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Neurology (Expert Forum)
Cervical Stenosis, Spondylosis, Annular Tear and Scoliosis in Thoracic Spine
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
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Cervical Stenosis, Spondylosis, Annular Tear and Scoliosis in Thoracic Spine
by INGRASS, Dec 13, 2006 12:00AM
I have posted before on 09/01/06 and 09/30/06.
I have recently returned from my follow-up appointment at the well respected place and have absolutely wonderful news. There is NO progression of my stenosis from last year and in fact, I was told that there is a very good probability that I will never need surgery for any of my spine issues. Words cannot express how wonderful this was to hear.
I had an appointment there with the neurologist that I saw last year and then the mri of my cervical and thoracic spine. I had a brief follow up appointment with the same neurologist the next day. I did not post the new mri pictures this time as I haven't received the CD and as you said, the quality from the CD is pretty poor. Here's the new mri report though:
13Nov2006 4:11pm Exam: MRI CSP & THSP wo
Indications: mri cap/tap - spinal stenosis^cervical; pain thoracic spine.
ORIGINAL REPORT - 13 Nove 2006 4:36PM GONDA
MR cervical and thoracic spine without contrast.
Stable when compared to prior evaluation dated 10/19/05.
Reversed lordosis, apex at C6. Spondylotic changes at C3-4 through C6-7, with moderate to severe central canal stenosis at C5-6 and C6-7, due to osteophyte disk complex, and without cord parenchymal signal change. Mild to moderate left neural foraminal narrowing at C6-7. Remainder of the cervical examination is otherwise unremarkable.
Focal annular tear at T7-8, with disk material contacting and without deformation of the ventral cord. Mild endplate osteophytic changes at T3-4 and T4-5, result in mild effacement of the (con't below)
I have recently returned from my follow-up appointment at the well respected place and have absolutely wonderful news. There is NO progression of my stenosis from last year and in fact, I was told that there is a very good probability that I will never need surgery for any of my spine issues. Words cannot express how wonderful this was to hear.
I had an appointment there with the neurologist that I saw last year and then the mri of my cervical and thoracic spine. I had a brief follow up appointment with the same neurologist the next day. I did not post the new mri pictures this time as I haven't received the CD and as you said, the quality from the CD is pretty poor. Here's the new mri report though:
13Nov2006 4:11pm Exam: MRI CSP & THSP wo
Indications: mri cap/tap - spinal stenosis^cervical; pain thoracic spine.
ORIGINAL REPORT - 13 Nove 2006 4:36PM GONDA
MR cervical and thoracic spine without contrast.
Stable when compared to prior evaluation dated 10/19/05.
Reversed lordosis, apex at C6. Spondylotic changes at C3-4 through C6-7, with moderate to severe central canal stenosis at C5-6 and C6-7, due to osteophyte disk complex, and without cord parenchymal signal change. Mild to moderate left neural foraminal narrowing at C6-7. Remainder of the cervical examination is otherwise unremarkable.
Focal annular tear at T7-8, with disk material contacting and without deformation of the ventral cord. Mild endplate osteophytic changes at T3-4 and T4-5, result in mild effacement of the (con't below)
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 07, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
I am glad to hear that your spinal stenosis has not progressed. Your current MRI report relates significant stenosis without a pathologic signal changes in the spinal cord. When stenosis progresses to pinch the spinal cord this can lead to pain, weakness, numbness/tingling and even bowel/bladder incontinence. If you develop these symptoms (especially the bowel and bladder incontinence) you should have new imaging as soon as possible. Foraminal narrowing as noted on your MRI can lead to problems if significant enough such as pain, sensation changes and even weakness. Focal annular tears are a common cause of chronic back pain, that is often refractory to treatment. You post relates "(con't below)", but I am unable to view the rest of your post. I am sorry if I did not address any further questions you may have posted. In addition, your previous posts are no longer loading (?)
I hope this has been helpful.
I am glad to hear that your spinal stenosis has not progressed. Your current MRI report relates significant stenosis without a pathologic signal changes in the spinal cord. When stenosis progresses to pinch the spinal cord this can lead to pain, weakness, numbness/tingling and even bowel/bladder incontinence. If you develop these symptoms (especially the bowel and bladder incontinence) you should have new imaging as soon as possible. Foraminal narrowing as noted on your MRI can lead to problems if significant enough such as pain, sensation changes and even weakness. Focal annular tears are a common cause of chronic back pain, that is often refractory to treatment. You post relates "(con't below)", but I am unable to view the rest of your post. I am sorry if I did not address any further questions you may have posted. In addition, your previous posts are no longer loading (?)
I hope this has been helpful.
So, with this great prognosis, I am ready to get on with my life.
I am currently being offered a full-time job (which I have actually been doing for 2 weeks on a temporary basis) and am ready to accept the permanent position. The position requires sitting at a computer all day.
The reason that I am writing is due to the fact that I am still experiencing the significant pain and muscle spasms in my mid to lower back that I previously wrote about. The pain is there daily and brought on by sitting. It started suddenly and I have had it for about 6 months now. It is interspersed with burning and stabbing pain and is not being completely controlled despite 1000 mg of Relafin, 8 mg of Tizanidine, 60 mg Cymbalta and the Tylenol that I have been supplementing all of this with. I have also continued to utilize the new therapy pool at our local YMCA several times a week.
The pain is interfering with my decision to accept the position and I would really like to find out the cause of it so that I may seek appropriate intervention without the need to take yet another drug. There is some possibility that I can delay my start date as the company's hiring season runs from January through March.
The neurologist at the well respected place told me that the pain was not coming from anywhere in my spine and the thoracic issue, in fact, did not even need to be followed. More great news!
Since my spine has been ruled out as the cause of this back pain and muscle spasm, could you possibly tell me where else this pain could be coming from? What other systems could be generating it? What type of doctor might be able to help me figure this out?
Thanks so much. I very much appreciate your responses.
I've printed out a lot of the material on Dr. Bookspan's website. Looks like I have a lot of work to do! Thanks.
Here is part of the neurologists notes from my two recent visits:
As recorded on electronic neurologic record of November 13, 2006, She is right-handed, alert, oriented and displays normal language and conversational speech. Cranial nerves 2 through 12 are unremarkable. No carotid bruits. Muscle stretch reflexes are moderately hypoactive in the upper extremities, but they are symmetrical. In the lower limbs they are normal, reactive and symmetrical and plantar responses are flexor. On general motor survey gait, station, coordination, and alternate motion are normal. No tremor dystonias. Good range of motion of the cervical and lumbar spine. No paraspinal spasm. Muscle strength is normal There is no muscle atrophy. Sensory examination is unremarkable.
MRI of the cervical and thoracic spine were obtained and compared with the previous MRI of 10/19/05. The findings have remained stable. There continues to be moderate to severe central canal stenosis