Back & Neck Community
I'm contemplating surgery - is it time?
About This Community:

This patient support community is for discussions relating to back and neck problems, exercise, pain, sleeping, and physical therapy.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

I'm contemplating surgery - is it time?

I need some help translating my results.  I have met with two neurosurgeons in the past 3 months, have been in PT for 7 weeks and chiropractor 3 weeks and massage 1x/mo.  I have had an epidural and left shoulder block, neither of which lasted very long (maybe 2 weeks).  Mayfield clinic is recommending that we do 3 fusions on C4-5, C5-6 and C6-7. I spoke with both the chiropractor and physical therapist today, and they seemed to concur with the assessment as we are only getting nominal results and we should be seeing much more than what we have. I am only 40 years old and this is all somewhat overwhelming.  Any help you can give me translating these tests would be greatly appreciated.  I was trying to do my research piecemeal online when I came across your sight and thought that maybe I could get a more comprehensive evaluation of these tests in layman's terms.  I have no idea what most of these words mean.  I fully understand that I will need surgery eventually, but need to evaluate if now is the time or if it can be delayed.

MRI results:

FINDINGS: No cerebellar tonsillar ectopia.  Craniocervical junction and C1-2 articulations are normal.  Straightening of lordosis is evident.  C2-3 shows shallow disc bulge.

C3-4 shows uncovertebral join spurring and facet arthropathy with mild rightward foraminal narrowing.

C4-5 shows diminution of normal disc height.  Spondylotic disc protrusion and uncovertebral join spurs contribute to moderate to servere left and moderate rightward neural foraminal narrowing and central canal impingement.  Slight mass effect upon the ventral cord is noted.

C5-6 shows retrolisthesis, spondylotic disc protrusion and uncovertebral joint spurs with severe biforaminal narrowing and mild central canal and recess stenosis with mass effect upon the ventral cord.

C6-7 shows bilobed spondylotic disc protrusion and uncovertebral joint spurs with severe right and moderate leftward neural foraminal narrowing.

C7-T1 and upper thoracic spine show no compressive disc abnormality.  Hemangioma is within the T4 vertebral body.

No cord myelomalacia, myelitis or mass.  No soft tissue mass.

CONCLUSION:
1. Moderate and severe foraminal impingement at C4-5, C5-6 and C6-7 from spondylotic disc protrusions and uncovertebral joint spurs without lateralizing soft disc component.
2. Moderate central canal and recess narrowing at C4-5 and C5-6.  Mass effect upon the cord is noted with flattening without reactive edema.

EMG Results:

The nerve conduction studies were normal.  The patient has an obvious tremor that can be seen in most of the muscles on the needle portion of the EMG.  She has what appears to be a chronic C5-6 radiculopathy with complex repetitive discharges in the deltoids and chronic decreased motor unit recruitment in the scapular muscles.  The C5-6 radiculopathies are bilateral.

Impression:  Chronic C5-6 radiculopathy bilaterally

NCV & EMG Findings:  All nerve conduction studies (as indicated in the following tables) were within normal limits.

Needle evaluation of the left deltoid muscle showed slightly increased spontaneous activity, slightly increased polyphasic potentials and diminished recruitment.  The right deltoid muscle showed slightly increased polyphasic potentials and diminished recruitment.  The Left supraspinatus muscle showed slightly increased spontaneous activity and diminished recruitment.  The Left infraspinatus and Right infraspinatus muscles showed diminished recruitment.  The Right supraspinatus muscle showed early recruitment.  All remaining muscles (as indicated in the following table) showed no evidence of electrical instability.

X-RAY RESULTS (XR Spine-cervical>=6 views):

Findings:  Normal cervical vertebral boides.  Loss of the normal cervical lordosis.  There is posterior subluxation C4 on C5 measuring 3 mm.  Advance degenerative disc disease C4-5 and C5-6.  Bilateral uncovertebral osteophyte formation producing component of neural foraminal narrowing.  Normal preverebral soft tissues.

Impression:  C4-5 and C5-6 degenerative disc disease.

Sorry to create such a long inquiry.  I'm just trying to wrap my mind around this whole thing before making this very big decision
351246_tn?1379685732
Hi!
I am sorry to hear about your medical problems. Instead of going in depth into the findings, I would just say that you have degenerative disc disease with slipped disc that is likely to cause pressure on the cord (C4-7)—there is flattening but no edema or swelling indicating that there is no pressure or break in the transmission of signals as also indicated by the EMG studies. However, you appear to be having cervical radiculopathy due to probably pressure on the spinal nerves caused by narrowing of the foramen or holes through which the nerves pass.
While most things are being tried in your case find out whether traction, spinal manipulation, dry needing and acupressure will help in your case. You could also wear a cervico-thoracic brace to correct he spine posture. If all this does not help, then you could probably opt for surgery. Please take a second opinion from a spine specialist in your area. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Back & Neck Community Resources
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank
Top Pain Answerers
7721494_tn?1408157057
Blank
philnoir
Four Corners, CO
Avatar_m_tn
Blank
Kalvin
Milwaukee, WI
1326416_tn?1370930601
Blank
shinty
Just south of Boston, MA
8221281_tn?1397574572
Blank
Pantx
Denton, TX
1613542_tn?1366472143
Blank
bigsissie
MO
1248623_tn?1406812015
Blank
EdwardPB
Pontiac, IL