There is extensive literature documenting that spinal imaging is essentially worthless for anything but showing what is causing the radiculopathy after the clinical diagnosis of radiculopathy has been made.
Of the two causes for 98% of the patients with chronic headaches, neck and/or upper back pain (facet joint or discogenic pain), an MRI, CT or myelogram is incapable of distinguishing asymptomatic patients from those with pain.
It almost exclusively distinguishes 15 year olds from 40 year olds because the aging changes that are medically called spondylosis and inaccurately referred to as degenerative changes NEVER cause pain.
They may predispose a patient to an injury that causes pain, but they don't cause it (thus, you have an "eggshell skull" case).
The disc ages in two ways:
The center part of the disc (the nucleus) has no blood supply and gets its nutrition from the cartilage on the vertebral endplates above and below each disc.
As the person goes beyond the mid teens (autopsies during Viet Nam showed the disc degeneration had already begun by the late teens), the nucleus that is initially 80% water gradually dries out and gets chunky.
Also as we age, the disc anulus gets small tears and loses structural integrity after any one of the countless twisting movements we make in life.
Neither of these changes causes pain, and there is extensive scientific literature (some of it award winning) proving it's correct.
At the same time the boney spine builds up perfectly normal bone on top of other perfectly normal bone.
Bone spurs are examples of this.
Unless the buildup is extensive enough to narrow the central spinal canal where the spinal cord (in the neck or mid back) or cauda equina (in the low back) is enclosed and can be compressed, the central buildup is irrelevant.
Similarly, if it happens to a sufficient degree laterally to compress the neuroforamen where a nerve root exits (the narrowing can be the result of a combination of bone buildup and disc compression and/or bulging) and causes a radiculopathy it would be significant but without a radiculopathy it is not.
The page of polysyllabic discussion on the MRI report is an accurate description of these changes but could be summarized with "normal for age" and be just as accurate and helpful.
The long and detailed reports typically change neither the diagnosis or the treatment.
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