My MRI images

pattismith

Senior Member
Messages
2,306
Likes
4,246
hello @sb4
I just had my cervical supine RMI done today, and it looks rather similar to your, with a small hernia( C5-C6 for me).
I'd like to do some pictures and mesures, what software should I use?
Any advise on this would be welcome, thanks!
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
hello @sb4
I just had my cervical supine RMI done today, and it looks rather similar to your, with a small hernia( C5-C6 for me).
I'd like to do some pictures and mesures, what software should I use?
Any advise on this would be welcome, thanks!
Did you have it done at medserena or elsewhere? Did the images come with software or just raw images?
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
@JenB I rarely use facebook so I am having some difficulty at understanding the layout. I click on discusions tab and I see the top posts I guess but I would have no idea where to post my images or how to view similar threads of other peoples images.
 

pattismith

Senior Member
Messages
2,306
Likes
4,246
@pattismith You have any luck with that software?
Hello @sb4 , thank you for your help, i finally managed to open the pics with the Software in the mri disc ! I will try to do some measures when I will back home. The radiologist said nothing significant, but the hernia leaves a free space for the cord that is about 10 mm or less so it seems consistant with a moderate stenosis. My transverse ligament seems similar to yours .
 
Messages
65
Likes
152
hello @sb4
I just had my cervical supine RMI done today, and it looks rather similar to your, with a small hernia( C5-C6 for me).
I'd like to do some pictures and mesures, what software should I use?
Any advise on this would be welcome, thanks!
Have you decided whether to treat it or not? I know thats a big choice to make, the cost / benefit is very difficult to estimate considering there's no guarantee that such a surgery will help you. That being said there's still a chance that it might.
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
Have you decided whether to treat it or not? I know thats a big choice to make, the cost / benefit is very difficult to estimate considering there's no guarantee that such a surgery will help you. That being said there's still a chance that it might.
There is no way I can afford surgery, especially considering how at the moment, I think based on my MRI that it could be causing or at least significantly contributing to my autonomic dysfunction but it could also not, or only be having a mild effect. I am really not sure at this point but at the moment leaning slightly in the direction of it being significant.

Either way my treatment plan would be non surgery.
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
Hello @sb4 , thank you for your help, i finally managed to open the pics with the Software in the mri disc ! I will try to do some measures when I will back home. The radiologist said nothing significant, but the hernia leaves a free space for the cord that is about 10 mm or less so it seems consistant with a moderate stenosis. My transverse ligament seems similar to yours .
Interesting. When you makes some measurements will you post them in this thread? I will be interested in comparing.
 

pattismith

Senior Member
Messages
2,306
Likes
4,246
Have you decided whether to treat it or not? I know thats a big choice to make, the cost / benefit is very difficult to estimate considering there's no guarantee that such a surgery will help you. That being said there's still a chance that it might.
I don't Know yet but there is very little chance that I might be offered any surgery for such benign stenosis. Surgery here seems to be proposed to patients who have motor or reflexe deficit only.
 

pattismith

Senior Member
Messages
2,306
Likes
4,246
@sb4
My grabb oakes measure is below 9 mm so still correct, even though my transverse ligament seems a bit thickened; Did you measure your grabb?
My stenosis is about 10 mm at C5-C6 and C6-C7.
I didn't expected much more from this MRI, the question now is wether or not the stenosis and concomittant instability of these 3 vertebras are potentially involved in my symptoms or not....

grabboakes.jpg
stenose.jpg
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
@pattismith I measured my grabb-oakes however it wasn't pathological. I think something like 7mm. Although comparing our images my upper spinal cord seems to bend more at this point.

I get about the same readings at you for the stenosis lower down.

Yeah the million dollar question is, is it causing symptoms. I wonder why your images look at lot clearer than mine? Perhaps I was moving too much.
 

pattismith

Senior Member
Messages
2,306
Likes
4,246
@pattismith I measured my grabb-oakes however it wasn't pathological. I think something like 7mm. Although comparing our images my upper spinal cord seems to bend more at this point.

I get about the same readings at you for the stenosis lower down.

Yeah the million dollar question is, is it causing symptoms. I wonder why your images look at lot clearer than mine? Perhaps I was moving too much.
Yes, I think you were sitting, whereas I was lying supine with a special pillow under my neck.
I learned from Small Fiber Neuropathy that polymorphism in the voltage gated sodium channel in the nerve can produce gain of function involved in this disease...So I wonder if this kind of polymorphism could be involved for some of us, making us more sensitive to any strain on our spinal cord...just a wild hypothesis...
 

pattismith

Senior Member
Messages
2,306
Likes
4,246
I forgot to say that I had a previous Xray in 2017 that showed arthrosis in C4-C5.
When i went to the osteopath in july this year, he told me my neck is deviated to the left, and took a photo to show me.
I had a look at my 2017 xray, and yes the deviation was already there. I can find it also on the last MRI.
I would like to know what is producing this deviation...
 

sb4

Senior Member
Messages
1,160
Likes
1,857
Location
United Kingdom
I have gotten my report back from Professor Smith and on the whole everything seems normal. The only abnormal things brought up were:
-Mild posterior annular bulges at C4/5 and C5/6 however this doesn't impinge on the nerve root or the spinal cord.
-Cervical spine angle measurement of extension was 72.1 degrees with normal mean values being 32 and upper limit 55 degrees. This may suggest increased flexibility however no element of ligament laxity, spinal instability, or fluctuating spinal stenosis.
-In neutral, the clivo-vertebral angle is estimated at 145.3 degrees (normal range 150-180).
-On turning to the right there are 35 degrees of rotation of the atlas over the axis which is at the upper limits of normal. No evidence of subluxation of the facets of the atlantoaxial joint to suggest atlantoaxial instability.

On the whole I am disappointed. I still don't know whether or not my symptoms are likely to be coming from my neck or not. The report notes the same things we noted but the way it was written seems to suggest they are of no concern. They being C4/5 5/6 bulges and clivo-vertebral angle being a little below range.

The fact that my neck extension was 72 deg with the upper limit being 55 and mean 32 indicates I do have connective tissue problems when taken in the wider context of things like TMJ, etc. It is annoying as well because for both flexion and rotations I could have gone a lot further however the head brace they put you in wouldn't let me. Makes me wonder if they would have shown up as increased flexibility.

I notice on @Hip survey (which I will now fill out) Smith dx the majority (53%) as okay yet Gillette has around 90%. Perhaps I would get some kind of dx from him but is he over-diagnosing or is Smith missing more subtle ques?

@pattismith @jeff_w @JenB @borko2100 @valentinelynx
 
Last edited:

Hip

Senior Member
Messages
13,051
Likes
24,243
I notice on @Hip survey (which I will now fill out) Smith dx the majority (53%) as okay yet Gillette has around 90%. Perhaps I would get some kind of dx from him but is he over-diagnosing or is Smith missing more subtle ques?
Looking at the 15 patients (so far) in the CCI survey who had their scans viewed by Prof Smith:

8 of these 15 were diagnosed negative fro CCI by Prof Smith. And 6 out of these 8 negative cases were diagnosed positive by Dr Gilette. So there are 6 discrepancy cases where Prof Smith diagnosed CCI negative, but Dr G diagnosed CCI positive.

In 5 of these 6 discrepancy cases, the pathological measurement detected by Dr G was the translational BAI, which is a measurement Dr G utilizes, and I believe Dr H does also, but it is not usually taken into consideration by Dr B (as Dr B does not usually look at images in flexion and extension, which are required to measure the translational BAI).

2 out of the 5 also had a pathological CXA as well as a translational BAI.

All 6 discrepancy cases were also positive for atlantoaxial instability (AAI).



You have a low number of cervical medullary syndrome (CMS) symptoms, just 3 out of 32. CMS symptoms are usually present in CCI, AAI, Chiari and cervical spinal stenosis. Most of the people in the survey diagnosed positive for CCI, AAI or related conditions had in the range of 12 to 28 CMS symptoms. Although there are a handful of positive cases in the survey where the number of CMS symptoms is low, in the range of 5 to 8.



It is annoying as well because for both flexion and rotations I could have gone a lot further however the head brace they put you in wouldn't let me. Makes me wonder if they would have shown up as increased flexibility.
Dr B points out that one issue with flexion and extension images is that the angle of head tilt is not standardized, so you get different amounts of tilt from different MRI setups.
 
Last edited: