctors around. I'm going to seek his input I think as well as my GP's.

No surprise, the Ortho never called me back!
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg & 2-3x 10mg Hydrocodone daily. Oxycodone 10mg for BT. .25-.5mg xanax as needed for sleep, Verapamil 240mg SR (for tachycardia).

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16795
   Posted 6/1/2012 2:12 PM (GMT -6)   
Cogito, I read your post several times and finally decided they are referring you to a neurologist and I hope like most times, that will not be a wasted appt. From what you have told us that was told to you I am not sure why they are sending you to one. What do they think a neurologist could do for you? Don't get me wrong, I have not a thing against them, lol, in fact was under the care of one for many years for various things.

Some surgeons will only do surgery for spurring only if they have symptoms to correlate with, a good one would not do surgery on a bulging disc unless there was nerves being compressed or the spinal cord was involved, many people have bulging disc never know it until they have a CT or MRI.

I do hope that your PT can come up with a good reputable neurosurgeon. If not get on the computer and do some research, you should be able to find a good one. This leaving you hanging is just nuts. Take care....Susie
Moderator, Chronic Pain Forum & Psoriasis Forum
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