Brief Answer:
Progressive degenerative disease in the neck.

Detailed Answer:
Hey XXXXXXX Welcome back to HealthCareMagic. Thanks for complimenting me like that. Though I wouldn't suggest you do it again. My God complex is alive and well.

Now to your latest scan. Line by line as before, shall we?

SCAN SAYS: 1. Multilevel cervical spondylosis as described in detail below. This results in mild central canal stenosis at multiple levels as well as moderate right foraminal stenosis at C4-C5 and moderate left foraminal stenosis at C6-C7.

ME: The radiologist STARTS the sentence by generalizing and saying that she / he is seeing lots of degenerative changes in the neck. Thats what cervical spondylosis means. The central canal of the spinal COLUMN is narrower than usual at multiple levels, which means the spinal CORD is probably feeling a little tighter than it should be, it also means that even a slight inflammatory reaction (say bruising from a violent jolt to the neck) would worsen your symptoms pretty severely.
The radiologist points out that at C4-5 the spinal nerve leaving the spinal COLUMN is getting pinched. That would mean to me that your right shoulder and arm should be showing symptoms of weakness, or numbness or pain. If they are not, then the finding is irrelevant. The same thing is happening on the left side at C6-7 (which I think we saw on the earlier scan as well, I'd have to eyeball the scans myself to see if the C6-7 level has gotten worse or stayed the same).

Onward.. we go...

SCAN SAYS: 2. A left central disc herniation at the C7-T1 level abuts the ventral T1 nerve root on the left as it arises from the upper thoracic card. Corresponding impingement is not excluded.

ME: So between C7 and T1, there's a disc right? The intervertebral disc that we talked about before. That disc is pancaking (flattening) out... The edge of the disc is now starting to touch the nerve T1. Which supplies sensation to your chest below the collar bone, your upper back and parts of your arm and forearm. If you have any pain or numbness in these areas, then the impingement is real. Otherwise, the process hasn't begun to affect the nerve yet.

I'm glad your gonna go to a spine surgeon. I think it's important that you get an opinion. I think some judicious interventions in the neck at least would do you some good. More importantly though.. your ENTIRE SPINE seems to have been affected by some sort of inflammatory process. You are too damn young to have your spine look like this. So I need you to start looking into other issues. For instance, do you have osteoporosis? Do you smoke? Are you clinically obese? Do you have an autoimmune disease or a thyroid problem? All of those are processes that could cause your spine to degenerate like this but there are more. I would like you to discuss the possibilities with your PCP and also maybe look into seeing a Rheumatologist to rule out an autoimmune issue.

I'm grasping at straws here. The big limit of services like HealthCareMagic is that I never get to eyeball the patient or their entire medical history. So I'm working on scraps... but I can't shake the feeling that we are missing something here. I may be over-reacting and this may be plain old arthritis of the spine.. It's just that I'm having trouble matching that idea to your age.

Anyways. You're always welcome to follow-up and bounce ideas off of me. If anything else seems pertinent to you, throw down and we will integrate it into our discussion.

Sorry for the delay in answering you. Am going on a bit of a vacation with my girlfriend and will be back in XXXXXXX on Monday. I still have my laptop on me though so you can drop me a line whenever you want. Will answer when she goes for a swim or something.

Catch you later XXXXXXX take care,

Vin

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