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Back and Neck Degenerative Disease and Stenosis
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Back and Neck Degenerative Disease and Stenosis

Hi.  I'm a 52 year old woman who in the last year was diagnosed with spinal stenosis in the back and neck.  Neck is the worst.  My MRI findings of the neck state:  There is disc degeneration at all cervical disc levels except C7-T1 and this relates to disc degeneration.  Marked disc narrowing at C4-5, C5-6, C6-7 due to degeneration.  Signal changes in vertebral endplates at C5-6 and C6-7.  There is spondylosis with disc bulging and bony spurring at C2-3 but no central or foraminal stenosis.  C3-4 level, disc bulging and spondylosis.  No cord compression.  C4-5 level, marked spondylosis with bony spurring and disc bulging.  This leads to narrowing of the intervetral foramina to a fairly marked degree.  Borderline changes from mild central spinal stenosis.  At C5-6 level, marked spondylosis is present with foraminal narrowing which is prominently bilaterally but more marked on the right.  Bony spurring and disc bulging leads to borderline changes from mild central stenosis.

C6-7 moderate spondylosis leads to moderate bilateral foraminal narrowing but no central spinal stenosis.  
Conclusion:  Spondylosis at multiple levels.  Finds most prominent at C4-5 and C5-6 where borderline changes from mild central spinal stenosis are seen

Lumbar MRI indicates:  Disk space narrowing and disk deslocation at T12-L1, L2-3 and L4-5 levels due to disk degeneration.  There is a Schmorl node in the interior endplate at L4.  There is apophyseal joint degenerative change at the L4-5 and L5-S1 levels.

Disk bulge at L2-3 level.  There is compression of the thecal sac which is borderline for mild central spinal stenosis.  There is also congenital shortening of the pedicle at this level and also at the L3-4 and L4-5 levels.

There is a mild disk bulge at L3-4 level.  Borderline changes from mild central spnal stenosis due to the disk bulge and the shortened pedicles.

At L4-5 level, a bulging disk is present.  This leads to compression of the thecal sac.  The posterior ligaments are prominent and the pedicles are congenially shortened.  There is mild central spinal stenosis.

At the L5-S1 level, there is a disk bulge.  There is an annular tear along the posterolateral right-sided disk margin.  There is no central or foraminal stenosis.

Conclusion:  There is mild central spinal stenosis at the L3-4 and L4-5 levels.

Sorry so long, but I need some answers.  I have an ortho & neuro doc.  The ortho took one look at the cervical MRI and was very worried.  Said the words "if I'm not careful I could end up like Chris Reeves" and that I would need surgery down the road for my neck.  This, of course, freaked me out.  I only take Advil for the pain.  The pain is more prominent in the lower back.  He does not give me anything else.  My neuro is in agreement with possible surgery but only until I have issues with numbness and weakness.  I do get electrical sensations in my legs from time to time and I have been experiencing lightening bolt flashes across my eyes.  I've been to an ophthmalogist and ruled out any retinal changes.  I also am being treated for a large hiatal hernia and GERD that gives me problems.  They also wanted to do surgery but I don't want it.  I've also been tested for MS and Lupus because of a lesion on my brain.  But that was negative.  I'm still not convinced.  I have been forcing myself to start working out after coming home from work to strengthen myself as I became a bit sedentary the last year or so due to this problem.  I used to be very exercise-conscious and in good shape.

The problem I am facing now is that I keep having the feeling of something stuck in my throat.  I'm not sure if it's from GERD or if perhaps a bony spur is pressing on something if that is even possible.  I'm starting to feel the neck problems and cannot wear anything heavy around my neck.  That is when the feeling of something in my throat becomes more prominent.  It comes and goes.  I'm worried.  And I don't know which way to turn or who to turn to first regarding this issue.  Could you give me any insight?  I'm worried about neck surgery and the fact that I would have to be out of work for quite awhile.  I just don't know who to call first about this issue.  I haven't felt good in a year.  Also, I am postmenopausal due to a total hysterectomy and am on hormone replacement therapy.  My prescription was lowered last year and right after that is when I really started having problems so now they have moved it back up thinking that I am deteriorating quickly.  

Please help!
Thank you.
A. Moore
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I am sorry to hear of your continued health problems.  You do present with a complex set of symptoms that may or may not be linked to each other.
The MRI reports do indicate multi-level degenerative disease in your cervical and lumbar spine.  The cervical spine appears to have more definitive abnormalities than the lumbar spine, primarily at C4-C5 and C5-C6 where there is evidence of spinal stenosis and narrowing of the neural foramen (through which the spinal nerve roots travel).
Multi-level spondylosis (vertebrae are slipping forward in relation to adjacent vertebrae)
It would seem, based on these findings that you would be having more severe symptoms of pain and nerve problems related to your neck rather than your low back.
It does look as though you will require surgery to your neck based on the multi-level problems noted.
The lumbar spine shows degenerative changes but not as prominent as the cervical spine.  Should the degenerative process continue in the lumbar spine, you may also need surgery in this area
I don't think that any bone spurs or other problems are causing your problems with swallowing or feeling that something is stuck in your throat as the spinal column is located behind the esophagus.  It could be related to innervation changes from the degenerative discs causing nerve irritation.  (Just a possible cause -- not definite)
The hiatal hernia and the GERD would seem more related to this problem.  
Are your physicians aware of these symptoms?
Are you contemplating neck surgery at any time in the near future?
I had anterior cervical discectomy and fusion C4-C7 done approximately 2 months ago and was restricted to not lifting greater than 5#  and no twisting/bending for just the initial two weeks postop.  Unless you have a labor intensive job, sedentary or minimally physical activity would not be prohibited after a short recuperative period. It would depend on the extent of the surgery and whether your doctor advocates wearing a neck collar postop.  My neurosurgeon does not have his patients wear collars after surgery as he feels the hardware stabilizes the neck sufficiently.  
What type of work are you currently doing?  Are your supervisors aware of your medical problems?  
There are a lot of issues that need to be addressed on a very personal level before proceeding with surgery.  The risk of potential permanent damage without surgery should be discussed with your ortho and neuro physicians.
Post with an update and any additional questions/concerns you may have.
Best wishes ----
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Avatar_f_tn
Your problems sound much like my own and I empathize with you....I am 56 and after complaining about a stiff neck was sent for xray then MRI...Surprise.......
Focal kyphosis C3-C7...discs are narrowed from 3-7
These are all cervical, no one has looked any further than my neck
anterior cord margin is slightly flattened behind 6/7 and 5/6 also at 5/6 moderate diffuse disc protrusion/osteophyte complex
3/4 shows disc protrusion with osteophyte complex
6/7 broad based central and right paracentral disc protrusion/osteophyte complex
Doc said 3 herniated discs
flattening of right ventral cord
kinda on and on
conclusion:
Kyphotic cervical curvature. Moderate to severe dengerative disc and facet disease
mild central stenosis and anterior cord flattening
Uncinate hypertrophy
foraminal stenosis
no abnormal cord signal seen (yippee this is good huh?)
Particularly severe 2 through 4 facet hypertrophy...
Also am on hormone replacement therapy and living a pretty good quality of life..
soooooo how can this be and what is to be done.
am going for PT and doc mentioned surgery  but am really new to all this and am searching for answers.
This was not an accident, never have had an accident...Go figure.
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Avatar_n_tn
Sorry to hear of all of your spine problems. I know what it is like. I have already had a laminectomy at my L4-5 and my orthopedic surgeon who performed the surgery said that he knew I was going to experience a lot of difficulties with my back which I have. Mostly degenerative disease and arthritis. I also have DD in my neck also which I am now having investigated. In November I was diagnosed also with hypothyroidism. After much reading about it, I have learned that one of the symptoms involves a difficulty in swallowing. You might want to have your doctor run a blood test and check for problems with your thyroid. Hope things clear up for you.
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Avatar_f_tn
I had c3 -c6 disc replacement surgery 2 weeks ago.  I need to know what "normal" pain is and what pain I should be worried about.  I wear a soft brace at home, which is ALL the time, and a Miami  J when outside which is NEVER!  I can't get anyone to tell me what is normal.
I can't bathe, clean or cook a meal, but no one can tell me why that movement is bad, my doctor just says don't!
Can anyone help me understand why I am not supposed to turn my head or raise my arms?  Why do I have sharp pains between my shoulders and down my arms?  Is this normal?
I know I am not alone, and I told my doctor he needs to be more forthcoming with the why's and why nots, even then he did not bother to help.
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Avatar_f_tn
Perhaps the lump in throat sensation is relted to allergies.  GERD could be as well.
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