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Cervical spine
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Cervical spine

I have had annoying neck problems for 7 or 8 years.  Nothing that didn't clear up in a few days on it's own until just recently.  Two months ago, I had severe neck, arm, etc. pain. I was sent for an MRI and here are the results.

Mild to moderate reversal of the cervical lordosis at C5 and C6 levels. There is reversal of the normal lordosis with mild hypertrophy of the posterior longitudinal ligament along the c6 certebral body, resulting in mild to moderate flattening of the anterior aspect of the spinal cord. The spinal canal measures 8 mm in the AP dimension at the level c6. This is consistant with patients clinical symptoms. There is no buldging or herniation at any levels. The vertebral hights are well maintained. The cervical medullary junction is within normal limits. The marrow and paravertebral soft tissue are unremarkable as well.

My questions are:
Is this a birth defect?
Since I have no buldging or herniations, would surgery be ncessary?
If surgery was necessary, what would be done?
I am in my late 40's, a smoker (but trying very hard to quite)
My current symptoms are all on my left side. Numbness in three fingers, with only one (the index finger) being very annoying because it feels like it wants to lock up. And an occational weird sensation down my arm. I am not currently in pain, but very worried that any surgery is going to start a domino effect on my some what healthy spine.  Thank you for your thoughts! Lin

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Dear Lin:

I cannot tell you that what the MRI showed is a congenital defect, but I think not.  The reversal of the usual lordotic curve of the spine means that these vertebrae are pushing anterior just alittle and therefore changing the curve of the spine.  There doesn't seem like your spine is being compromised much and that is good.  I can't see your film so I can't make a judgement about surgery.  But, I would think that surgery is not a priority yet.  I would see your neurologist and see what medical things can be initiated.  Likely, you will need alittle physical therapy and excercises to initially decrease the irritation of the nerves then to halt the process that is inducing the change in your spine.

Sincerely,

CCF Neuro MD
19 Comments
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Dear Doc, I've had an Anterior Fusion on c4,5,6 and 7 last year. Can I resume a normal life as well as physical activity? Please let me know. Hans
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Dear Hans:

Unfortunately, that is a question for your rehab team and neurosurgeon.

CCF Neuro MD
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what does miminam anterior compression of t12 is seen with sclerosis and osteophytes.. anterior osteophytes are seen at 4-5 and 5-1 mean???
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Dear Denise:

What did your neurologist tell you?  The vertebrae at T12 is slightly compressed at the front, with boney formations at the same area with inflammatory changes that have caused boney changes.  There are boney changes in the vertebrae 4-5 and 5-1.  You did not tell me which vertebrae. likely the lumbar and lumbar sacral.

Sincerely,

CCF Neuro MD
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Avatar_n_tn
Dear Dr:

In August 1999, I awoke with a stiff neck, the orthopedic started treating as if TOS.  To no avail, I had an MRI in January 2000 -
Early degenerative disc disease from C2-3 to C4-5 with straightening and slight reversal of the cervical curvature, central disc herniation at C4-5, slightly deforming the sac.

4 months of physical therapy has not helped and the orthopedic and neorologist do not feel that the herniation or the degenerative disc disease are that bad.  I have arm numbness (shoulder down to arms), tingling of the hands while I sleep. Both arms.  When I raise my arms, the shoulders and the biceps feel heavy and week. My arms are dead after one minute on the UB arm bicycle.  I also have a constant pain in my neck, just at the start of the back.  Limited mobility and pain when I put my head forward and side to side.

Is any of these symptoms due to the straightening of the spine, degenerative disc disease or could this all possible be related to my shoulders???
Any ideas of where to go next?
I appreciate any comments you can make.

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Avatar_n_tn
Dear Sheila:

Sorry to hear about your pain and numbness.  Before you procede further with the TOS thought, it is very rare entity.  I would recommend an EMG before any surgery is considered. If there are no systemic diseases, then I would suggest that you talk to your neurologist about what he/she feels is going on.  It might be due to the cervical spine, but I can't tell over the internet.  You may want to seek a second opinion from another neurologist.  What do your rehab PT and physician tell you?  

CCF Neuro MD
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For over a year, I've had a pain in my neck that traveled down my right arm and felt very tender in my right shoulder blade.  The pain would last for several days and then would lessen, but not fully recover.  I started to see a chiropractor who took an x-ray of my cervical spine and informed me that my neck curve bends outward rather than inward, as it is suppose to.  Over the past year I've felt ok, but still have episodes every couple of weeks of the pain that travels.  He sent me for an MRI and informed me that I have a buldging disk between the 3rd & 4th veribrae in my neck.  He said that I would not need surgery, but I should make an appointment with my primary care doctor to review options for treatment.  He said that sometimes they try to treat this with a very heavy dose of anti-inflamitory drugs for about 2 weeks, or with epidoral treatments if the drugs did not work.

Is a buldging disk a common ailment?  Has history shown successful treatment with anti-inflamitory drugs or epidoral treatments (what are epidoral treatments anyway?)?  Will this be a reoccuring problem or once treated will it be gone for good?  How does this ailment come about (injury, or caused by my "deformed neck")?

I'm 33 years old and have never had any health problems of any signifigance.  Please explain my problem to me - thank you.
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Avatar_n_tn
For over a year, I've had a pain in my neck that traveled down my right arm and felt very tender in my right shoulder blade.  The pain would last for several days and then would lessen, but not fully recover.  I started to see a chiropractor who took an x-ray of my cervical spine and informed me that my neck curve bends outward rather than inward, as I'm told that it is suppose to.  Over the past year I've dealt with the pain, but still have episodes every couple of weeks of the pain that travels and incapacitates my mobility.  He sent me for an MRI and informed me that I have a bulging disk between the 3rd & 4th vertebrae in my neck.  He said that sometimes it's treated with very heavy doses of anti-inflammatory drugs for about 2 weeks or with epidural treatments if the drugs did not work.

Is a buldging disk a common ailment?  Has history indicated successful treatment with anti-inflammatory drugs or epidural treatments (what are epidural treatments anyway?)?  Are these treatments just masks that will cause the bulging disk to reoccur?  How does this ailment come about (injury, or caused by my "deformed" neck curvature)?

I'm 33 years old and have never had any health problems of any significance.  Can you explain exactly what a bulging disk is, treatment options, and if this is something that I'll have to suffer with for the rest of my life.

Thank you for your help.
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Avatar_n_tn
I just recently had an MRI which showed I have a moderately large left paracentral disc herniation C5-C6 with a deformity of the vertical thecal sac and displacement of the loft C6 nerve root.
Also theres moderate spinal and neuroforaminal stenosis at this level.

I also have a right paracentral disc herniation at C6-C7which touches the right nerve root.

It has been suggested I have Anterior Cervical Fusion but I was wondering if a Percutaneous Cervical Discectomy might do the trick.

I am told that my spinal cord has degenerated and is compressed.  Is there any kind of physical therapy, chiropractic care or exercise I can do to prevent surgery all together
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Avatar_n_tn
What procedures would you do to investigate someone's posture profile. i.e whether they have excessive lordosis or thoracic kyphosis
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Avatar_n_tn
I have been diagnosed with reversed cervical lordosis from C4-C7 with disc bulge at C5-6 and C6-7.  My questions are:
What is lordosis?
And is it a result of an older injury?
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Avatar_n_tn
4 years ago my wife had a cervical dicetomy in her neck, performed by doctor todd albert at the u.of penn.recently her symptoms are returning,neck arm and shoulder pain. were fereful somthing could be wrong what do we do thank you.
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Avatar_n_tn
Hello I am currently researching cervial spine injuries for a assignment and I would really love it if u could help me.  My questions are;
Why would a patients neck be sore and stiff if they have had no injury to the neck. But have slight scolisis, narrowing of c5-c6, and anterior and lateral osteophytes?
Would the osteoplhytes affect the patients range of neck movement?
Why was the onset of pain and stiffness so sudden (patient had pain and unable to move neck in mornings for one week)?
What nerves would be affected?
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Avatar_n_tn
My husband is 56 yrs old and has some slippage between C1 and C2. There is no encroachment on the spinal cord at this time. He is relatively sedentary and not engaged in any sports. We are discussing whether or not to have surgery to fuse these segments to prevent a potentially life threatening problem or to wait and have a follow up MRI in six months since he has no apparent symptoms at this time. Please advise us as to what questions we should ask the neurosurgeon to help us make an informed decision. Thanks
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Avatar_n_tn
Dear Dr:  

In October 2000, I awoke one morning with pain and stiffness in my upper back, with the pain radiating into my left shoulder and left upper arm. After approximately one-month of PT treatments (electrical stim; gentle stretches; massage), and even a few accupuncture treatments, the pain continued, actually growing worse over the four weeks.

Last week, I finally had an MRI of my C-Spine performed, since non of the above treatments were helping with the pain.  The salient portion of the MRI results reads as follows:

'C2-3; C3-4; C4-5; C5-6; C7-T1 levels show no significant abnormality.'

'C6-7 level shows dorsal osteophytes with interposed disc.  There is a disc herniation extending centrally and to the left of midline.  There is a mild bilateral uncinate process hypertrophy.  There is moderate to severe central spinal stenosis, but no cord compression is seen.  There is moderate to severe left lateral recess stenosis.  There is mild bilateral foraminal stenosis.'

The pain continues, often extreme.  My primary care physician (a D.O.) has prescribed PT treatments x3/week, and has also referred me to another D.O. Neurologist for some 'release(?)' treatments??  (Have not yet started these and have no idea what they are).

Otherwise, I am a 48 y.o. male in very good health.  I am mildly obese, but with no chronic, underlying disease or pathology.  Heretofore, I have not felt 'old or infirmed,' but feel as though my whole life is now controlled by this condition and the pain and discomfort it brings.  I AM WORRIED SICK ABOUT THIS AND WANT TO BE ABLE TO CHART A COURSE OF ACTION, BUT HAVE NO IDEA WHERE TO GO FOR OTHER OPINIONS OR INFORMATION REGARDING MY CONDITION.  

Does this mean I will progressively worsen until I am 'crippled?'  Is there something POSITIVE I can do now to slow down or stop the progression of this condition?  I have also stopped ALL ACTIVITIES (walking, jogging, weightlifting, biking) because I am terrified that I'll make the condition worse.  The longer I remain inactive, the more depressed and dispondent I become.  Can you offer any general advice?
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Avatar_n_tn
Dear Dr:  

In October 2000, I awoke one morning with pain and stiffness in my upper back, with the pain radiating into my left shoulder and left upper arm. After approximately one-month of PT treatments (electrical stim; gentle stretches; massage), and even a few accupuncture treatments, the pain continued, actually growing worse over the four weeks.

Last week, I finally had an MRI of my C-Spine performed, since non of the above treatments were helping with the pain.  The salient portion of the MRI results reads as follows:

'C2-3; C3-4; C4-5; C5-6; C7-T1 levels show no significant abnormality.'

'C6-7 level shows dorsal osteophytes with interposed disc.  There is a disc herniation extending centrally and to the left of midline.  There is a mild bilateral uncinate process hypertrophy.  There is moderate to severe central spinal stenosis, but no cord compression is seen.  There is moderate to severe left lateral recess stenosis.  There is mild bilateral foraminal stenosis.'

The pain continues, often extreme.  My primary care physician (a D.O.) has prescribed PT treatments x3/week, and has also referred me to another D.O. Neurologist for some 'release(?)' treatments??  (Have not yet started these and have no idea what they are).

Otherwise, I am a 48 y.o. male in very good health.  I am mildly obese, but with no chronic, underlying disease or pathology.  Heretofore, I have not felt 'old or infirmed,' but feel as though my whole life is now controlled by this condition and the pain and discomfort it brings.  I AM WORRIED SICK ABOUT THIS AND WANT TO BE ABLE TO CHART A COURSE OF ACTION, BUT HAVE NO IDEA WHERE TO GO FOR OTHER OPINIONS OR INFORMATION REGARDING MY CONDITION.  

Does this mean I will progressively worsen until I am 'crippled?'  Is there something POSITIVE I can do now to slow down or stop the progression of this condition?  I have also stopped ALL ACTIVITIES (walking, jogging, weightlifting, biking) because I am terrified that I'll make the condition worse.  The longer I remain inactive, the more depressed and dispondent I become.  Can you offer any general advice?
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Avatar_n_tn
Dear Dr:  

In October 2000, I awoke one morning with pain and stiffness in my upper back, with the pain radiating into my left shoulder and left upper arm. After approximately one-month of PT treatments (electrical stim; gentle stretches; massage), and even a few accupuncture treatments, the pain continued, actually growing worse over the four weeks.

Last week, I finally had an MRI of my C-Spine performed, since non of the above treatments were helping with the pain.  The salient portion of the MRI results reads as follows:

'C2-3; C3-4; C4-5; C5-6; C7-T1 levels show no significant abnormality.'

'C6-7 level shows dorsal osteophytes with interposed disc.  There is a disc herniation extending centrally and to the left of midline.  There is a mild bilateral uncinate process hypertrophy.  There is moderate to severe central spinal stenosis, but no cord compression is seen.  There is moderate to severe left lateral recess stenosis.  There is mild bilateral foraminal stenosis.'

The pain continues, often extreme.  My primary care physician (a D.O.) has prescribed PT treatments x3/week, and has also referred me to another D.O. Neurologist for some 'release(?)' treatments??  (Have not yet started these and have no idea what they are).

Otherwise, I am a 48 y.o. male in very good health.  I am mildly obese, but with no chronic, underlying disease or pathology.  Heretofore, I have not felt 'old or infirmed,' but feel as though my whole life is now controlled by this condition and the pain and discomfort it brings.  I AM WORRIED SICK ABOUT THIS AND WANT TO BE ABLE TO CHART A COURSE OF ACTION, BUT HAVE NO IDEA WHERE TO GO FOR OTHER OPINIONS OR INFORMATION REGARDING MY CONDITION.  

Does this mean I will progressively worsen until I am 'crippled?'  Is there something POSITIVE I can do now to slow down or stop the progression of this condition?  I have also stopped ALL ACTIVITIES (walking, jogging, weightlifting, biking) because I am terrified that I'll make the condition worse.  The longer I remain inactive, the more depressed and dispondent I become.  Can you offer any general advice?
Blank
Avatar_n_tn
Dear Dr:  

In October 2000, I awoke one morning with pain and stiffness in my upper back, with the pain radiating into my left shoulder and left upper arm. After approximately one-month of PT treatments (electrical stim; gentle stretches; massage), and even a few accupuncture treatments, the pain continued, actually growing worse over the four weeks.

Last week, I finally had an MRI of my C-Spine performed, since non of the above treatments were helping with the pain.  The salient portion of the MRI results reads as follows:

'C2-3; C3-4; C4-5; C5-6; C7-T1 levels show no significant abnormality.'

'C6-7 level shows dorsal osteophytes with interposed disc.  There is a disc herniation extending centrally and to the left of midline.  There is a mild bilateral uncinate process hypertrophy.  There is moderate to severe central spinal stenosis, but no cord compression is seen.  There is moderate to severe left lateral recess stenosis.  There is mild bilateral foraminal stenosis.'

The pain continues, often extreme.  My primary care physician (a D.O.) has prescribed PT treatments x3/week, and has also referred me to another D.O. Neurologist for some 'release(?)' treatments??  (Have not yet started these and have no idea what they are).

Otherwise, I am a 48 y.o. male in very good health.  I am mildly obese, but with no chronic, underlying disease or pathology.  Heretofore, I have not felt 'old or infirmed,' but feel as though my whole life is now controlled by this condition and the pain and discomfort it brings.  I AM WORRIED SICK ABOUT THIS AND WANT TO BE ABLE TO CHART A COURSE OF ACTION, BUT HAVE NO IDEA WHERE TO GO FOR OTHER OPINIONS OR INFORMATION REGARDING MY CONDITION.  

Does this mean I will progressively worsen until I am 'crippled?'  Is there something POSITIVE I can do now to slow down or stop the progression of this condition?  I have also stopped ALL ACTIVITIES (walking, jogging, weightlifting, biking) because I am terrified that I'll make the condition worse.  The longer I remain inactive, the more depressed and dispondent I become.  Can you offer any general advice?
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