Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Help Reading MRI Results Plz?

Hiya.

Most of my issues are si & lumbar, but I just had a cervical & thoracic MRI and was wondering if some of you vets could tell me what the heck this means? I could look it all up of course, but I sure do love laymen terms & friendly "it's all mild, you're fine!" better than what I'll find on the net.

And it does say mild a few thousand times, so that's good.

The parts that have me stumped are bolded. THANK YOU IN ADVANCE for your help!!!!!!!!!!!!!!!

T4: The bone marrow signal is unremarkable. No acute thoracic fracture is identified. No spondylolisthesis is visualized. No syndesmophytes are identified. There is mild spondylosis anterolaterally at T8-9, T9-10 and T10-11.

There is moderate disc desiccation at T8-9 and T9-10. Blah, blah. There is a 2.4 mm central disc protrusion at T9-10 which mildly impresses on the thecal sac. No disc herniation or spinal canal stenosis is seen at the remaining thoracic disc levels.

C2-3: Mild disc desiccation is noted.

C3-4: Mild disc desiccation is noted. There is a 2.0 mm broad-based disc protrusion which mildly impresses on the thecal sac. The protrusion measures 1.4 mm in flexion and 2.2 mm in extension. No neural foraminal narrowing is visualized.

C4-5: Mild disc desiccation is noted. There is a 2.0 mm broad-based disc protrusion which mildly impresses on the thecal sac. The protrusion measures 1.4 mm in flexion and 2.2 mm in extension. No neural foraminal narrowing is visualized.

C5-6: Mild disc desiccation is noted. There is a 2.0 mm broad-based disc protrusion which mildly impresses on the thecal sac. The protrusion measures 1.0 mm in flexion and 2.0 mm in extension. No neural foraminal narrowing is visualized.

C6-7: The disc hydration is within normal limits. No disc herniation, spinal canal stenosis, or neural foraminal narrowing is visualized.

Holly, med-speak often makes my brain twitch, but I googled 'anterolaterally' and I'm wondering if they mean 'squaring' of the thoracic vertebrae (ie. the sides fill in so instead of being sort of hour-glass-shaped the vertebrae are more rectangular). I had that on the first set of x-rays back in 2001.

I also googled 'thecal sac' since I hadn't a clue:

The thecal sac is a spot in your spinal canal. It has the cauda equina, spinal fluid and spinal cord in it. It is a membrane that is around the spinal cord.

So, it sounds like the protruding discs are pressing on the sac that protects your spinal chord?

Dear god, I think I just developed another twitch.

Hope someone else can help more. One day, you'll surprise yourself by actually knowing what they're saying without asking.

Warm hugs,

Sorry to make you twitch Kat. ;-) Thanks for the help. I did google a bit before I posted, but it seems like one term leads to another to another and another...

Most of my problems are si / lumbar, so I'd be surprised if someone comes back and says any of this is a big deal. I mean, my neck and upper back hurt a lot, but nothing like my si & lower back. She sent me because of the numb arms & dropping things. Well, and because I said my neck hurts. ;-)

It really can be like some perverse, convoluted puzzle, can't it.

I hope they at least can see their way to helping you because of these results. There is stuff going on most definitely and with the neck vertebrae (those are the ones labled 'C4' or 'C5' etc.) mildly impressing on the spinal cord protection, that might explain the numbness. Maybe???

I was getting numbness and tingling in my pinkie fingers and pain that shot down from my shoulder, through my elbow into the outside of my hand. I'm relatively certain that was ulnar nerve related. It was rather troublesome because I type for a living. Gotta use the pinkies when you type and I kept missing the key or didn't have the strength to push it down when I hit it! Luckily, switching biologics helped (because Remicade wasn't working as well, so I went to Enbrel). I still get it every so often, but nowhere near as badly as last year.

Warm hugs,

I emailed a very good friend off the board with the report too and he replied back with some great layman's terms for me. He said:

You're fine.

So that'll work for me. And just to reiterate, my AS related stuff is si & lumbar. That's where all of the magic is happening. Those reports are super easy to read. They say, "you're screwed."

This cervical / thoracic is all just fun bonus stuff. Sounds like when my pain is under control and I can work on my posture, I'll be fine, just fine.

That's a relief.

I have lumbar and SI as well, but also thoracic and (maybe) neck, and last year my Achilles decided it wanted to play too. Yay.

Don't you just love this game?

Warm hugs,

Ha. No. :-)

Me either, you two...let's play something else for awhile...don't you wish it were that easy?

Spondylosis is the Big Word for degeneration of the spine - i.e.: wearing out! Antero-lateral means towards the sides and front of the vertebra. In the thoracic spine this is because this curve in concave to the front, so that's where the wear & tear is usual...

Dessication (drying out and therefore loss of height or disc space...)of the discs also indicates aging and degeneration and that's what causes the bulging of the disc material into thecal sac (which as Kat said is the lining of your spinal canal) - the fibrous ring around the outside of the disc is aging too. Loss of disc height will reduce the cushioning effect and hasten the spondylosis too.

In other words, from this sort of report, this physio is convinced that your avatar is some gorgeous young chicky babe whose pic you stole off the internet and you are in fact 20 years+ older and probably have wiry grey hair and loads of wrinkles!

Yikes, Holly! If in fact you are that gorgeous smiling blonde babe with young kids then you are definitely showing very early signs of degeneration... perhaps not surprising given that you have an AS diagnosis, tho'...

This sort of degeneration is not likely to be the cause of spinal nerve impingement (no evidence of this sort of finding on the MRI) and therefore to be the cause of you dropping stuff, Holly. (IMO - remember that I am basing this purely on your MRI report....I would be assessing muscle power, sensation and all sorts of other things if you were in my rooms and I was not being a 'virtual' PT!)

Hi Holly!

Disc Desiccation is the drying out of the discs. It is a degenerative process. It happens to everyone to a degree over time. If you look at your discs on an MRI they should be light and full. As discs begin to wear out they will look gray and be smaller. The space between your vertebrae will be shorter. Disc protrusion means that some of the jelly-like center of the disc is protruding out. It is a disc herniation that allows the disc material to come out. Think of a disc as a shock absorber with a tougher outside layer and jelly-like material in the middle. The thecal sac is a membrane on the spinal cord or spinal nerves. Your MRI means that that disc material is leaking out of the disc and touching the thecal sac. A lot of people have herniated discs that aren't causing any symptoms since the disc material isn't touching anything. Some people have a lot of problems because the material is impinging or compressing a nerve. It sounds like you are in the middle. The material is touching your spinal cord or spinal nerves but not compressing them. Spondylosis is a type of degenerative osteoarthritis in the spine. Anterolaterally would be the location on the particular levels noted (T-8 through T-11). I hope this helps!

Craig