What Is The Minimal Degenerative Changes Of The Lower Cervical Spine ?

Posted on Mon, 9 Nov 2020

Mon, 9 Nov 2020 Answered on

Wed, 7 May 2025 Last reviewed on

Question : About 3 month ago, I started having numbness in my right upper back (diminished or no feeling when scratch or touch the area). A about a week later the numbness spread to my right arm/hand, and a few days later to my right leg/foot which is been gradually worsening. It has also spread to my lips. Sometimes a have a tingling feeling in the right ear (no pain). My right arm feels very weak at time I have been having spills of dizziness on and off (wavy feeling). I have noticed some erectile dysfunction in the last 2-3 months. I have had on/off chest pain for the last six months (negative cardiac workup). I have also noticed some tremor in my jaw and and hands (more for on the right hand). Sometimes I feel that my internal body is shaking. I have been increasingly feeling fatigued over the last few weeks with some sporadic pain throughout the body (. I have seen a neurologist and he ordered a brain and c-spine MRI. All blood work has been normal so far
MRI Result
Comparison: MRI dated April 20, 2016. FINDINGS: HEAD: No evidence of recent or remote intracranial hemorrhage or infarction. Normal signal intensity of the brainstem. Again noted small left sub lenticular prominent perivascular space. No hydrocephalus or intracranial mass. Normal brainstem and cerebellum. No intraorbital, sellar or parasellar abnormalities. The visualized upper spinal cord is normal with unremarkable craniocervical junction.
CERVICAL SPINE: At C4-C5 level there is small central disc protrusion indenting the ventral surface of the cord without compression. No neural foraminal narrowing. At C5-C6 level there is mild diffuse disc osteophyte complex with left-sided predominance without significant neural foramen or spinal canal stenosis.
IMPRESSION: No intracranial abnormalities. Minimal degenerative changes of the lower cervical spine as described above.

Answered by Dr. Dr. Erion Spaho (2 hours later)

Brief Answer:
Thyroid gland function and CSF examination are necessary.

Detailed Answer:
Hello again.

I have read your new query and the MRI report.

Since the MRI of your brain and cervical spine didn't show any conditions mentioned in our previous conversation that may justify your symptoms, it is necessary for further tests in order to achieve a correct diagnosis.

Blood tests to evaluate thyroid gland function, and spinal tap to examine the cerebrospinal fluid for a possible multiple sclerosis ( oligoclonal bands ), are necessary.

Low vitamin B12 is another possible explanation for these symptoms, but you are using supplements, so, this possibility is minimized.

Discuss with your Doctor these issues.

Hope you found the answer helpful.

Feel free to ask if you have further questions.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Erion Spaho (18 hours later)

I did thyroid functions about 4 months ago which were normal. Is it possible for it to be MS without brain or cervical lesions?

Answered by Dr. Dr. Erion Spaho (1 hour later)

Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

The brain MRI is positive for multiple sclerosis lesions in the majority of the patients with the definite disease, even if the diagnosis is achieved clinically the MRI may show no lesions in about 5% of the patients.

In the initial phases, there may be no lesions at all in the MRI.

Hope this helps.

Take care.

Above answer was peer-reviewed by : Dr. Yogesh D