Cervical/Thoracic Surgery

[Boodoe]

Subject: Verebras keeps slipping out in the Cervical and Thoracic spine.  When the Disc in the Cervical spine come out of alignment, I can't focus my eyes, I am dizzy and I have excruciatin pain up the left side of my head.  I continually go to the Chiropractors. My Neurologists and PCP tells me not to go to a Chiropractor.  What do you think?  My Neurologist calls some of the head pain I have "Ice-Pick" headaches, but, when I get the Chiropractor to move C1 & C2, the pain immediately stops.  No pill will make the pain stop.  C6 & C7, when they are out of alignment, I have a pinching pain that runs down my shoulder and sometimes a numb feeling in the left arm, along with this pressure at the base of my skull. I feel about crazy until the bones are put back.  Every time I sit down on soft surfaces, these bones come out of place. What can I do to keep the bones from slipping out?  If anything.  Would Physical Therapy be an option?  Like training the muscles around these bones to strenghthen up so the bones would not slide out of place!  I had two MRI's which read:

C5-C6:  There is a central disc bulge versus small central disc protrusion causing mild impression on the anterior thecal sac.  The neural foramina are widely patent.
C6 & C7:  There is broad-based annular bulge causing mild impression on the central thecal sac.  The neural foramina are widely patent.  No focal cord signal abnormality is seen.
T4-T5:  There is a tiny focal annular bulge to the left of the midline at T4-T5.  No other disc abnormality is identified.  The vertebral bodies and intervertebral discs otherwise appear normal.  No focal cord signal abnormality is seen.  What is your reccomendation and diagnosis?

[Kathi50]

First of all...STOP with the Chiropractor.  Sorry, don't mean to sound abrupt but the doc here is right...discs just don't pop in and out.  If they did, your whole spine would be popping in and out and that just does not happen. :)  I also realize no med will touch the pain...I had the same thing.  Ask your Neurologist about Occipital Neuralgia and/or Cervicogenic headaches.  And, YES, both can and do cause dizziness...and more than likely coming from the C2/C3 (perhaps a pinched nerve).  However, my ORIGINAL culprit was the C3/C4.  Injections from a good spinal pain management doctor can determine where the pain generators are.  Anyway, long story short...I had a fusion done of the C3/C4.  But I know the C2/C3 has some spurring or rather an osteophyte complex with facet arthritis...soooo...I am having the old head pain again.  But, hopefully, a facet injection will help pretty soon.  But please, STOP with the manipulations.  

[Stephen Ryu, MD]

Sorry for your problems, but there are some philosophical issues here that might not get resolved.

For medical doctors, discs do not go in and out of alignment just like that. They are usually in alignment or not. So, I don't know why you have dizziness and problems focuing your eyes. That is not from your neck. Pain up the back of your head can be from your neck if one of the nerve high up is pinched. I don't mind chiropractors until they start claiming they can treat medical disorders with manipulation and when they manipulate necks that clearly have bad spinal disease. But their fixes usually don't last very long - so you have to keep going back to them.

I don't really believe anyone can specifically C1 and C2 - they are really really deep inside and cannot be touchd - C2 lies straight through the back wall of your mouth (really) and C1 sits above than and from behind 5 inches deep at the very very base of the skull. But interestingly, compression the C2 nerve can cause pain up the back of the head. - best way to check this is have an injection of the nerve and see if they can deaden it. If so, you might have a compression there.

As for C6-7- I don't think the discs are out of alignment but you bones move around and they could cause a pinch. Physical therapy can help you build up strength. If not, surgery will prevent bones from moving by fusing them together - the problem is, even with fusing to prevent movement, people have pain - that is one of the reasons we don't believe that 'slipping' causes the problem - you can fix the 'slip' but the pain is there - why?

Avoid things that make you feel worse - like soft surfaces.

Finally, your MRI implies there is nothing pinching anything.You hve some disc bulging at C5-6 C6-7 - very common, usually doesn't need anything done, yet.

[Boodoe]

Subject: Verebra keeps slipping out in the Cervical and Thoracic spine.  When the Disc in the Cervical come out of alignment, I can't focus my eyes, I am dizzy and I have excruciatin pain up the left side of my head.  I continually went to the Chiropractors.  My neurologists calls some of the head pain I have "Ice-Pick" headaches, but, when I get the Chiropractor to move C1 & C2, the pain immediately stops.  No pill will make the pain stop.  C6 & C7, when the are out of alignment, I have a pinching pain that runs down my shoulder and sometimes a numb feeling in the left arm.  Every time I sit down on soft surfaces, these bones come out of place. What can I do to keep the bones from slipping out?  If anything.  I had two MRI's which read:

C5-C6:  There is a central disc bulge versus small central disc protrusion causing mild impression on the anterior thecal sac.  The neural foramina are widely patent.
C6 & C7:  There is broad-based annular bulge causing mild impression on the central thecal sac.  The neural foramina are widely patent.  No focal cord signal abnormality is seen.
T4-T5:  There is a tiny focal annular bulge to the left of the midline at T4-T5.  No other disc abnormality is identified.  The vertebral bodies and intervertebral discs otherwise appear normal.  No focal cord signal abnormality is seen.  What is your reccomendation and diagnosis?