Hello All,
I have been suffering from CFS/ME and POTS for 5 years. I have had
NO response to the typical medications prescribed for CFS/ME and POTS. Dietary and lifestyle changes have somewhat helped me marginally manage my illness. Like may others, this has caused me to think spinal mechanical issues may be at the root of my illness.
Specifically:
- CSF Leak - Front runner at this point. All my symptoms are orthistatic and relieved within 30 minutes of lying completely flat. Plus I have a lot of trigeminal nerve and ear/hearing problems. It appears these types of symptoms are commonly linked to CSF Leak. I'm already working with Duke, UTSW, and Cedar-Sinai on a proper CSF Leak work-up.
- Cervical spinal stenosis - Second place. I have a 2016 cervical MRI which shows multiple problems. See report details below.
- CCI - It's on the table, but I have my doubts. I don't think I have any hypermobility symptoms. Perhaps, the opposite. My PT tells me my back is very stiff and guarded. Also, my symptoms don't seem to be exacerbated by turning or rotating my neck.
- Tethered cord - On the table, but I haven't done any research.
- Chiari malformation - Doubtful. I have two 3T brain MRI's which show very normal Chiari formation.
Can anyone help me with the following questions?
- Cervical spinal stenosis: Can someone point me to a good article or write up that summarizes cervical spinal stenosis? i.e. symptoms, imaging, diagnosis, treatment, etc.
- Tethered Cord: Can someone point me to a good article or write up that summarizes tethered cord? i.e. symptoms, imaging, diagnosis, treatment, etc.
- Chiari malformation: Does two normal brian MRI's with and without contrast rule-out this condition? Can someone point me to a good article or write up that summarizes chiari malformation? i.e. symptoms, imaging, diagnosis, treatment, etc.
- Are there other spinal mechanical issues that I should consider?
Results from 2016 T1.5 Cervical Spine MRI with and without contrast:
Morphology: The vertebral bodies are well maintained and show normal signal characteristics.
Alignment: Cervical spinal alignment is normal.
Cord: The spinal cord shows normal contour and signal content throughout its length. There is no abnormal enhancement within the spinal canal.
Craniocervical Junction: Cerebellar tonsils are normally positioned. The visualized portions of the posterior fossa are unremarkable. The regional osseous anatomy is normal.
C2-C3: Unremarkable.
C3-C4: Unremarkable.
C4-C5: Mild osteophytic ridging and uncovertebral spurring. The central canal and bilateral neural foramina are mildly narrowed.
C5-C6: Left paramedian disc osteophyte and bilateral uncovertebral spurring left worse than right. The central canal is mildly narrowed. The left neural foramen is moderately narrowed. The right neural foramen is mildly narrowed.
C6-C7: Right paracentral disc osteophyte. Bilateral uncovertebral arthropathy.The central canal and bilateral neural foramina are mildly narrowed.
C7-T1: There is a broad-based posterior disc osteophyte with bilateral uncovertebral spurring. The central canal is mildly narrowed. The left neural foramen is mildly narrowed. The right neural foramen is patent.
Soft tissues: The paraspinous soft tissues are normal.
IMPRESSION: Multilevel spondylosis as described above. No evidence of focal cord lesion.