HERNIATED CERVICAL DISKS

[Frank]

HERNIATED CERVICAL DISC: My MRI Conclusion: C6-C7 broad Herniated Nucleus Propulsis; C5-C6
     retrolisthesis*** and suspected cord gliosis from myelomalacia; multilevel spondylosis and uncinate process
     degenerative change; multilevel mixed spondylotic and soft disc disease--as described in the "body" of the MRI as
     follows: (***Grade 1 only retrolisthesis.)At C6-C7, broad H N P superimposed on spondylotic change causes cord
     flattening and moderate central stenosis, bilateral uncinate process causes high grade neural foramen encroachment
     and mass effect on the exiting bilateral C8 nerve root complexes; At C5-C6 bilateral uncinate process spurring
     causes high-grade neural foramen encroachment and effacement of the C7 nerve root complexes bilaterally;anterior
     spurs, most markedly at C5-C6 and C6-C7.  
The high level chronic pain radiates across my left shoulder,down the
     left arm to the end of the left index finger, with numbness on the underside of that finger and mildly to a small part of
     the left thumb.

     I am a surviver of three earlier surgeries at my L4-L5, L5-S1 done only AFTER trying ALL of the non-invasive various modalities of rehab
     therapies offered at "world class" Pain Clinics which did not solve the low back problem.
     Surgery, then, for my L-spine was a "last resort" and surgery is now a "last resort" for my C-spine, BUT this begs a serious and sobering question, which is stated below.

   Before my question,  I was told a chiropractic physian in my community had a very similar C-spine problem like mine described above.
     He tolerated the pain for an extended period of time, the amount of time not known by me.They tell me HE
     WAITED TOO LONG to have surgery until he had to have "plates" put in his neck. By waiting, his muscles shrunk so significantly
     that he lost the strength and use of his left arm and hand. I have been told that I have lost 10% to 15% of my
     strength in my left arm/hand with only a slight "tape  measurement" difference of left arm/right arm. My relentless acute pain
     episode started in July 1999 and continues to date, without a break.

     MY QUESTION IS: What is the "range" of time one can continue use medicines, epidural shots and
     non-invasive therapies, without surgical intervention, with ongoing nerve pain going down the left arm/hand , and still feel comfortable that the risk of "loss of use" of the arm/hand  or muscle atrophy is still in the low risk or acceptable risk probability
     range?

     Perhaps with your answer you could refer me to further specific information related to my problem or to a location
     that I can research. Please accept my sincere appreciation of your expected reply.

[CCF Neuro[P] MD, RPS]

Dear Frank:

What does your neurologist suggest?  The description would indicate that you are suffering from significant changes in your cervical cord.  The distibution of your symptoms corresponds to the level of your lesion.  I would not worry about your chiropractor friend, as previously mentioned to you, one cannot compare one person's findings with another's.  When the cord becomes compromised, surgery is indicated.  When medical efforts do not control pain, then a decision must be made concerning surgery.  As previously stated in these postings, surgery is of consistent benefit when there is mechanical induced pain.  The loss of muscle power precedes muscle atrophy, so you have a window of where things can be analyzed.

I would talk to your rehab person as it sounds like you must at least know one from your past history.  See what they say.  Talk to your neurologist and see what their opinion is on the matter.

Sincerely,

CCF Neuro MD

[Helen Lilly]

I have a Bulging Disk and Sciatic Nerves.  What can done for that?

[CCF Neuro[P] MD, RPS]

Dear Helen Lilly:

See your neurologist and rehab specialist and begin to work out a rehab program.  If this fails then seek out the best neurosurgeon that your health plan allows.

CCF Neuro MD

[John]

I've been attempting, repeatedly, to get my e-mail of a concise, 2 paragragh discription of my issues. Why can't I get through? Is this letter is successful, the when and how do I get the advise of your neurology forum? P.S. My symtoms found positive in an E.M.G. appear to be progressing. Thank you.

[dorothy]

I had surgery on Dec. 9th.  Decompression for Chiari, laminectomy C1-7 and Fusion with metal rods from C3-7.  This was all done posterior.  How long would pain in the upper shoulders be associated with this type of surgery?  I am starting PT this week for soft tissue but no range of motion.  Also how difficult is it for the screws used in this process to come loose?  I wear a hard collar during the day, but not at night.  Thank you.

[CCF Neuro[P] MD, RPS]

Dear Dorothy:

I would ask your neurosurgeon as he knows you case far better than I do.  Each patient is different and rehab is very individual.  Sorry, but I can't tell you much.

CCF Neuro MD

[Terry Solomon]

I was in auto accident 10-28-99. After P-T I had pain in neck still with tingling sensation in left arm at times regardless
of activity.But moreso with activity. M.R.I. shows left paracentral C6-7 cervical disc herniation,Central C5-6
cervical disc herniation with cervical cord compression
at the C6-7 interspace. I can tell a steady worsting of the condition.I also have lower lumbar pain that at times
radiates to the hips and down my left leg.I have already been told I have degenrative arthritis of the lower lumbar area.
Could the auto accident stirred up the arthritis or should I
ask the neurosurgeon if he should run a MRI to check for
further damage.       surgery or not do I have a choice
with mild cord compression?

[Carolyn]

I, injured myself over a year ago at work, september 1998.  i was diagnosed with a bulging and herniated disc, between c5 and c6, c6 and c7, with spinal cord compression. went to several doctors, neurosurgons, neurologist and was told no treament was nescesary and the problem would go away in a year.  i was released to go back to work, full release, no treatment.  Hurt myself at work agin and suffered more problems.  I suffered from severe neck,left shoulder and arm pain, neck stiffness, problems moving my neck.  then I began having numbness in my left arm and fingers.  I also have lower back pain radiating down left leg, numbness on sides of both feet, with periodic numbness in feet and toes, sometimes numb from the knees down.  Severe loss of strength on my left side and loss of balance.  Workers comp is just now sending to a neurologist from the second accident.  MRI lower back fine.  Waiting to have another MRI on neck.  on prescription neurontin, 300mg, 3 pills, 4x a day. i seem to be getting worse.  Q: My neck injury causing these problems?  Having these problems this long can perminate damage be done.  I've been on all types of meds, but nothing works for the pain, is ther something that will work.  could I worse and what would the porblems be, I can't imagine anything worse then what I already live with.  With no treatment what would happen?  wiil i get worse with dropping things I try to pick up or hold, with left and right hand?

[CCF Neuro[P] MD, RPS]

Dear Carolyn:

It sounds like you might have worsened you neck condition.  Herniation of the the discs can compromise the spinal column and give some of the symptoms you describe.  I would wait for the the MRI of the neck and see your neurologist.  Whether your pain medication is correct or not is difficult to tell you, we have several patients on neurontin (although at higher doses) and they seem to be doing okay.  Other patients have not responded as well. The heart of the matter is correct rehab with pain management and lifestyle changes.  Once the MRI results are back you can concentrate on these.

Sincerely,

CCF Neuro MD

[maggie]

I fell very hard on a hard surface.  MRI results showed Herniated cervical disc L4-L5.  What happens when one feels numbness on his/her entire left side of the body. And is still lingering.  Will Epidural stop it or induce it?

[CCF Neuro[P] MD, RPS]

Dear Maggie:

A herniation at L4/L5 should not cause numbness over the entire side of your body.  This must be another reason for this.  I would see your neurologist just to check other things out.

CCF Neuro MD

[ALAN DERBER]

i THREW MY LOWER BACK OUT 7 DAYS AGO PAIN WAS UNBELIEVABLE DOWN THE SIDE OF THE RIGHT LEG WHICH DAYS LATER WENT INTO THE LOWER CALF & TIGHTENED IT   THEN i NOTICED MY RIGHT HALF FOOT WAS NOT WORKING PROPERLY IT FELT  SLIGHTLY PARALIZED i WENT TO HOSPITAL THEY GAVE ME A MRI & THE SURGEON SAID i HAD A BULDGING DISK BETWEEN L4 & L5  & HE COULD STOP THE PAIN  BY SURGERY ..  SO WE SAID WE WOULD WAIT & SEE HE GAVE ME PILLS  TO REDUCE THE NERVE SIZES.. IT IS NOW 7 DAYS LATER A LOT OF THE PAIN HAS SUNSIDED i HAVE HAD VERY LITTLE SLEEP THE PAIN HAS GONE COMPLETELY FROM MY BACK BUT i AM HAVING THE SAME PAIN AT THE CALF & FIND IT HARD TO SIT oR LIE IN ANY POSITION FOR A LONG TIME WALKING IS LESS PAINFULL...
WILL THIS HEAL ON ITS OWN & ALWAYS KEEP HAPPENING

OR SHOULD i GO FOR THE SURGERY!!!!!

[Tricia R]

Hi,

I'm waiting to see a Nuerosurgeon but in the mean time was wondering what the report from the MRI means. Mine says "Large left paracentral disc protrusion at c5-c6 which contacts and partially flattens the spinal cord. There is no significant cord compression. There is no evidence of spinal stenosis or neural foraminal stenosis at this level."

My symptoms have been severe pain in the left shoulder/neck and shoulder blade area. The pain comes and goes, most recently I had the pain with it radiating down my arm. I also have had an increase in tension migraine headaches.

Just curious does this usually mean surgery down the road? or not?

Tricia

[MARIO SANCHES]

PLEASE INFORME ABOUT CIRUGIE OF A HERNIE DISCAL CERVICAL C6 C7
WHAT ARE THE RISCS OR PROBLEMES.

[dee olterman]

I was diagnosed with herniated C5 & C6 discs ( after seeing a chiropractor, muscle therapist, and internist).  This diagnosis was made via x-ray and MRI of the cervical spine. The symptoms began in late June and diagnosis in early August.  I have been in P.T. 3xweek as well as home traction 2xday since mid August.
There seems to be little improvement. What should I expect?

[Anne Howard]

I have one main question and then several that I could possibly be related.
Can dizziness, memory loss when turning head, weakness in arms and shoulders be attributed to Herniated disks C5 and C6? I also have bilateral cervical ribs at the area of the 7th Vertibrae. Is it possible or likely that the ribs causing the herniation?
To give you some history :I am now 38 but at 16 I had difficulty getting my drivers lisence since I could not turn my head all the way to the sides. I was pushed backwards off a swing sometime in my early teens (blacked out for several seconds and have a small bald spot on the back of my head). It wasn't until I was about 28 that I found out about the ribs and soon after started going to a Chiropractic physician, this care has helped over the years. But I still have dizziness and difficulty after excercising.But this past spring my lumbar muscles kept going into spasms, and stopped the chiropractic visits. I was also experiencing kidney problems so everything seemed to get clouded together as far as a cause. The pain was so bad that I would nearly pass out (I've always had a high tolerance for pain). Two years before this I was 'diagnosed with Chronic fatigue syndrome and really didn't excercise for over two years. This fall I started going to a Physical Therapist mainly for the back spasms but I felt that the pain seemed to start in my neck, so we were alternating therapy. I tested positive to the arterial----(?)test and could not do several of the back exercises - they made me very dizzy, even in a neutral position. I will be going to a Rehab Physical Orthopediac doctor on Tuesday, but I wanted to gain some understanding before I went and try to unravel what information from my history relates to the current (progressing?) problem.
Thank you!