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severe degenerative disc disease at C4-5,5-6, 6-7
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severe degenerative disc disease at C4-5,5-6, 6-7


    
      Re: severe degenerative disc disease at C4-5,5-6, 6-7
    


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Posted by CCF Neuro MD on June 28, 1997 at 11:12:41:

In Reply to: severe degenerative disc disease at C4-5,5-6, 6-7 posted by J. Gregorian on June 22, 1997 at 01:24:08:
  After workouts at the gym, I would feel a tightness in my shoulders and sometimes tingling in my right arm.  I finally went to my doctor to have this checked out.  After x rays and MRI, I was told that I had severe degenerative disc disease at C4-5,5-6,6-7. Milder degnerative change at theC3-4 level. The disc spaces are narrowed. Uncovertebral joint spurs encroach on the neural foramina.  Reversal of the usual cervical lordosisis probably related to muscle spasm. The MRI report states: Prominent spondylotic changes are seen at C4-5,C5-6 and C6-7, worse to the left of midline at all 3 levels, causing significant central stenosis at all 3 levels (particularly C6-7). There could be actual disc herniation on the left side at one or more of those 3 levels (with the left sided findings most focal at C5-6). Much milder, symmetrical, spondylotic changes are seen at C3-4. Some foraminal narrowing seen at multiple levels, most evident atthe right C3-4 foramen, which could affect the right 3rd cervical nerve root. There is loss of cervical lordosis.I have never had an injury or trauma (that I can remember) that could havecaused this but I was a tomboy growing up. Also my father owned a grocerystore so I was lifting heavy objects from an early age.  My questions are:1. Is it possible to avoid surgery without putting myself in real danger in the event of a possible future trauma to the neck area?  Will surgery remove that danger?2, I don't have any pain in the neck or back since I have stopped workingout.  If I don't have surgery, will this change?3.  How can I be sure that the MRI images correctly reflect the conditionof my neck?  Does it make sense to have a high resolution CT scan doneto see if it will show something different?4.  If I have such a problem in my upper neck, should I have xrays, etc.done of the lower spine to see if there is damage there as well?5.  Could osteopathic manipulative therapy help with my condition?Any answers you can give would be greatly appreciated.  I am only 43and it looks like my neck is falling apart (with no pain!!).  Otherwise,I am healthy and my blood chemistry is well within the norms.Thank you, Joyce Gregorian
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Hello, Joyce,
  In general, begining in the fourth and fifth decade of life, both cervical and lumbar discs are liable to herniate and impinge on the cord, the roots or both.  Two factors contribute to this alteration in the intervertibral discs: degeneration and trauma.  In the setting of degerative changes, relative minor trauma can potentially lead to herniation.  Without a full neurological examination, it would be difficult to say if surgery is the best option for you, although in principle a surgical approach may be warranted in the instances of clinical and radiological signs of an accompanying myelopathy, unremitting pain or progressive weakness.
MRI is nowadays widely applied to aid the diagnosis of disc degerative diseases.  In the cervical region, MRI is equivalent in diagnostic capacity to CT-myelography.  The best way to be certain that MRI reflected the true pathology of your neck is to correlate its report with neurological examination.
As mentioned above, both cervical and lumbar spines are prone to spondylitic changes.  They don't have to be symptomatic at the same time.  A neurological exam focusing on leg motor and sensory funtions usually is well sufficient to reveal early lumbar findings.
Since the treatment should be individualized, the benefit of osteopathic therapy for you is difficult to predict.  The best way to deal with your condition is to have a visit to our Center for the Spine at the Cleveland Clinic Foundation.  The Spine Center provides second opinions regarding the approriateness of back surgery. If you like to see one of our spine specialist, please call 1(800)223-2273 ext.42225 or (216)444-BACK.
This information is provided for general medical education purposes only. Please consult your primary physician for your specific medical conditions.






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