Question
I'm writing because my Neurosurgeon has asked my insurance for authorization based on my MRI and we are now on a second appeal because they denied. I also sent another question today because I have both Lumbar and Cervical problems. My recent cervical MRI was on 6/12/14. Findings: Visualized brain and skull base demonstrate no acute findings. Prevertebral soft tissues are normal. Mild leftward curvature is seen of the cervical spine. Vertebral body height are presented. There is mild spondylosis. Minimal retrolisthesis is present of C3 over C4. There is disk desiccation throughout the entire cervical spine and upper thoracic spine. Moderate disc narrowing is at C5-6. There is mild disc narrowing at C6/7. Imaged cervical spinal cord demonstrates normal signal with no evidence myelomalcia or mass lesions. Soft tissue of the neck are unremarkable. The atlantoaxial joint is normal. Sagittal images demonstrate a small posterior disc osteophyte complex at C2/3 with no significant stenosis. C3/4: A 3mm posterior disc bulge is present along with mild facet hypertrophy. There is minimal central canal stenosis. Mild right neural foraminal canal stenosis is seen. C4/5: A 3mm posterior disc bulge is present along with mild facet hypertrophy, there is minimal central canal stenosis as well and minimal bilateral neural foraminal canal stenosis. C5/6: A 2mm posterior disc bulge is noted along with mild facet hypertrophy and right unconvertbral joint hypertrophy. There is overall mild central canal stenosis. AP dimension is 9mm moderate right neural foraminal canal stenosis.  C6/7: A 1mm disc bulge is present along with mild facet hypertrophy and uncovertebral joint hypertrophy. there is no central canal stenosis. Mild bilateral neural foraminal canal stenosis are noted. C7/T1: A 3mm posterior disc bulge is present that leads to mild central canal stenosis. The AP dimension is 10mm, no neural foraminal canal stenosis is seen. There is mild rightward curvature of the thoracic spine. A Small round structure of high T1 and T2 signal with scattered tiny low signal foci is observed of the T5 vertebral body that most likely represents a hemangioma. Tiny posterior disc bulges are noted of the upper thoracic spine with no significant stenosis. Impression: Stable multilevel degenrative changes most significant at C5/6 with mild central canal stenosis and moderate right neural foraminal canal stenosis at level C7/T1. There is also mild central canal stenosis. Can you tell me if surgery is needed or is the insurance right in denying twice allready. Thank You, Amy Casper

Answer
Hello, Amy,

Bulging discs, dessication (dehydration) and narrowing; curvature and displaced vertebrae come from chronically contracted neck (cervical) and thoracic spinal muscles.

Surgery can't help that; you need neuromuscular retraining to regain the ability to relax those muscles.

Please read the following entries for understanding and a fruitful course of action:

http://somatics.com/whiplash.htm
http://somatics.com/HSEdescription.htm
http://somatics.com/back_pain_terms.htm (for "disc bulge/herniation")

So, although the insurance people don't understand the condition you're dealing with, their denial is to your benefit.