Question
I am a 41 year old female, who has been suffering with shoulder, arm and neck pain for almost 2 years. My doctor is pretty sure a pinched nerve is involved in my cervical spine. I recently had a new MRI done and have not yet seen my doctor since the results. The report lists annular bulges and osteophyte formations at most levels of my cervical spine,  but one thing on the report has me concerned and I cannot seem to find any information on it. It is quoted as, "At the C2-3 through C3-4 levels, there is a contour impression of the spinal cord with widening on the dorsal subarachnoid space. It is suspicious for a subarachnoid cyst with slight atrophy of the spinal cord." What is a subarachnoid cyst? Is it dangerous? I work at a job which requires some lifting, reaching, tugging and pulling throught the day, could this cause further injury?

Answer
Dear Ms. Downton,

The Brain and Spinal cord are enveloped in three covering layers called meninges. From outside to inside, these layers are called Dura, Arachnoid, and Pia. An Arachnoid cyst is a cavity filled with normal spinal fluid, which can form outside the Dura or inner to it. The cause of these cysts is not very clear, and more often than not, they are incidental findings on MRI, and require no treatment.
On the other hand, an Arachnoid cyst might at times compress the nerve tissue of the spine and require surgical intervention. Compression at the C2-3-4 levels will usually not cause the type of pain you describe, and the cause of your pain should probably be found elsewhere, but I cannot state that with absolute certainty without examining you first.
I suggest you see your Physician so she/he can evaluate the MRI and decide if your clinical signs and symptoms correlate with the radiological findings.

Sincerely,

Dr. N. Rahamimov