A friend of mine has been having bad headached, including electrical shocks that about knock her down; I've seen her in a darkened room, lying on her bed, holding an ice pack to her head, and crying. She is a strong woman and continues to work, so I am writing on her behalf to ask your opinion of her cervical MRI results and what should be done regarding them.
FINDINGS: There is a loss of the normal cervical lordosis. Vertebral body heights are maintained. No sublaxation is seen. There is multilevel degenerative disk disease with mild disk space narrowing at the C4-5 and of more moderate severity at C5-6 and C6-7. Craniocervical junction is normal.
At C3-4, there is posterior disk osteophyte complex, including a small focal central component which abuts and deforms the ventral cord along the midline. There is effacement of the thecal sac with moderate-to-severe central canal narrowing. There is bilateral uncinate process hypertrophy. Neural foramina appear patent.
At C4-5, there is posterior disk osteophyte complex with right-greater-than-left uncinated process hypertrophy. There is severe central canal narrowing with deformity of the underlying cord. There is a mild neural faraminal narrowing bilaterally.
At C5-6, there is large posterior disk osteophyte complex. There is right-greater-than-left uncinate process hypertrophy. There is severe central canal narrowing with deformity of the underlying cord. There is severe right-greater-than-left neural foraminal narrowing.
At C6-7, there is posterior disk osteophyte complex. There is moderate central canal narrowing. There is bilateral uncinate process hypertrophy. There is severe bilateral neuroal foraminal narrowing.
The C7-T1 level is relatively unremarkable.
IMPRESSION: Severe cervical spondylosis with severe spinal stenosis and mild cord compression at multiple levels, as decribed above.
It is impossible to know if her headache is related to her neck. Atypical migraines can be another possiblity. An epidural for her neck is reasonable to try first and see what symptoms, if any, are improved. Neck surgery for headaches is a very difficult proposition and may not be as helpful as one hopes. Surgery for neck and arm pain can be helpful in many instances. She needs a thorough evaluation and physical examination by a spine surgery specialist.
Her neurologist read the results and called before their scheduled follow-up to tell her that she needed to see a neuro-surgeon. Her physical therapist read it and said "you understand you'll be needing surgery, right"?
My question was asking how long recovery from surgery for this condition of cervical spine take. I didn't ask if it would cure headaches; The findings on the MRI show much that could cause spinal cord damage if it is not dealt with. I looked at her MRI, compared it with mine, and even as a layperson I could see that it is in serious condition. The white part of the spinal cord on the T2 images is just about completely obscured.
I appreciate your taking the time to answer; I wish you could have taken a little more time to read. I also wish that there wasn't such a limit on how much one can post, or I would have been able to tell you that she has neck and shoulder pain, occasional pain and tingling in her wrists/hands, as well as her neuologist's response to the report.
I wanted to help her prepare for the time she needs to take off to work, give her some idea of possible scenarios. I realize you are limited in your ability to offer help online, but I am very disappointed.
The only way to determine if surgery is needed is to actually perform a physical exam and correlate with the mri....something not possible on the internet. Sorry you were dissapointed but your request for "input" was a bit nonspecific.
My question was "Surgery for this condition; how long is recovery?" I thought that was specific.
I do understand that you can't do a physical exam on the internet, and I was just grasping at straws, hoping you could tell me the possible surgeries and recovery times for a cervical spine in this condition.
I would have been more specific, if space had allowed. I thought it was important to put all the specifics of the MRI report, so you could have the most information. Unfortunately, that didn't leave me room to be more specific about anything else.
My friend will be seeing her neurologist before long, and will learn more from her, and will be referred to a neurosurgeon, who will be able to give her more information. She is understandably concerned, and I was hoping to find some more information to give her some idea of what to expect. Waiting is so difficult.
You must work all the time! Two responses, nearly 12 hours apart!
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