Spinal MRI findings:Possible Cervical Radicular compression according to MRI

Dear Ask The Doctor: Can someone dissect this for me? My arms keep falling asleep and my hands and even when I'm lying on my back. My toes and fingers are often numb and tingly. This happens throughout the day and wake me up in the night. I also have chronic muscle cramping all over...hands, fingers, calves feet, abdominal and back.... I have a lot of neck pain as well as pain in my tail bone that radiates down into my legs..I can not sit for long periods of time. Unfortunately they did not MRI my lumbar spine but did do the rest. No serious injuries. I'm 44 and female. Many thanks. Comparison: None Technique: Routine sagittal and axial images acquired without gadolinium per protocol. FINDINGS : Normal posterior fossa. The visualized spinal cord is normal in contour, caliber and signal. No evidence of mass or syrinx. Bony alignment is notable for reversal of normal cervical lordosis between C3 and C7 level, there is mild kyphosis. Grade 1 anterolisthesis of C3 on C4 is present. Disk height loss involves the C5-C6 level to moderate extent and C6-C7 level of mild to moderate extent. There is diffuse disc desiccation most notably from C3-C7 levels. Marrow signal is normal, small focus of T1 and T2 hyperintensity in the inferior aspect of the T1 vertebral body likely represents a fatty hemangioma, a benign incidental finding. Findings by disk level are as follows: C2-C3: Normal C3-C4: Severe right-sided facet and disc osteophyte hypertrophy with anterolisthesis noted above combine to cause severe right foraminal narrowing. There is partial effacement of the ventral CSF. C4-C5: Mild bilateral facet hypertrophy and mild disc osteophyte complex. There is partial effacement of ventral CSF. There is mild left foraminal narrowing. C5-C6: Mild posterior disc osteophyte complex partially effaces ventral CSF. Evaluation at this level is slightly limited by patient motion. There is mild left and moderate to severe right foraminal narrowing. C6-C7: Moderate posterior disc osteophyte complex appears to nearly contacts the ventral aspect of the cord causing mild overall canal stenosis. There is moderate bilateral neural foraminal narrowing. C7-T1: Unremarkable Paraspinal soft tissues are unremarkable appearance. IMPRESSION: Multilevel degenerative changes are observed in the spine. These are notable for severe right foraminal narrowing at the C3-C4 level, moderate to severe right foraminal narrowing at C5-C6, and moderate bilateral foraminal narrowing at C6-C7 with mild canal stenosis at C6-C7 secondary to disc osteophyte disease. No intrinsic cord signal abnormality seen.

Dear Jill: According to the MRI report you have bone degenerative changes at many levels in your cervical spine that may be producing the symptoms that you described. In the younger patients, cervical radiculopathy may be a result of a disc herniation or an acute injury causing impingement of an exiting nerve. In the older patient, cervical radiculopathy is often a result of spinal canal narrowing from bone (osteophyte) formation, decreased disc height and degenerative changes due to aging process. The treatment strategy usually includes: start a physical therapy program aimed to control pain and inflammation, and the use of anti-inflammatory medication (“motrin”, “aleve”), also  you should have a re-education of habits and posture to improve your quality of life. You also should be independent in a stretching and strengthening program and continue with these exercises under the periodic supervision of a physical therapist initially and then completely on your own. If your condition fails to improve with a comprehensive rehabilitation program and selective injections, you may be considering a re-evaluation by an Orthopedic surgeon to explore other treatment options more aggressive.