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Thread: Myelomalacia and all this, what to do?

  1. #1

    Myelomalacia and all this, what to do?

    Is there anything to do about this rather than surgery?
    Latest MRI with contrast results.
    49 year old female

    Comparison: 1/2/11
    There is again identified increased signal on T2-weighted images
    at the C4/C5 level within the cervical cord.. There is no evidence
    of enhancement of this area after gadolinium abnormal signal on
    the T1 weighted pre-gadolinium images.

    C2-C3: No significant central or lateral stenosis.

    C3-C4: Mild loss of disc height. Mild posterior disc bulge and
    osteophyte complex resulting in mild central canal stenosis and
    mild left neural foramina narrowing. No significant change from
    prior examination.

    C4-C5: Mild loss of disc height. There is a broad-based disc
    protrusion present which is abutting the cervical cord and
    indenting it slightly resulting in moderate central canal
    stenosis.. This is at the level of increased signal on T2
    consistent with myelomalacia. There is moderate to severe
    bilateral neural femoral narrowing present.

    C5-C6: Mild loss of disc height. There is a posterior disc
    protrusion/osteophyte complex present resulting in moderate to
    severe neural phenomenon present worse on the left than the right.
    There is moderate central canal stenosis present.

    C6-C7: Mild loss in disc height. There is a broad-based disc
    protrusion present which in combination with a disc/by complexes
    resulting in mild central canal stenosis and moderate right neural
    foraminal narrowing. This is abutting the right C7 nerve root
    which appears slightly swollen. This is not appreciably changed
    from prior study.

    C7-T1: No significant central or lateral stenosis.

    ** IMPRESSION **:
    Multilevel degenerative changes, not significantly changed from
    prior study. Changes consistent with myelomalacia of the cord with
    some narrowing of the cord at the C4/5 level.

    Thank you,
    Laura

  2. #2
    Quote Originally Posted by lauvw View Post
    Is there anything to do about this rather than surgery?
    Latest MRI with contrast results.
    49 year old female

    Comparison: 1/2/11
    There is again identified increased signal on T2-weighted images
    at the C4/C5 level within the cervical cord.. There is no evidence
    of enhancement of this area after gadolinium abnormal signal on
    the T1 weighted pre-gadolinium images.

    C2-C3: No significant central or lateral stenosis.

    C3-C4: Mild loss of disc height. Mild posterior disc bulge and
    osteophyte complex resulting in mild central canal stenosis and
    mild left neural foramina narrowing. No significant change from
    prior examination.

    C4-C5: Mild loss of disc height. There is a broad-based disc
    protrusion present which is abutting the cervical cord and
    indenting it slightly resulting in moderate central canal
    stenosis.. This is at the level of increased signal on T2
    consistent with myelomalacia. There is moderate to severe
    bilateral neural femoral narrowing present.

    C5-C6: Mild loss of disc height. There is a posterior disc
    protrusion/osteophyte complex present resulting in moderate to
    severe neural phenomenon present worse on the left than the right.
    There is moderate central canal stenosis present.

    C6-C7: Mild loss in disc height. There is a broad-based disc
    protrusion present which in combination with a disc/by complexes
    resulting in mild central canal stenosis and moderate right neural
    foraminal narrowing. This is abutting the right C7 nerve root
    which appears slightly swollen. This is not appreciably changed
    from prior study.

    C7-T1: No significant central or lateral stenosis.

    ** IMPRESSION **:
    Multilevel degenerative changes, not significantly changed from
    prior study. Changes consistent with myelomalacia of the cord with
    some narrowing of the cord at the C4/5 level.

    Thank you,
    Laura
    Laura,

    The MRI shows that you have discs that are pushing against the spinal cord in your neck. The spinal canal, in which the spinal cord sits, is narrow at C4/5 and there are changes consistent with damage to your spinal cord at this level (myelomalacia). You also have disc pressing on your C7 spinal root.

    What are your symptoms? One should never do surgery based on images alone. If you don't have sensory loss or weakness that is consistent with changes of C4/5 (shoulders) or C7 (upper arm, triceps), surgery may not be indicated. Surgery should be carried out to treat neurologic loss. Pain alone may not justify surgery because surgery frequently will not alleviated pain.

    Wise.

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