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Back and Spine Surgery (Expert Forum)
Cervical disk issues
Answered by
Paul J Slosar - Spine Surgery, low back pain, neck pain, Whiplash, artifical disc replacement
SpineCare Medical Group
San Francisco - CA
Questions in the Back and Spine Surgery forum are being answered by Paul J. Slosar, MD, President, SpineCare Medical Group of Daly City, CA.
Cervical disk issues
by JT37, Oct 08, 2008 12:21PM
Dear Doctor,
I’m a 40 year old male, very active and in good health except for following issues. I had some neck accidents doing sports (snowboarding, kitesurfing) and for a few weeks am having moderate pain on my right arm and shoulder. Had an MRI with the following results:
C4-C5: Disc height and signal are relatively well maintained. A right paracentral focal disc protrusion is identified. Protruding disc material extends approximately 3mm dorsal to the back of the vertebral body with impingement upon the central and right anterolateral aspect of the spinal cord. Effacement of the CSF from around the spinal cord is noted in keeping with mild central spinal canal stenosis. Neural foramina appear widely patent bilaterally.
C5-C6: Disc height and signal appear well maintained. A broad disc bulb is identified. Superimposed left posterolateral focal disc extrusion is identified. Disc material extends into the proximal aspect of the left neural foramen. Associated impingement upon the left anterolateral aspect of the thecal sac noted as well as upon the axilliary and neural foraminal component of the left C6 nerve root. Mild broad annular disc effacement of the ventral thecal sac and mild cord contact. Right neural foramen appears patent.
C6-C7: Mild loss of disc height and signal. A broad annular disc bulge is identified with superimposed right paracentral focal disc protrusion. Protruding disc material extends to impinge upon the right anterolateral aspect of the spinal cord as well as upon the axillary and neural femoral component of the right C7 nerve.
Trying to get an appointment with a neurosurgeon but nothing available for a couple of months. What’s the prognosis and recommended treatment? Is surgery recommended? What kind of surgery? Can I continue exercising or stop completely for a while?
Thank you for your help and I’m sorry for the long email.
Joe
I’m a 40 year old male, very active and in good health except for following issues. I had some neck accidents doing sports (snowboarding, kitesurfing) and for a few weeks am having moderate pain on my right arm and shoulder. Had an MRI with the following results:
C4-C5: Disc height and signal are relatively well maintained. A right paracentral focal disc protrusion is identified. Protruding disc material extends approximately 3mm dorsal to the back of the vertebral body with impingement upon the central and right anterolateral aspect of the spinal cord. Effacement of the CSF from around the spinal cord is noted in keeping with mild central spinal canal stenosis. Neural foramina appear widely patent bilaterally.
C5-C6: Disc height and signal appear well maintained. A broad disc bulb is identified. Superimposed left posterolateral focal disc extrusion is identified. Disc material extends into the proximal aspect of the left neural foramen. Associated impingement upon the left anterolateral aspect of the thecal sac noted as well as upon the axilliary and neural foraminal component of the left C6 nerve root. Mild broad annular disc effacement of the ventral thecal sac and mild cord contact. Right neural foramen appears patent.
C6-C7: Mild loss of disc height and signal. A broad annular disc bulge is identified with superimposed right paracentral focal disc protrusion. Protruding disc material extends to impinge upon the right anterolateral aspect of the spinal cord as well as upon the axillary and neural femoral component of the right C7 nerve.
Trying to get an appointment with a neurosurgeon but nothing available for a couple of months. What’s the prognosis and recommended treatment? Is surgery recommended? What kind of surgery? Can I continue exercising or stop completely for a while?
Thank you for your help and I’m sorry for the long email.
Joe
Doctor's Answer
by Paul J Slosar, Oct 08, 2008 06:18PM
, Oct 08, 2008 06:18PM
Tough to tell which of those disc levels is the culprit until you get examined by the surgeon. Epidurals can be very useful as a first line of treatment before considering surgery. If you can exercise without aggravating the symptoms it is good to keep moving. Take it easy if symptoms are disabling. An orthopedic spine surgeon is another good choice rather than waiting for the neurosugeon :)
Good luck
Good luck
