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Neurology (Expert Forum)
C4567 Severe degeneration
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C4567 Severe degeneration
by nerval, Sep 23, 2002 12:00AM
40 yr old female, recurring pain at base of neck, numbness and tingling down arms, loss of forearm and strength on left side the first onset 16 years ago, nothing significant found but sent for traction to relieve pain. Pain on and off for next six years, same symptions, MRI showed protruding disc C5-C6, no surgery recommended. Traction, exercise and massage therapy used to reduce pain, but present at all times.
Last recurrence this year, now constant radiation down arms, outside two fingers both hands intermittent numbness, coldness. Right thumb and forefinger involuntarily contracting, tingling left thumb and now pins and needles down back of buttucks, legs and bottoms of feet with sharp needling pain in back left heel when I bend over.
Recent xrays also shows anterior and posterior osteophytes, with marked lipping on right side, waiting for MRI results. Any suggestions - I am thinking anterior cervical fusion but wonder about so many discs involved and option for artificial disc replacement.
Last recurrence this year, now constant radiation down arms, outside two fingers both hands intermittent numbness, coldness. Right thumb and forefinger involuntarily contracting, tingling left thumb and now pins and needles down back of buttucks, legs and bottoms of feet with sharp needling pain in back left heel when I bend over.
Recent xrays also shows anterior and posterior osteophytes, with marked lipping on right side, waiting for MRI results. Any suggestions - I am thinking anterior cervical fusion but wonder about so many discs involved and option for artificial disc replacement.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Sep 26, 2002 12:00AM
Sounds like you may have maxed out on conservative therapy for your C5-6 disk herniation with possibly new problems in the lower back. The more prominent symptoms (which appear to be in the neck) theoretically should be fixed first. The specific surgical procedure depends on the appearance of the spine anatomy, disease state, and surgeon's preference.Without reviewing your films, I would have to defer to your neurosurgeon or orthopod. In the meantime, take it easy. Don't lift anything heavier than a gallon of mild. try NSAIDS like Motrin or even newer generation ones like Celebrex, and do light stretching and exercise. Nothing intense. An MRI of your Lumbosacral spine may be indicated to evaluate the pain radiating from the buttocks to the legs. GOod luck.
Member Comments (8)
by nerval, Sep 23, 2002 12:00AM
Forgot to note that last xrays show severe degeneration C4-5, C5-6 and C6-7, slight degeneration and lipping C3-4. Any comments would be greatly appreciated - I am worried about surgery.
by pandora8687, Sep 24, 2002 12:00AM
To: Nerval
I'm 6 months post-op from pretty much the same thing as you have.I had ACDF at three levels along with instrumentation. Not too many problems following the surgery except for swallowing, still have that. Started having some new symptoms or should I say, recurrent symptoms. Had MRI which showed C5/6 posterior osteophyte causing severe canal stenosis, I go to the Dr. in two days to see what we're going to do about it. C5/6 happens to be one of the areas that were fused. So to let you know, when you go back to the Dr. for your results and if surgery is one of your options, just ask him/her about more osteophytes forming where you would have surgery. I'm not sure how common this is and finding info about it has been kind of hard but I do wish you all the luck in the world. Just follow what the Dr. has to say and if for some reason you don't like what is being said, don't be afraid to go to someone else, afterall, it's happening to you and not them. Best wishes.
by nerval, Sep 27, 2002 12:00AM
To: MRI results
mild retrolisthesis of C4 on C5 and C5 on C6 compatible with degenerative subluxation given the diffuse disk height loss at these levels. No evidence of significant malalignment or aggressive bone abnormality. C2-3 small central disk herniation w/o high grade mass effect on thecal sac or spinal cord. C3-4 small cnetral disk herniaton with some mild mass effect on thecal sac w/o h.g. cord compression or any significant heural foraminal exit stenosis. C4-5 marked broad based disk osteophyte complex mildly compresses the anterior aspect of thecal sc with moderate spinal canal stenosis evident w/o evidence of h.g. stenosis, any other spinal canal mass or focal cord signal abnormality. Mild bilateral neural foraminal exit stenoses are apparent. C5-6 similar but lesser broad based disk osteophyte change with lateral changes create moderate bilateral right greater than left n.f.e.s. and only mild spinal canal compression w/o evidence of high grade spinal cord compression. C6-7 very mild symmetric disk bulging creating only very mild spinal canal narrowing w/o any significant n.f.e.s. No significant paraspinal abnormality.
by On the up side, Oct 12, 2002 12:00AM
You need to find yourself a really good neurosurgeon. Take tinker's advice and have a fusion. I have been a neurospine surgical nurse for 11 years and have seen great results with what is currently available. It is not necessary to live with that kind of pain. Understand, you will never be 100%, but you will be better. I can't stress enough, make sure you find an excellent Neurosurgeon, not orthopod!! Any questions, please ask me.
by nerval, Oct 15, 2002 12:00AM
thanks for your comments. I have a referral to Dr. Neil Duggal at London Health Sciences Centre in Ontario, Canada. He is the first neurogsurgeon in North America to do a synthetic disc replacement as well as regular fusion, so I am quite pleased. Still using NSAIDS, which works to bring down inflamation and pain. We shall see!
by Blueknight1213, Oct 22, 2002 12:00AM
Thank Goodness I have found a place for problems with cervical. I fell at work in Dec 2001 and ws treated for neck sprain and shoulder sprain at the Emergency Room. In February 2001 I started having bad headaches, unable to sleep due to neck pain and shoulder pain. In March 2001 I went to an Orthopedic Dr and found I had severe degenerative arthritis in c2-3,c4-5, c6-7 with spinal stenosis. Also had subacromial impingement in shoulder. They did surgery on shoulder and it is better but neck is still giving me fits. I have lost ROM to both sides and have severe loss holding head up. I have been to PT continually and has not helped. One Neurosurgeon said non-surgical and I have appt with another to see if anything can be done. I cannot work because I can't keep my head up after being up for 4 or 5 hours it wants to go to my chest. I have headaches continually and shooting pains throughout neck and shoulders. I take Celebrex and Skelaxin but don't help. Having problem with tremors in shoulders and spine area. I'm 55 and never really been sick in my life. I know what this pain is and I feel sympathy for anyone else with it.
by nerval, Oct 22, 2002 12:00AM
To: blueknight
I don't know yet if I am a candidate for surgery - I am still waiting for my appt with neuro to be confirmed, which in Canada could be a one to two year wait if I am not emerg. Since I've lived with the pain