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Please, in need of help deciphering this report

Started by Ionman on 02/21/2010 2:58am

I have looked up much of this report, but I still don’t speak the lingo, jargon, med speak.
All I get out of it is a lot of degenerative this and degenerative that.
I had surgery 7 years ago and thi s reads like I need surgery again, and then what? more surgery?
Can someone please explain this report so I can understand it.
I have lots of pain in neck, burning feeling back of left arm & hand, left arm numb and aches, including shoulder, both hands numb, but ache at night, hands have a lot of arhtirus anyways, part of feet and middle toes to little toes numb on both feet. Recently right arm & shoulder ache and pain between shoulder blades. Back of right arm feels cool. I feel clumsy, loss of dexterity & strength, and have fell down a few times. I am a 53 year old man.
Thanks in advance.

FLUORO GUIDED LUMBAR PUNCTURE AND CT CERVICAL MYELOGRAM 15TH FEBRUARY 2010.
Indication: Neck pain with upper extremity radicular symptoms.
Comparison: CT cervical spine without contrast March 2003.
CT cervical spine technique: 2 mm contiguous axial CT images were obtained of the cervical spine using 10 mL of Isovue-M 300. Sagittal and coronal reformats were performed.
Findings: There are postoperative changes of anterior plate and screw fixation with corpectomy and interbody bone graft at C4-C5 and C5-C6, which are new since 6 March 2003. Hardware is intact in standard position. There is good incorporation of the bone graft. On the sagittal images, the AP diameter the spinal cord is flattened by disc
osteophyte complex at C3-C4. The ventral cord is minimally indented at C4-C5 due to residual endplate osteophytes. Remaining cervical spinal cord is normal in size and signal without intradural extra medullary lesion. There is no cerebellar tonsillar ectopia.
There is redemonstrated diffuse degenerative disc disease and degenerative facet joint arthritis without listhesis. The extant cervical vertebral bodies are preserved in normal height and alignment. The remaining intervertebral discs are normal in height.
There are atlantoaxial degenerative changes.
At C2-C3, there is no focal disc herniation, neuroforaminal narrowing or spinal canal compromise.
At C3-C4, there is disc osteophyte complex, with prominent broad-based central disc component, uncovertebral spurs and degenerative facet joint arthritis, which result in severe acquired spinal canal compromise and moderate bilateral neuroforaminal narrowing. The AP diameter the spinal canal is narrowed to 3 millimeters at this level with flattening of the AP diameter the spinal cord.
At C4-C5, there are residual endplate osteophytes with uncovertebral spurs and degenerative facet joint osteoarthritis which result in acquired spinal canal compromise severe right and moderate left neuroforaminal narrowing. The AP diameter the spinal canal is narrowed to 6 mm with minimal ventral cord margin deformation.
At C5-C6, there are residual endplate osteophytes with uncovertebral spurs and degenerative facet joint osteoarthritis, which result in severe right and moderate left neuroforaminal without acquired spinal canal compromise. The AP diameter the spinal canal measures 9 mm at this level.
At C6-C7, there is disc osteophyte complex with uncovertebral spurs and degenerative facet joint osteoarthritis, which result in moderate to moderate to severe bilateral neuroforaminal narrowing without acquired spinal canal compromise. The AP diameter the spinal canal measures 9 mm at this level.
At C7-T1, there is no focal disc herniation, neuroforaminal narrowing, or spinal canal compromise.
There is minor mucosal thickening in the maxillary sinuses with mucous retention cysts. The mastoid air cells are under pneumatized and sclerotic with partial fluid/soft tissue density opacification. There are mild atherosclerotic desiccation is in the carotid bulbs.
Remaining included cervical soft tissues are unremarkable as seen on this non-IV contrast examination.
Impression:
1. Anterior fusion, corpectomy, and bone graft placement at C4-C5 and C5-C6, new since 6 March 2003, with intact hardware in standard position. There is good bone graft incorporation.
2. Diffuse degenerative disc disease with severe disc osteophyte complexes at C3-C4 and C6-C7 and residual endplate osteophytes at C4-C5 and C5-C6, which result in spinal canal compromise at C3-C4 and C4-C5 with cord impingement, most severe at C3-C4.
3. Multilevel degenerative facet joint arthritis without listhesis.
4. Varying degrees of moderate to severe neuroforaminal narrowing from C3-C4 through C6-C7, and with moderate to severe bilateral at C6-C7, severe right and moderate left at C4-C5 and C5-C6, and moderate bilateral at C3-C4.

Cliff

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15 Responses

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Cliff:

I am no doctor, but I do think you should discuss this with your doctor. Is he one of those that don't listen and allow you to ask questions?

Sorry I don't have more advice to give.

Pam

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I have seen the doctor who ordered the myelogram and when I asked about long term he responded with "lets worry about short term first", also he is not very good at communicating in my opinion.
The only thing I took away from the meeting that I consider positive is that the next appointment, in 5 weeks, will include the surgen who worked on me before, and I liked her a lot, easy to talk to and communicate with and no bull sh*t. Seven years ago I was sent directly to her. I guess I was lucky then. This guy is young, I don't hold that against him, but he needs to learn to talk to his pateints, I see him as a "gatekeeper". Unfortunatly, too much time to ponder on the unknown.

Cheers
Cliff

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i have recently been diagnosed with very similiar and multiple problems like you have.
i find that most neuro's are very evasive when it comes to discussing what is going on. i asked mine if he would support my ssdi claim and he said "probably not"-wtf!! my neuro is also certified in mri,eeg and emg and translates his own studies that are done in his office..get this... my c3-4 alone is horrid, for starters -- spinal canal stenosis with ap diameter of 9mm and he calls it mild to moderate??but he explained that we have to watch it closely, as it gets close to 7mm, surgery will be required (not an option).. at that level of the spine it should be 17-18mm.. so how the heck is already half the normal size, with only 2mm left to require surgery considered mild to moderate?? i will do my own initial post to list my mri findings..
i feel your pain ! i am wondering if you are on ssdi, when you applied, what you had diagnosed at the time and how long it took you to get it..
sorry i can not decipher for you. to decipher mine, i looked up various medical terms i didnt understand to figure out what they mean. i know osteophytes are bone spurs, facet arthropathy is facet joint arthritis, stenosis is narrowing of the spinal canal. a protrusion and bulging disc are basically the same as herniated disc. i have all of those problems and then some..

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I have been doing a lot of reading and think I have a pretty good handle on most of the medi-speak, well I looked up most of the words, then read more, then started to put some of it together. Problem is late at night I consider the worst case scenario, the fix it guy mentality, and then I worry. Who wants to have a neck that will not turn side to side and will not be able to look up or down, a head that is welded to my shoulders for all intent and purpose.

Some of the issues like the DDD and DFD, and the way I seem to grow osteophytes, see I am learning, worry me when I consider the long term. I would like to see everything in my neck fixed all together once at the same time and be done with it, but I am beginning to think that I am going to need something done every few years for as long as I live. But I don’t get to choose, just along for the E-ticket ride.

No not on ssdi,, although am considering it, knees are wrecked + a whole host of issues, Chronic arthritic pain (Originally Knees then fingers and hands & now Neck)(both knees have been scoped, right one twice and both or either can sideline me when they act up.), Diabetes, Depression, Asthma / Chronic bronchitis, Allergies and recently told I have Carpel Tunnel in both hands. oh and they want to take my gal bladder out too, that one is new, but on hold till I know what is going on with my neck. But none of my doctors seem to want to go that far, yes you have these things but, but, but

I am beginning to wonder, “is that all there is”, I worked hard for many years, had a home and even had a pretty nice amount in my 401K at one time, but now when I look at things I feel like I was run over by a train in 2001 and regularly to date, since then most of what I had, well… I have very little to show for it now, no comfortable retirement for me and the body is so broke down I would not be able to enjoy it even if I had the money. Well I am getting morbid, so time to “watch a comedy”, funny how your problems are still there when the movie is over. (but “don’t worry”, I have to say that when ever one of our so called health professionals and councilor types say “don’t let it worry you” or “don’t worry’ I get a little steamed, easy for them to say, ……… got to go, rant mode kicked in. good night.

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Hi There, I would highly suggest that you continue to research all options for all issues. Get as many opinions and make multiple appointments to get opinions and possible solutions. I have multiple issues as well and it can be a frustrating challenge, however, the issues are still there. If you can address something that will need to be done anyway, while waiting for another answer, keep after it. I say this because I have had a hernia surgery, double ankle surgery and hand surgery in the last 10 months.....I have advanced disc degeneration in my lumbar and cervical so two more surgeries to go....and after many months, I am close to those surgeries now, if I would have kept looking for answers those sugeries might be done already and recovery might be happening....instead I waited for insurance to turn me down several times for ADR and I am unable to fund alone......if I had kept researching other options right along that insurance may cover...even if they are not my first choice, I might be closer to returning to work.......at 44 years old I face SSDI otherwise.....not good.

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you have all the spinal problems, and diabetes to boot you should definitely apply for ssdi. if you do, have copies of anything and everything relative from all treating doctors when you apply.all test results from mri,xray etc... the more you provide, the better. i have been fighting ssdi for 4.5 years and have been denied all the way thru. atty is currenly filing a suit in us district court to either overturn the alj decision or remand back for new hearing. mind you my c-spine problems were not detected at that point.
atty told me to file a new claim, so i have. ssdi is currently gathering med records from doctors, although i personally submitted 99% of them myself. will explain further in my own post.
this doesnt mean that you will be denied all the way thru, as it varies per case.

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I am new to the "community" and do not really have any answers regarding the medical questions.

But I am struck by the fact that your ages are so young and you have multiple joint involvement. So here is my contribution/suggestion:

Do any of ya'll have a Rheumatologist? If you have that many joints involved - you might have a very real rheumatological issue. If you have a lot of odd and strange random health issues, along w/ your back problems (like eye infections (uveitis, iritis); odd "staph" infections that show up mysteriously on your legs/skin; GOUT; high level of exhaustion and feeling of malaise, night sweats ... just odd random things that you may likely dismiss as nothing ... there could be an autoimmune disorder and / or a Rheumatoid Condition that a good Rheumatologist could pick up.

It is much easier to gain the support of the medical community for "disability" purposes if they believe that you have a true disability - right? And let's be real: there are a lot of loosers out there just trying to get something out of the "system". And maybe there are even more doctors and medical personnel who are so skeptical that you wonder why the hell they ever decided to go into medicine ... maybe just to torture those of us who already feel like a looser because we can't just "snap out of it"??

When you are really hurting - and your doctor does not believe in you or your pain .... it's enough to make you want to go absolutely crazy.

My husband is 41; his Short Term Disability Claim (through the policy with his job) was denied. I had to fight them tooth and nail and practically threaten to take them all to court because they have a bunch of idiots reading the medical records - and have no clue what the implications of any of these terms mean. So they denied the claim and hoped we would go away. (I didn't - and I won.)

We had the intial support of his neurologist - but once we realized this was not exclusively a neuro issue ... we could not get any of the other many doctors to really support us. It was amazing. But ... we have finally figured out that all of his odd, seemingly unrelated medical conditions (over the course of many years) were being caused by an Autoimmune Disorder.

Now that we have found this physician - he was admitted to the hospital ... he had to get that sick in order to find someone to figure it out - It took this dr. less then 20 minutes with us to determine that he is in seriously bad condition and she diagnosed him and started him on very aggressive anti-inflammatory; immunosuppressent and aTNF medication(s) to help. I called her office to schedule an outpatient follow up ... I was amazed to hear the message on the automated machine ... there is actually a number to dial if you need to discuss your disability/insurance issues.

The right doctor could make your "appeal" process a lot less stressful. And that could equate to a better and more successful recovery.

And also - if your doctors think you need surgery ... they must think you are in pain. So why would they not support your need for Supplemental Income since you can't work? Or are they just doing surgery to practice on someone? If they can justify the need for surgery to a Health Insurance company - then they ought to be able to support the same issue to a Disability Insurance Company!! If not ... then I would not use them. I would not pay them. I would find someone else.

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I am seeing both a rheumatologist & a neurologist. the neuro is the one who did the mri's and ncv testing. but when i asked him if he would support my ssdi case he told me "probably not".. what the ????-- he does his own mri and ncv in his office and translates his own work- he is license in both fields to do so. he knows how severe my problems are. he has offered epidural steroid injections, pain meds, and acupuncure as treatment options. my insurance will not pay for acupuncture (which i prefer) and i can not afford the cost, as we only have one income for almost 5 years due to my problems.that leaves meds and epi's.. i do not like the way strong pain meds make me feel like a zombie. i am terrified of needles going into my spine, especially in the neck where there isnt much room to begin with. but as i told the neuro a couple of weeks ago, i have to try other anti-inflammatory meds (as i have only used diclofenac, naproxen and mobic). diclo doesnt work for me. mobic works part of the time but it is time released and it doesnt work when you need it most. i have taken naproxen so long, it doesnt work as good as it used to. my rheumatologist gave me a new med today- relafen. we will see how that works. the rheum is supporting me in my ssdi claim the best she can.my atty said to find another neurologist that will support me. most of them do not want to do that. i feel at times they dont want to support you, cause they feel they can get more $$ out of you and insurance if they dont...
as for being young to have all these problems, i think so too. but i worked in a manufacturing plant for 19 years, the last 4 1/2 being in a distribution center pulling and pushing on boxes that i had no business. that is what happened to my spine..
sunnyd50

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Wow! You have a lot going on in your body. Everyone has responded well and I think you have it covered.

I agree that you have bone spurs (ostephytes) etc.

DDD can be a direct result of aging and even surgery (due to your age surgery is likely culprit) and arthritis is the next step of DDD. It is a pattern. I would check into that fast.

The good news is that your surgery area is holding but it may be putting pressure on the others to cause the spurs, DDD etc. Make sure you force the doctor to go over it in detail. I found an anesthesiologist was the only one who would (he gave me nerve blocks - don't worry those shots aren't bad). They are easier than the other back and neck pains.

Doctors do not like to deal with SSDI. Period. I have not found one yet in all my (15) years of problems that is willing to stand up and say "this person has this and this and can't function, etc.". They do not want to because once they do, they can be summoned by SSDI to review other people and they get paid very little for this (I heard $15.00).. It's horrible that they do it, but they do and I offered to pay one doctor on the side and he said No way. I also can not understand radiologists who report and minimize what is wrong with you when it's clear that something is severe that even I could see it (and I have no training). They are all coverying their but really. It's unfortunate but that is what insurance industry has done to doctors and patients (like the one who fought for disability earlier).

And now the government is going to help? Yeah. Right. I'll probably be exterminiated for lack of contribution. lol. I'm just joking on that one - I know insurance needs revamping but so does SSDI.

So keep asking, keep after it, and try another doctor - anything but do not let it drop. Get an answer.

The suggestion for autoimmune (comment above mine) is excellent advice if everything else hasn't helped. I tried some of the meds but they didn't help me, but I did not go deeper (hmmm..)

Never give up....
Take care...
Dee

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Hi to all. I am new in this commuity but have excretiating low back pain and down my left leg. I had a MRi done Monday and my doctor told me everything looked good and normal expcept the following: L3-L4 level minimal facet arthropathy, L4-5 more advanced facet arthropathy, and L5-SI there is decrease in disc height and mld bilateral facet arthropathy. So their impression was Muitlevel Facet Arthropathy and Degnerative Disc Desease. At this point he schedule me to see another doctor on September 9th to have the Facet Injections done on a trial bases to see if that helps with my pain. Is this worth trying. So far not any of the meds they put me on or therapy has helped.

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i have not had any facet joint injections, i have refused them and been using meds and topicals (voltaren gel, flector patch and lidoderm patch).. what meds have you tried so far???

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Hi cliff, my name is Rene and I recently joined this site ,for I too suffer from spinal issues w/ chronic pain and had surgery, u can visit my site to read my story for I hope it can help. Anyway, I read ur story and I am an experienced orthopedic NURSE for over 12 years. If u havnt found the answer to your question already, Im going to try and help you understand the medical mumbo jumbo of terms that unfortunatly surgeons dont take the time to explain to their patients.I see this all the time being in the field. Basically we r just another # to them, sorry to say.but its true,and they dont listen to our pleas for help w/ the pain, they treat us as drug addicts looking for pain meds, even though they have in front of them all the bodily problems we r experiencing. very very sad isint it,and this is coming from a nurse. but anyway, Im going to try and answer all your concerns pertaining to your MRI report, and simplify them for you, I hope I can help.
1. C4,5,6 screws and plates that they inserted in 03 are still intact with no movement changes.

2. In the AP view your disc has collapsed and is flattening out and pressing on your spinal cord in that area.

3.C2+3 no changes since your last MRI

4.C3-6 u have bone spurs (they look like thorns on a rose bush) have developed which press on nerves.

5.Narrowing of the Foramina. Think of your spinal cord which runs threw a straw. Well the straw has thickened so much that it is squeezing your spinal cord.

So with all of this,,,this is why u r experiencing numbness, tingling and pain and even throwing u of balance.
Hopefully you have chosen a very good neurosurgeon to take care of this issue. Good luck to u, I hope I was of help and I will b visiting the site. Feel free to ask me more questions if needed. Again good luck ,hope u feel better, and u can read my issues in the forum. again my name is Rene.

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Hi ion man
Well you have got some issues going on with your spine, and reading others comments I think they have covered most things. Getting to disability, I live in Canada so maybe our system is a little different, but when it comes done to government they like to screw us if they can. I have a whole bunch of issues going on with my spine and have had 4 back surgeries including a fusion. My surgeon was the one who suggested I should look into disability, so I applied and of course was denied. I appealed and got legal aid to help fight for me. It seems what they want is a Drs report stating you are not capable of any type of work including part time work, and that your conditions is not expected to improve and it is permanent. Once I got the right letter the decision was reversed and I was granted disability. It didn't help with the pain but it did help take the financial worry away, so now I can do what
I can when I can.
Don't give up, keep fighting and get the answers from the Drs to help you made informed decisions, it's your body not theirs so once you leave the office your just another number, demand answers and don't let them bs you with medical jargon.

Good luck.

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I am a 50 year old M with DDD+Kyphosis+severe osteoarthritic changes thru my entire spinal column and bulging big toe joints,this being the OA kicking in big time,2.I read your report & I see alot of changes occuring in your spine,2.The advancement of the DDD+K is rapid in my case,my 1st symptoms appearing in 11/09.This is not the same 4 you as it appears 2 be an average case of progression in your DDD with no mention of Kyphosis.You had a fluoroscopic with resolution dye 2 hilight the areas of highest aggravation.It passes out in your urine in a few days,just plenty of water.The myelogram they performed @ the same time shows no significant advancement in any cervical vertebrae other than the presence of osteophytes,which are normal calcium and its by-products leaving stalactite-like structures like you see in caves.Partial fluid and soft tissue density means that your joints are drying up like every other arthritis sufferer.Going in2 your thoracic spine I see no significant trouble here yet.Again I must mention that I haven't seen your case history,which I have no desire 2 see,don't get me wrong,I'm not trying 2 make a buck in any way,shape or form.I am just a guy with a like condition with a strong passion 2 learn everything there is 2 learn about this congenital disease that my father bestowed upon me.If I'm right,you had neck surgery and you are uncomfortable more so now than be4 or is it more areas becoming worse 2 bear?Anyway,the hardware in your neck is A-OK,no sign of any changes you should worry about.As I said,my case is very different from yours in that it has progressed so rapidly leaving me with more questions than I began with and so few answers.Every day 4 me now is a new challenge as the medical experts(neurologists)have given up on me as they can't give me a couple new discs and charge 4 that surgery,then down the road they can bring you back in 4 more surgery,but you have 2 ask yourself CAN I HACK ANOTHER PROCEDURE?As surgery is not an option 4 me as I've been told it's not unless something else goes wrong which is entirely possible as my bowel and bladder have become involved as of late.But I would like 2 correspond with you some more as I have now been officially declared disabled or handicapped,whichever you prefer.spinelessinalberta :)

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I guess I erred when I assumed that any1 would actually chat with me on this or any other similar site.I seem 2 be getting the same kind of treatment that I got when I embarked on this journey 2 discover what exactly was happening 2 me.I have now seen 26 doctors(that's correct,actual md's)was informed recently that I have seen this many people and have had 46 seperate imaging tests alone in the past 23 months.It took a major slide in my condition 2 get any attention,I guess as I have been the absolute model of patience 4 all of these appointments and enquiries(I have discovered in my travels you must ask 4 explanations,paper is just that,paper)I have a file folder @ home,now,had 2 buy another 4 the sheer volume,it all amounts 2 exactly 0 if you don't have a face 2 associate with the papers.I was thrilled 2 learn that they got me in 2 see the neurosurgeon so quickly,6 weeks from assessment 2 neuro appointment(normally takes 18 months,neuro who did assessment said we can't do that in your case,I miss him,but I'll never see him again)so you can imagine my optimism soared.Yes,some1 who actually thinks there is something wrong with me!My enthusiasm was short lived,however,as the 1st thing out of the neuro's mouth is,I can't help you,your spine is far 2 disintigrated,I can't fix 14 places on your spine.This all started as an irritating upper G.I. pain that just kept getting worse at work,home,anything I tried seemed only 2 aggravate,so I first complained of this pain in Nov.\09 and up until Jan.\12 I slowly lost 25% of my functional capacity.On Mar./ 11\12 I attended the er of our local hospital complaining of upper L G.I pain,subsequently I was admitted the next am as the same problem occured upon ingestion of solids.The 28th I was released 2 my own care as there are no surgical options at this time,unless complications arise,as they did between March 11 and 28.I am now at less than 25% F.C.My bowel has slowed 2 a crawl,2 laxatives seem 2 do the trick as I can no longer push,bladder is functioning ok so far,but difficulty starting flow and maintaining it is more difficult than ever and continues 2 worsen daily,as well as mobility,energy and overall attitude.I have not been told straight out 2 go and convalesce at home,we don't have the time or space,we'll manage your pain and be sure 2 let us know immediately of any and all changes..If I had a dollar 4 every time I've heard that phrase.........well,you know the rest.So,I will crawl back into my corner and be quiet.The chiropractor this charge nurse told me about him,practically begged me 2 go see him,thought he could help me.I thought,unconventional disease requires unconventional treatment?Turns out he's in his 80"s,has seen 10's of thousands of spines,and he says there is a good chance that he can help me.I think he is just trying 2 comfort me more than anything,he is a very compassionate individual,and I got the appointment and a cd 4 myself so that I can tell my 4 grand kids and my 5 children,this is what might happen 2 your spine if you're not careful and do 2 much physical labor.If my parents had told me that I was in line 4 this affliction and all the complications that go with it,I certainly would not have become a carpenter,possibly saving me this horrific pain and loss of mobility,possibly not.Any way,I'm sorry if I intruded on your cyber world,all the best of luck 2 everyone here,may all of your enquiries come 2 a better conclusion than mine.spinelessinalberta :)

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