Cervical Radiculopathy C4-C5 MRI

Patient

Q: This is my MRI report and I am looking to see what are my oppoins and more of understanding that is happen on my neck and back. I do get alot of pain all day long and my arm on my left side goes numb on me atleast a good 10 times a day and it lastest for a good 20-30mins long. I am a mother of a 5 and 9 year olds and I am looking for what is the best advice and what is out there for me. The MRI was taken 2/18/2010

At C3-C4 there is left unvocertebral hypertrophy and mild left foraminal stenosis. There is no central or right foraminal stenosis. At C4-5 there is a moderate to large central disc protrusion causing mild indetation of the vertral aspect of the spinal cord. There is no cord edema. There is no cental or foraminal stenosis. At C5-6 and C6-7 There are minimal posterior osteophyte/disc complexes. there is no central or forminal stenosis.

At the other levels in the cervical spine, there is no disc herniation or spinal stenosis. Cervical spine alignment and signal intensities are normal. The cervical spinal cord is normal in position size and signal intensities. The cervicomedullary junction and the visualized upper thoracic spinal cord are normal

C4-C5 morderate to large central disc protrusion causing mild indentation of the ventral aspect of the spinal cord. No cord edema.

C5-6 and C6-7 minimal posterior osteophyte/disc complexes.

THank you for your time

Doctor

A:   The described results of your MRI revealed a cervical nerve compression (C4-C5), but it would be also important to rule out inflammation of the peripheral nerves at the level of the arm and hand. In the younger patients, as you are, 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 same described before for the cervical spine applies to the lower back in terms of cause of pain and numbness in the legs, same causes, different spinal level. The treatment strategy usually includes: physical therapy program aimed to reduce pain and inflammation, and the use of anti-inflammatory drugs (as ibuprofen), also a re-education of habits and posture to improve quality of life. You 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. Patients whose condition fails to improve with a comprehensive rehabilitation program and selective injections should be presented with a surgical evaluation. Often, patients should show progressive improvement over the first 6-8 weeks with conservative treatment. If there is no significant improvement in this time frame, consider a surgical evaluation.

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