We are trying to interpret an MRI scan report of the cervical spine. In some places it says “No evidence of cord compression or focal abnormal signal within the cervical spinal cord.” In other places it says “There is a (central, right central, etc) disk protrusion causing mild to moderate narrowing of spinal canal.” These are referring to different levels (C4, C6 etc).
These seem contradictory. The cord occupies the spinal canal, so if the canal narrows, it’s compressing the cord, right?
Or is there perhaps extra space in there, so where the canal narrows, there is less clearance between the cord and the canal?
This is all about diagnosing tingling and pain in the extremities. We are trying to make sense of this on the basis that some part of the nervous system is being tormented in one way or the other. All the references to the foramina say that they are patent. We think either something is getting compressed, or this is all irrelevant to the initial complaint of tingling and pain.
It seems doctor consultations are brief and take a LONG time to schedule. Can anybody help us out in the meantime??? Thanks!
Former MRI Tech here and can tell ya that there seem to be definite contradictions in that report. It may not be accurate and needs reviewed again - period. IME where stuff like this occurred, you have a few choices. First, you can call the Rad Dpt Supervisor where scan was done and ask him/her if you received an accurate reort as it seems to not be coherent in content (ie "Did the Rad get my images mixed up with someone else?, etc). They’ll look at it and if not all proper, they will get with radiologist dpt to straighten things out.
Secondly, you can call radiologist’s office yourself (can get contact info from MRI office) and explain that you think there was a mistake and you need it looked at again for accuracy. You tell them that the report contradicts itself, and trust me, it will get annother look, LOL. IME, this has never been a problem w/me (with some of the many images of my daughter over the years).
Thirdly, if it absolutely makes no sense (the report), then your Doc/nurse can do the above for you if you get nowhere.
There is the possibility that the Rad was stating normal-looking for one axis, then saw bulging on other views (ie side to side -v- front to back). It is not unusual to only see bulging on one or two of the series of images, IME.
And also, generally the ‘summary’ on report is what carries the weight of the report in toto, so to speak. There is always a ‘last paragraph’ which summates the statements above it. Just FYI and may help make more sense of this.
It reads pretty straightforward (tho obviously excerpted heavily) to me. The spinal cord looks normal, no signs that it’s being compressed. But the canal that it’s in is narrowed by a disk protrusion. So it’s not a universally wide-open canal but it doesn’t seem that the area of narrowing is impacting on the cord itself, which is good. A tighter fit due to narrowing, but not that tight as to cause cord compromise. The canal can and does narrow without compressing the cord.
I’d be looking for verbiage in the report regarding whether or not protrusions are impinging on nerve roots where they come off the spine, given the symptoms you describe.
But I’m just a primary care doc looking for the most blatant sorts of findings on these things, not the subtle nuances the neurosurgeon or spinal surgeon is most capable of interpreting and treating.
I second Qadgop’s interpretation based on the report excerpt.
The neurologist(s) should be the ones who can best explain it and whether there’s likely any connection to the described symptoms.
There are plenty of spinal/disc abnormalities that can be found on an MRI that do not necessarily correlate with signs/symptoms of disease. This is part of the reason that physicians and insurance companies are reluctant to authorize MRIs for people with back pain or related complaints (from insurance companies’ standpoint, I suspect the dominant reason is cost).
When my cervical radiculopathy was diagnosed, my MRI had a very specific lesion involving disc material which my physical therapist had predicted. But, my doctor had forewarned that cervical disc disease is a dynamic process, and a “normal” MRI would not preclude a diagnosis of radiculopathy.
About the foramina, at every level is noted “Bilateral neural foramina are patent.” We understand this means the openings through which the nerve roots branch off are all open and not compressing the nerves.
There’s also a note, “No definite demyelinating lesion in cervical spinal cord.”
The “IMPRESSION” paragraph only echos earlier remarks.
