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Neurology (Expert Forum)
cerical DDD and neuroforaminal stenosis
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cerical DDD and neuroforaminal stenosis
by caynetina, Jan 31, 2002 12:00AM
Hi, I'm 33 years old & had an MVA about 5 yrs ago. Been suffering with L shoulder blade pain into bicep, down side of arm to fingers(thumb,index,middle) w.neck pain, muscle spasms in neck & shoulder & headaches. Arm feels numb most of the time & severe burning,stabbing pain on & off. Really bad when sitting upright. On Baclofen 10mg every 3 hrs has helped w. spasms a bit. Have unexplained dizzy spells on & off. When I turn my head to the L have a shock sensation and twice when I bent my head to the chest. Tried physio, acupuncture, trigger point& occipital blocks & being sent for a facet block. Here's what my MRI showed:C6-7 mod.to early DDD with L postlat osteophyte & focal disc component which indents L side of cord. Canal size markedly reduced with only at best a sm.amt.of CSF left on R side of the cord. Severe L neural foraminal narrowing. Mod.post.facet disease.
C5-6 at least mod.DDD with sm.diffuse post.osteophyte and L.postlat osteophyte-mildly indenting L ant.hemicord. Canal size sm.& only sm.amt.of CSF remaining on R.side.At least mod.narrowing L neural foramina.Mod. post.disease.
C4-5,mod DDD.Canal size maintained.Mode L neural foraminal
narrowing.Mod. post.facet disease. Alignment &vertebral body marrow signal adequate.No abnormal cord signal seen.
Q.-is there anything further I can do conservatively?
why does it mention CSF in the report & is cord indentation serious?
if I leave this too long can I have permanent nerve damage?
lastly if I require surgery what type of recovery can I expect? would I be able to still do aeorbics & ride coasters?
Thank you
C5-6 at least mod.DDD with sm.diffuse post.osteophyte and L.postlat osteophyte-mildly indenting L ant.hemicord. Canal size sm.& only sm.amt.of CSF remaining on R.side.At least mod.narrowing L neural foramina.Mod. post.disease.
C4-5,mod DDD.Canal size maintained.Mode L neural foraminal
narrowing.Mod. post.facet disease. Alignment &vertebral body marrow signal adequate.No abnormal cord signal seen.
Q.-is there anything further I can do conservatively?
why does it mention CSF in the report & is cord indentation serious?
if I leave this too long can I have permanent nerve damage?
lastly if I require surgery what type of recovery can I expect? would I be able to still do aeorbics & ride coasters?
Thank you
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jan 31, 2002 12:00AM
The spinal cord is bathed in CSF throughout its length. When we look at the cord on an MRI, we look for the CSF to completely surround it. If something has pushed all the CSF out of the way at certain points in the spine, it could compress the cord which could lead to neurological problems. Please keep in mind that it's impossible to accurately comment on a secondhand MRI report as we always base major clinical decisions on a personal review of the films. From what you report, it sounds moderately severe and you may want to consider getting it reviewed by a neurosurgeon. Depending on the actual degree of cord/nerve root compromise as well as clinical symptoms, it's possible that you could have permanent damage if no intervention is done. Sounds like you've tried extensive conservative measures without significant relief, so I'm not sure what else is left. Finally, every patient is different, and it's difficult to predict what one person's recovery will be. But usually if the postop course is uncomplicated and everything looks good at the post-op check at 4-6 weeks, then you should theoretically return to baseline status. GOod luck.
