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Cervical Stenosis, Spondylosis, Annular Tear and Scoliosis in Thoracic Spine
Hello again Doctor.
Thanks again for the information you provided in response to my first post on 09/01/06.
I have posted the pictures from the 2005 MRI on the net. You can view them, if you wish, at:
http://new.photos.yahoo.com/kwujek1/albums
When you double-click the individual pictures, a larger version comes up and the viewer can add comments.
Since I posted the first time, I have seen both my primary care doctor and a local neurologist. I had appointments with both
of them the same week.
Before I saw them, I remembered that I had had a consultation with a chiropractor back in 2002 during which he took standing
x-rays of the entire spine. In addition to this, I had also been to a large county fair on September 11th of this year at
which a couple of chiropractors were set up with scale like equipment that measures how straight you are.
One of the chiropractors at the fair did some measurements and handed me a paper with a diagram on it that shows that my left
hip is 2 1/2 inches higher than my right hip, the left shoulder is 7/8" higher and the head curves downward to the left. The
screening showed that I am putting 12 lbs more weight on my right leg as opposed to my left.
I picked up my films from the chiropractor that I saw in 2002 and brought both them and the recent diagram to my primary care
doctor with complaints of reoccuring significant left hip pain which he had previously diagnosed as trochanteric bursitis and
given me an injection for about three months prior to this most recent visit. (Con't below)
Thanks again for the information you provided in response to my first post on 09/01/06.
I have posted the pictures from the 2005 MRI on the net. You can view them, if you wish, at:
http://new.photos.yahoo.com/kwujek1/albums
When you double-click the individual pictures, a larger version comes up and the viewer can add comments.
Since I posted the first time, I have seen both my primary care doctor and a local neurologist. I had appointments with both
of them the same week.
Before I saw them, I remembered that I had had a consultation with a chiropractor back in 2002 during which he took standing
x-rays of the entire spine. In addition to this, I had also been to a large county fair on September 11th of this year at
which a couple of chiropractors were set up with scale like equipment that measures how straight you are.
One of the chiropractors at the fair did some measurements and handed me a paper with a diagram on it that shows that my left
hip is 2 1/2 inches higher than my right hip, the left shoulder is 7/8" higher and the head curves downward to the left. The
screening showed that I am putting 12 lbs more weight on my right leg as opposed to my left.
I picked up my films from the chiropractor that I saw in 2002 and brought both them and the recent diagram to my primary care
doctor with complaints of reoccuring significant left hip pain which he had previously diagnosed as trochanteric bursitis and
given me an injection for about three months prior to this most recent visit. (Con't below)
Ingrass,
Definitely take a look at the prestige cervical disc website. They say the advantage of the artificial disc is that it probably doesn't cause the extra wear and the adjacent levels because it doesn't stop movement. I know for me if the artificial disc surgery is offered I can't wait to get it. I will be 41 next year and I would like to take a chance on some pain relief and try to enjoy as many years as I can. The last almost 20 years have been very unpleasant at times.
Good Luck!
Hopefully Prestige
Definitely take a look at the prestige cervical disc website. They say the advantage of the artificial disc is that it probably doesn't cause the extra wear and the adjacent levels because it doesn't stop movement. I know for me if the artificial disc surgery is offered I can't wait to get it. I will be 41 next year and I would like to take a chance on some pain relief and try to enjoy as many years as I can. The last almost 20 years have been very unpleasant at times.
Good Luck!
Hopefully Prestige
Ingrass,
My problem is definitely from my neck. I have never been a smoker. I have been looking at the Prestige Cervical Disc website and the artifical disc looks very promising. Have you taken a look at this option. I think tehy are guessing they may have full approval in the US by mid next year. I am hoping to endure the pain until this is an option and head back to the neurosurgeons again and hope to finall get some releif and quality of life. I'm not sure how long you have been dealing with it but it has been over 19 years for me. I was feeling sort of hopeless for a while but I am very optimistic about the artifcial disc. Take a look and see what you think!
My problem is definitely from my neck. I have never been a smoker. I have been looking at the Prestige Cervical Disc website and the artifical disc looks very promising. Have you taken a look at this option. I think tehy are guessing they may have full approval in the US by mid next year. I am hoping to endure the pain until this is an option and head back to the neurosurgeons again and hope to finall get some releif and quality of life. I'm not sure how long you have been dealing with it but it has been over 19 years for me. I was feeling sort of hopeless for a while but I am very optimistic about the artifcial disc. Take a look and see what you think!
I too, have suffered with tremendous neck pain. In my case, 2 large protruding disks and arthritic changes are compressing my cervical spinal cord. The compression is significant and is the main issue when it comes to surgery.
I am being monitored by a neurologist and neurosurgeon at a big name place. The disks and compression are highly visible on the MRI. If there were cord damage, it would also have shown on the MRI, most likely as a bright spot. I also had an emg and a physical exam which showed no true neurological deficit or nerve or muscle problems.
I do not yet have myelopathy (cord damage) or nerve root compromise, so therefore do not need surgery yet. I am trying to do everything in my power to avoid it. This is a big and dangerous surgery and should not be taken lightly. It often doesn't do anything for your pain and many times makes you much worse. Once you have it done, it creates many more problems with other levels of your spine and thus more surgeries. I want no part of this whatsoever, but of course, if I have to, I have to.
Neurosurgeons have much more training in spine issues than orthopedic surgeons. They spend something like 14 years in training in order to be able to deal with these things. They do not recommend this surgery unless it is really needed and the good ones do not tell you it will solve your problems.
As far as my neck pain went, it was tremendous and very hard to deal with. My local doctor put me on the antidepressant Cymbalta which is known to help with pain and it has been working for me for 8 months now. It took about 5 weeks to kick in, though, but once it did, I continued to see improvement for several more weeks. My neck pain is non-existent on most days and that in itself is a tremendous relief.
Since it is your shoulder bothering you, did you have a chest x-ray? This could be significant, especially if you are a current or past smoker. Perhaps you should mention this to your gp and ask about the Cymbalta.
Keep us posted.
I am being monitored by a neurologist and neurosurgeon at a big name place. The disks and compression are highly visible on the MRI. If there were cord damage, it would also have shown on the MRI, most likely as a bright spot. I also had an emg and a physical exam which showed no true neurological deficit or nerve or muscle problems.
I do not yet have myelopathy (cord damage) or nerve root compromise, so therefore do not need surgery yet. I am trying to do everything in my power to avoid it. This is a big and dangerous surgery and should not be taken lightly. It often doesn't do anything for your pain and many times makes you much worse. Once you have it done, it creates many more problems with other levels of your spine and thus more surgeries. I want no part of this whatsoever, but of course, if I have to, I have to.
Neurosurgeons have much more training in spine issues than orthopedic surgeons. They spend something like 14 years in training in order to be able to deal with these things. They do not recommend this surgery unless it is really needed and the good ones do not tell you it will solve your problems.
As far as my neck pain went, it was tremendous and very hard to deal with. My local doctor put me on the antidepressant Cymbalta which is known to help with pain and it has been working for me for 8 months now. It took about 5 weeks to kick in, though, but once it did, I continued to see improvement for several more weeks. My neck pain is non-existent on most days and that in itself is a tremendous relief.
Since it is your shoulder bothering you, did you have a chest x-ray? This could be significant, especially if you are a current or past smoker. Perhaps you should mention this to your gp and ask about the Cymbalta.
Keep us posted.
Please Help. I have been suffering from a neck problem that was caused from a car accident almost 20 years ago. It was diagnosed as a compression fracture between c6 and c7. The orthopedic surgeon gave me the option of fusion surgery after a year or two because of pain and also numbness in my fingers and my right arm. I decided to wait at the time because everyone told me how painful it was to have the bone taken from your hip. After about 5 years most of the arm and hand problems went away. I continued to have a lot of pain in my neck and shoulder blades. This year has been brutal for about 8 months so far so I had an MRI and xrays done and went to the neurosurgeon. I think I made a mistake by telling him the pain was neck pain and I have now realized the pain I have been calling neck pain is mostly in my shoulder blade and when it's really bad it is in my shoulder and slight numbness in my thumb and index finger. He diagnosed the problem as Spondylosis and said I have a old healed end plate injury. He noted that since I had only told him chronic neck pain that he didn't think surgery would help. I have tried all of the conservative treatment and I am taking the NSAID's and muscle relaxers now but nothing seems to help. I have a couple of different business's with employee's and most days I find it hard to keep going. I guess I am wondering if I wait for the artifical disc's to be approved what the likelyhood is that this type of surgery could help me? This pain has really taken a toll on my quality of life and ability to function daily.
Thanks for any HELP! Hopefully Prestige
Thanks for any HELP! Hopefully Prestige
All this information is really helpfull, (I suffer from similar problems) but one thing not mentioned was that weight plays a part I feel the most back pain when i am at 20 to 25 lbs overweight,
Hi Tim,
I am so sorry to hear of your ordeal. This is exactly what I am trying to make sure doesn't happen to me. I don't want ANYBODY cutting me anywhere, especially the spine.
Doctors are notorious for abondoning you afterwards. I'd bet money that you are now treated like a drug addict.
I'm sorry, but I don't have any suggestions for your pain as I have no experience with either the spinal surgery or narcotics. I have refused two seperate offers for narcotics from my gp in recent months.
I do suggest that you copy, paste and save the message you posted today. Keep trying to post it here to the doc. You may have to keep trying, but he is usually pretty responsive the first time you post. It worked for me twice between 6:00 and 6:45 a.m. CST.
Other thank that, the only thing I can offer is encouragment not to give up. You have certainly been through a lot, and your depression sounds understandable, but pretty severe. I take Cymbalta 60mg and it has helped tremendously with the neck pain, but not all that great on the depression or other symptoms. Keep seeking information and a good doctor. It will be hard to find one, especially if you live in hickville like I do, but one day it will happen.
Just curious, though. Why did you have the surgery? Was there cord damage or neurological deficit, or where you told it would solve your pain?
Good luck.
Kathy
I am so sorry to hear of your ordeal. This is exactly what I am trying to make sure doesn't happen to me. I don't want ANYBODY cutting me anywhere, especially the spine.
Doctors are notorious for abondoning you afterwards. I'd bet money that you are now treated like a drug addict.
I'm sorry, but I don't have any suggestions for your pain as I have no experience with either the spinal surgery or narcotics. I have refused two seperate offers for narcotics from my gp in recent months.
I do suggest that you copy, paste and save the message you posted today. Keep trying to post it here to the doc. You may have to keep trying, but he is usually pretty responsive the first time you post. It worked for me twice between 6:00 and 6:45 a.m. CST.
Other thank that, the only thing I can offer is encouragment not to give up. You have certainly been through a lot, and your depression sounds understandable, but pretty severe. I take Cymbalta 60mg and it has helped tremendously with the neck pain, but not all that great on the depression or other symptoms. Keep seeking information and a good doctor. It will be hard to find one, especially if you live in hickville like I do, but one day it will happen.
Just curious, though. Why did you have the surgery? Was there cord damage or neurological deficit, or where you told it would solve your pain?
Good luck.
Kathy
hello I am new here. I just need some advice on what I should do, In aug 2003 I was diagnosed with spinal stenosis at the c1,c2 level, By the way I am a 28 yr old male with no previous neck problems. Ok a month later in sept 2003 I had 2 surgeries one was to remove the bone on the back side of c1 c2 and the next surgery they had to graft bones cut from my hip and place it where they cut out the old bone, and a halo device was placed on me four the next four months. I lost everything my car my home my will to live. I had some pain before the surgery but after the operations my pain seemd to grow ten fold, I was on a morphine pump for 5 weeks in the hospital and they sent me home with 100mcg fentanyl patches and 10mg percocets.I stayed with my family doc after that and he controlled my pain with up to 3 80mg. oxycontin a day and percocets for breakthrough pain, I was sent to a pain center and I've been going there for almost 2 yrs and they have actually decreased my meds, I take 3 100mg ms contin and 3 30mg msir everyday which doesnt cut it like what I was on before. I have mentioned it to them several times but to no evail it didnt help.Im in pain 24/7 cant hardly sleep and I just dont know what to do. Also I have 2 herniated disk at the t5, t6 level which doesn't feel the best either. I appreciate any feedback.
Tim
Tim
I have read the rest of your post and you asked more questions than I can answer without seeing in person. I am unalbe to diagnose your health problems over the internet and a lot of your frustration comes from the different opinions that your have collected form the half-dozen doctors that have actually been able to see you and review first hand all of your information. I would recommend that you choose a good neurologist that you trust and stick with him/her. I commented in your first post on the MRI findings which your related about an annular tear, my opinion is unchanged, based on the information that I have (I am unable to examine you). Your cervical spondylosis seems should be followed closely and early spinal cord compression may be diagnosed by somatosensory evoked potentials (SEPs). Scoliosis in many patients is without any symptoms, but it can become symptomatic if the degree of scoliosis becomes more severe. I would suggest a consultation with a neurosurgeon to answer these specific questions. The neurosurgeon will also be able to discuss the options of mimimally invasive surgery (each surgeon has different techniques in many cases). There are many excellent CCF neurosurgeons, but 2 of the senior staff include Dr. Benzel and Dr. Kalfas.
Given your complaints of burning pain etc I would also suggest an EMG to evaluate for neuropathy. Your back pain symptoms, are possibly due to the annular tear as we discussed previously.
I reviewed the MRI pictures that you posted on the internet. unfortunately, they were not of sufficent quality for me to offically comment on (I am also not a radiologist). I was able to appreciate the cervical stenosis that is quite obvious. In another viewing situation, it may be possible to appreciate the scoliosis in the MRI, but not from these images. Plain xrays of the entire spine are the best way to look for scoliosis, not MRI.
I see that you have been to many doctors at well respected places, I would suggest now that you choose one doctor who can coordinate your care to cut down on the confusion.
Given your complaints of burning pain etc I would also suggest an EMG to evaluate for neuropathy. Your back pain symptoms, are possibly due to the annular tear as we discussed previously.
I reviewed the MRI pictures that you posted on the internet. unfortunately, they were not of sufficent quality for me to offically comment on (I am also not a radiologist). I was able to appreciate the cervical stenosis that is quite obvious. In another viewing situation, it may be possible to appreciate the scoliosis in the MRI, but not from these images. Plain xrays of the entire spine are the best way to look for scoliosis, not MRI.
I see that you have been to many doctors at well respected places, I would suggest now that you choose one doctor who can coordinate your care to cut down on the confusion.
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
I am only able to see half of your post and I am unclear on what your question is. As far a chiropractors are concerned with the multiple measurements that suggest musculo-skeletal misalignment, are sometimes helpful to some people, but the results inbetween different practioners are inconsistent and they routinely engage in potentially dangerous practices such as "cracking the neck" (could potentially lead to artery dissections and strokes). Many patients are in need of physical therapy and the services of this type by chiropractors, physical therapist and rehab doctors is very valuable and should not be overlooked. However, due to the rare potential of unsafe practice and inconsistent practice, then I would suggest seeing a registered physical therapist instead. I will post more if I can see the rest of your post after this is submitted.
I am only able to see half of your post and I am unclear on what your question is. As far a chiropractors are concerned with the multiple measurements that suggest musculo-skeletal misalignment, are sometimes helpful to some people, but the results inbetween different practioners are inconsistent and they routinely engage in potentially dangerous practices such as "cracking the neck" (could potentially lead to artery dissections and strokes). Many patients are in need of physical therapy and the services of this type by chiropractors, physical therapist and rehab doctors is very valuable and should not be overlooked. However, due to the rare potential of unsafe practice and inconsistent practice, then I would suggest seeing a registered physical therapist instead. I will post more if I can see the rest of your post after this is submitted.
i've had 6 MRIS on my back before i began a quest to "fix myself" and hence am very familiar with the terminology used in the reports, and what it means. I've learned that the words tend to mislead patients, as they did me. cord compression does not cause pain, it causes loss of function and weakness. canal narrowing does not necessarily mean cord compression. I only tried to help you understand your report. You have a juicy herniation at c5/6, but the symptoms you described in your original post do not seem to be related. thereofer it makes sense to say that surgery, minimally invasive or not, does not seem to be the answer. your skeleton, YOU said, is way out of alignmnet- you mentioned specific measurements regarding your shoulders and hips. Just becasue , as you say, that you have abnormal findings does not mean that those findings are responsible for your symptoms. muscle pain, spasm and tightness can not be fixed by anyone else but you. trigger point therapy, muscle retraining, posture exercise-- it all takes months and months of consistent, frequent, and unrewarded effort before yeilding results. you can't say trigger point therapy did not work unless you did it for a few months, many times per day, combined with stretching properly and retraining weak muscles. look up Erik Dalton and read about the "crossed Syndromes" (i looked at your MRI image. there is a nice herniation at c5/6, and then below that the spine bends so you cannot see the canal.) yeah there's cord compression, and alot of people have it, including me. it had nothing to do with my pain syndrome. good luck. i've stated my case twice, now i'll leave you where i was left by my great team of doctors..... in pain.
Mike,
I think you mean well, but please do not tell me whether or not I have significant compression. I have a wonderful neurologist and one of the country's top neurosurgeons for that. I use my dentist for my teeth.
If you want to see what this looks like. just go to http://new.photos.yahoo.com/kwujek1/album/576460762316092310/photo/294928803119687121/7
Believe me, I wish you were correct regarding my problems being normal for my age, but they are not.
I am not looking for sympathy, just trying to make a point. You are correct that the compression is not causing the pain. The disk in my thoracic spine that has a tear in it very well might be causing the back pain, however. My local neurologist says that it is.
As far as the myofacial pain release, the jury is still out on that one. I do, in fact, have claire davies book and another on trigger point therapy. I used these a couple of years ago with no results.
I am glad this worked for you and give you credit for sticking with it as long as you did.
Since you, like me, have been down this road, we do have some information that may be beneficial to other people, like the nerve root compromise and what pain may or may not be coming from the spine. Let's just be careful about advising them about the extent of their spinal problems. That is best left up to the neurosurgeon.
Thanks though, for explaining the minimally invasive surgery to me. I am still trying to educate myself and by no means know it all.
Kathy
I think you mean well, but please do not tell me whether or not I have significant compression. I have a wonderful neurologist and one of the country's top neurosurgeons for that. I use my dentist for my teeth.
If you want to see what this looks like. just go to http://new.photos.yahoo.com/kwujek1/album/576460762316092310/photo/294928803119687121/7
Believe me, I wish you were correct regarding my problems being normal for my age, but they are not.
I am not looking for sympathy, just trying to make a point. You are correct that the compression is not causing the pain. The disk in my thoracic spine that has a tear in it very well might be causing the back pain, however. My local neurologist says that it is.
As far as the myofacial pain release, the jury is still out on that one. I do, in fact, have claire davies book and another on trigger point therapy. I used these a couple of years ago with no results.
I am glad this worked for you and give you credit for sticking with it as long as you did.
Since you, like me, have been down this road, we do have some information that may be beneficial to other people, like the nerve root compromise and what pain may or may not be coming from the spine. Let's just be careful about advising them about the extent of their spinal problems. That is best left up to the neurosurgeon.
Thanks though, for explaining the minimally invasive surgery to me. I am still trying to educate myself and by no means know it all.
Kathy
ingrass---- do the stretching for 45 minutes each time, 3 times per day. get massage where muscles are tight. massage often. lay on a baseball where it hurts and loosen upthose muscles. get one of those hook shaped things that have nons onthe end and use it. your "cord compression" is not causing pain. cord compression, i was told by my nuerosurgeon, is usually painless. it causes loss of funtion, not pain. most people by the time they are 40 have arthritic spinal changes. i read your MRI report. i don not want to make light of it, but "marked narrowing of the spinal canal" does not mean you have significant cord compresssion, and osteophytes are everpresent in 40+ year olds. get your pelvis straightened out. stretch and massage your scalenes-- first you have to read about them and learn where they are. relieve your trigger points. stop the positioning that causes bad posture. stand straight. retrain YOURSELF. go to JOLIE BOOKSPAN's website. It helped me more than anything. you can do this and feel way better by x-mas.
"conservative treatment" depends upon who does it and what that treatment is. if you are given 10 mintes of manual therapy 3 times per week and told to do some stretching, you won't get better. if your issues are soft tissue, ie muscular, stretching needs to be done hours per day in combinatioon with ALOT of self or professsional massage. with falls, whiplash injuries etc, muscles cam go into spasm as a way of protecting your skeleton. when you have surgery and bones get fused together, muscles can go into spasm even more because you are eliminating joints and are skeletally less mobile. I would not under any circumstance have spinal surgery unless there was an EXACT reason--ie myelopathy or nerve root irritation along a specific dermatome that can be traced to a specific nerve root. gereralized neck pain, shoulder pain, arm symptoms can be from muscle tightness. remember that nerves run through muscles, so guess what happens when muscles become taught a rope??? like i advised ingrass, check out a website by John Barnes who is known around the world for his experience with myofascial issues. Read, and go visit the clinic as a patient if you can. don't let the fact that you have an HMO dictate the course of your treatment. feeling better is paramount----remember, at the physical theray office you may only be getting 10 minutes of attention becasue they are only getting paid $8.42........... Are you going to get surgery becasue of that. seek out the best therapy you can get and pay for it if yopu have to. it's better than getting surgery you may not need, and that may make you worse.
Sorry - new question wouldn't be accepted, so tagging on here:
I am seeing a spine doc at my HMO tomorrow - Kaiser.
I am worried that IF I need surgery, it will not be done/offered, since it is an HMO - are there legal rules about this stuff, or is there clear protocol for treatment, so that I will know my doc isn't being negligent in the long run (I need to ask because the family physician already told me to not get surgery, even before seeing ANY x-rays or the MRI!)?
So far, I know I have: some bulging cervical discs, osteoarthritis, and stenosis of the spinal canal - I wass told about all of that 6 years ago (I am now 49, 5' 9", 122 lbs, and in good health for my age - I've had at least 3 BAD falls involving my neck - one on a bike - split vhin open, lost a tooth - another falling down stairs - 3 years ago
Symptoms: unrelenting pain - taking Tylenol #3, numbness in right shoulder/arm/hand - pain in shoulder/upper arm, pain along necck in various places -
X-rays show: Reverse cervical curve and upper cervical certebrae curve to the right, 20 degrees - altho I have been seeing a chiropractor to try to staighten that part out out - the reverse cervical curve was evident at age 26, when I first had neck problems (the bike accident happened at age 20)
The chiro looked at my MRI results yesterday and told me about the stenosis - she said I will probably need surgery eventually - and THAT was coming from someone who was totally against my even going to a normal doc to begin with - in other words, the MRI wasn't a pretty picture...
I understand, from surfing the Net, that attempts at conservative treatments should last about 8 weeks - I will not take NSAIDS because I have Celiac Disease (diagnosed 2o months ago - I am completely gluten and dairy-free - taking calcium/mag/vit D), and i don't want to get leaky gut again...
I've had ESIs one time before (a set of 3) - 6 years ago - they took care of the pain then, but...MUST I agree to them again? The chiro doc siad they destroy cartilage....
ANY input is appreciated.
I am seeing a spine doc at my HMO tomorrow - Kaiser.
I am worried that IF I need surgery, it will not be done/offered, since it is an HMO - are there legal rules about this stuff, or is there clear protocol for treatment, so that I will know my doc isn't being negligent in the long run (I need to ask because the family physician already told me to not get surgery, even before seeing ANY x-rays or the MRI!)?
So far, I know I have: some bulging cervical discs, osteoarthritis, and stenosis of the spinal canal - I wass told about all of that 6 years ago (I am now 49, 5' 9", 122 lbs, and in good health for my age - I've had at least 3 BAD falls involving my neck - one on a bike - split vhin open, lost a tooth - another falling down stairs - 3 years ago
Symptoms: unrelenting pain - taking Tylenol #3, numbness in right shoulder/arm/hand - pain in shoulder/upper arm, pain along necck in various places -
X-rays show: Reverse cervical curve and upper cervical certebrae curve to the right, 20 degrees - altho I have been seeing a chiropractor to try to staighten that part out out - the reverse cervical curve was evident at age 26, when I first had neck problems (the bike accident happened at age 20)
The chiro looked at my MRI results yesterday and told me about the stenosis - she said I will probably need surgery eventually - and THAT was coming from someone who was totally against my even going to a normal doc to begin with - in other words, the MRI wasn't a pretty picture...
I understand, from surfing the Net, that attempts at conservative treatments should last about 8 weeks - I will not take NSAIDS because I have Celiac Disease (diagnosed 2o months ago - I am completely gluten and dairy-free - taking calcium/mag/vit D), and i don't want to get leaky gut again...
I've had ESIs one time before (a set of 3) - 6 years ago - they took care of the pain then, but...MUST I agree to them again? The chiro doc siad they destroy cartilage....
ANY input is appreciated.
Hi Gina,
Mike is right. You DO NOT want this surgery. I wouldn't worry about the doctors not recommending surgery if you really need it, which it doesn't sound like you do. No doctor is going to withhold surgery when you have myelopathy (CORD damage).
Just because you have bulging disks, arthritic changes, etc. does not mean that your cord is compressed. This is one thing you should ask your doctor tomorrow. Is my spinal cord compressed? If so, to what degree. If it is compressed, he or she will tell you to watch out for loss of bowel or bladder control. weakness in arms or legs, or pain down a specific dermatome (like Mike told you).
It is probably a neurologist or neurosurgeon you are going to see. He or she will do a physical exam. They will check your reflexes (very important when looking for early signs of myelopathy). He will test your strength and sense of sensation. He will watch the way you walk, etc. Bring your MRI if you have it. Tell him about your pain, but if he says its not related, believe him and BE HAPPY about it. If he orders other tests, make sure you do all of them.
There are some doctors who will tell you that they can get rid of your pain if you agree to surgery. This is probably why your gp told you not to have surgery. He doesn't want one of these guys talking you into it. You should be dealing with a neurologist and a neurosurgeon, not an orthopedic surgeon.
I personally don't like chiropractors. I can't imagine one telling you not to see a regular doctor when you have bulging disks. If she manipulated your neck knowing this she should be shot. (well, maybe not shot...lol). Why is she recommending a real doc now? Could it be she pushed the disks further into the spinal canal? Think about it. For an eye opening education on chiropractors and the tricks they employ to get patients, go to www.chirobase.org
Keep in mind that I have the same problems you have, but the disks and arthritic changes are compressing my cord. The compression is significant but I do not yet have myelopathy or nerve root compromise. While I need to be very careful because I am suceptable to total paralysis if I get hurt again, and my condition needs to be monitored very closely, I do not yet need surgery. I am trying to do everything in my power to avoid it. This is a big and dangerous surgery and should not be taken lightly. If often doesn't do anything for your pain and many times makes you much worse. Once you have it done, it creates many more problems in your spine and thus more surgeries. I want no part of this whatsoever, but of course, if I have to, I have to.
Mike's suggestions are good ones, although not many of us can afford the $30,000.00 it would take to be treated at the clinic he is talking about. Mike is lucky, he is a dentist. Still, there is a ton of information at the site he suggested and the others he suggested to me.
I just bought a very good book at Waldenbooks today that is all about stretching excersises. I think I paid $16.95. I figured that this was better than accepting the narcotics my gp has offered me twice.
I hope this helps.
Mike is right. You DO NOT want this surgery. I wouldn't worry about the doctors not recommending surgery if you really need it, which it doesn't sound like you do. No doctor is going to withhold surgery when you have myelopathy (CORD damage).
Just because you have bulging disks, arthritic changes, etc. does not mean that your cord is compressed. This is one thing you should ask your doctor tomorrow. Is my spinal cord compressed? If so, to what degree. If it is compressed, he or she will tell you to watch out for loss of bowel or bladder control. weakness in arms or legs, or pain down a specific dermatome (like Mike told you).
It is probably a neurologist or neurosurgeon you are going to see. He or she will do a physical exam. They will check your reflexes (very important when looking for early signs of myelopathy). He will test your strength and sense of sensation. He will watch the way you walk, etc. Bring your MRI if you have it. Tell him about your pain, but if he says its not related, believe him and BE HAPPY about it. If he orders other tests, make sure you do all of them.
There are some doctors who will tell you that they can get rid of your pain if you agree to surgery. This is probably why your gp told you not to have surgery. He doesn't want one of these guys talking you into it. You should be dealing with a neurologist and a neurosurgeon, not an orthopedic surgeon.
I personally don't like chiropractors. I can't imagine one telling you not to see a regular doctor when you have bulging disks. If she manipulated your neck knowing this she should be shot. (well, maybe not shot...lol). Why is she recommending a real doc now? Could it be she pushed the disks further into the spinal canal? Think about it. For an eye opening education on chiropractors and the tricks they employ to get patients, go to www.chirobase.org
Keep in mind that I have the same problems you have, but the disks and arthritic changes are compressing my cord. The compression is significant but I do not yet have myelopathy or nerve root compromise. While I need to be very careful because I am suceptable to total paralysis if I get hurt again, and my condition needs to be monitored very closely, I do not yet need surgery. I am trying to do everything in my power to avoid it. This is a big and dangerous surgery and should not be taken lightly. If often doesn't do anything for your pain and many times makes you much worse. Once you have it done, it creates many more problems in your spine and thus more surgeries. I want no part of this whatsoever, but of course, if I have to, I have to.
Mike's suggestions are good ones, although not many of us can afford the $30,000.00 it would take to be treated at the clinic he is talking about. Mike is lucky, he is a dentist. Still, there is a ton of information at the site he suggested and the others he suggested to me.
I just bought a very good book at Waldenbooks today that is all about stretching excersises. I think I paid $16.95. I figured that this was better than accepting the narcotics my gp has offered me twice.
I hope this helps.
ps i personally do not feel the crepitus in your neck is a surgical problem or for that matter related to your pain symptoms. i had a ton of it. when my neck muscles eased up, it went away. I could not bend my head forward or backward without hearing snaps crackles and pops galore. when i bent my head forward i felt an electric shock up and down my entire spine and body. the crepitus and tightness is gone and i haven't had the electric shock feeling in a year. which makes me believe it (crepitus) was present because the muscles were pulling each vertebrae every which way (they were so short and tight) and hence the vertebrae did not want to move easily and instead grinded on each other.
remember: neck surgery is for myelopathy/nerve root impingement/ weakness/numbness/pain along a specific distributuion. I had the minimally invasive surgery. It did squat and i was in agony for 3 weeks. Yeah, it's minimally invasive because they go through the back of your neck, not the front (which requires disc removal and hence fusion) but remember when they go through the back of your neck they have to pierce through and retract many important muscles---- and this is exactly what you don't want--- more trauma to muscles that are already tight and out of balance. it created more problems for me in the short term, ie in the muscular sense, until i was able to properly stretch them again-- which was a good 6-8 months later. Just becasue it's minimally invasive does not mean you should try it. many, if not most, middle aged adults would have MRI reports similar to yours-- it;s part of aging. it does not automatically translate into pain. "Abnormal" or for that matter any finding on a report does not mean it needs to be "rectified". it could just be an incidental finding unrelated to your pain. In my humble opinion, you should start thinking that way and start trying to fix yourself.
remember: neck surgery is for myelopathy/nerve root impingement/ weakness/numbness/pain along a specific distributuion. I had the minimally invasive surgery. It did squat and i was in agony for 3 weeks. Yeah, it's minimally invasive because they go through the back of your neck, not the front (which requires disc removal and hence fusion) but remember when they go through the back of your neck they have to pierce through and retract many important muscles---- and this is exactly what you don't want--- more trauma to muscles that are already tight and out of balance. it created more problems for me in the short term, ie in the muscular sense, until i was able to properly stretch them again-- which was a good 6-8 months later. Just becasue it's minimally invasive does not mean you should try it. many, if not most, middle aged adults would have MRI reports similar to yours-- it;s part of aging. it does not automatically translate into pain. "Abnormal" or for that matter any finding on a report does not mean it needs to be "rectified". it could just be an incidental finding unrelated to your pain. In my humble opinion, you should start thinking that way and start trying to fix yourself.
ok. keep in mind i am a dentist, not an MD. I also have never met you, or even had the chance to look at you. You have some symptoms (whole body burnng pain and scoliosis) which I did not. I however had (and still sometimes get) symptoms you did not mention such as pain in my chest muscles and arm, and the inability to turn my head. The following is my opinion only, not a diagnosis. You may have other problems I am not aware of. Disclaimer aside:
Your problems to me sound like they are due to muscle imbalances. The fact that your pelvis is 2 1/2 inches out of whack is huge. no wonder you have hip pain. Your hip flexors are probably tight and short. when the pelvis is out of alignmment, so is almost everything else. My right leg was an inch shorter than my left, because my right hip was high, becasue my HIP FLEXORS were too tight on the right. Now my legs are of equal length. I stretch my right side hipe flexors every morning for 10 minutes. When I stretched them properly and frequently, my hip pain was gone after about 10 days. My neck was a mess. My scalene muscles were like taught rubber bands, and exqisitely painful. I learned that they are called "the great imitators" they refer pain all over the place, including the upper back and chest. This required about 2-3 months of proper stretching and self massage. With the easing of my scalenes, the chest muscle pain disappeared. How is surgery on your neck (minimally invasive or not) going to help pain in your hip? It's not. You don't have myelopathy or nerve root symptoms, so you do not need surgery. It probably will not help.I read your MRI report-- sounded alot like mine, osteophytes, heriniations, canal narrowing. My neck feels great now because THE MUSCLES are looser.
you should do what you can of the following: go to John Barnes' website and read. Visit his clinic if you can. Go to a website by Jolie Bookspan and read read read. get her book on the Ab revolution. Go to Barnes and Noble and get a book on posture (i'm sure your posture is horrible) that has daily exercises. do them diligently 3 x per day. Get Clair Davies trigger point manual.
Right now go stand with your butt and heels against a wall. Does the back of your head touch the wall???? It should. If not, your posture is poor.you need to retrain your muscles so you stand like that all the time. Read about Upper and Lower Crossed syndromes. This is probably what's wrong with you. Go to a website by Erik Dalton for this and read.
There, that's the most important stuff out of 3 years of research i did.
I know you have scoliosis and i don't know for how long you've had it, but it does not have to be the culprit here-- it may in fact be DUE to your muscle balance being so poor. I doubt your "anular tear" is causing pain. It may have happenned (and cannot heal) because the muscles are pulling on the vertebrae in a way that is stressing vertebral structures.
The computer is horrible for your neck. stay off it. when you are on it, you can't slouch. you must consciously sit up straight with your head properly balanced over your torso, and you scapulas pulled together. it's a good time to exercise them, and i'm sure your rhomboids are weak and stretched (part of Upper crossed syndrome).
That's enough to get you started. good luck.
Your problems to me sound like they are due to muscle imbalances. The fact that your pelvis is 2 1/2 inches out of whack is huge. no wonder you have hip pain. Your hip flexors are probably tight and short. when the pelvis is out of alignmment, so is almost everything else. My right leg was an inch shorter than my left, because my right hip was high, becasue my HIP FLEXORS were too tight on the right. Now my legs are of equal length. I stretch my right side hipe flexors every morning for 10 minutes. When I stretched them properly and frequently, my hip pain was gone after about 10 days. My neck was a mess. My scalene muscles were like taught rubber bands, and exqisitely painful. I learned that they are called "the great imitators" they refer pain all over the place, including the upper back and chest. This required about 2-3 months of proper stretching and self massage. With the easing of my scalenes, the chest muscle pain disappeared. How is surgery on your neck (minimally invasive or not) going to help pain in your hip? It's not. You don't have myelopathy or nerve root symptoms, so you do not need surgery. It probably will not help.I read your MRI report-- sounded alot like mine, osteophytes, heriniations, canal narrowing. My neck feels great now because THE MUSCLES are looser.
you should do what you can of the following: go to John Barnes' website and read. Visit his clinic if you can. Go to a website by Jolie Bookspan and read read read. get her book on the Ab revolution. Go to Barnes and Noble and get a book on posture (i'm sure your posture is horrible) that has daily exercises. do them diligently 3 x per day. Get Clair Davies trigger point manual.
Right now go stand with your butt and heels against a wall. Does the back of your head touch the wall???? It should. If not, your posture is poor.you need to retrain your muscles so you stand like that all the time. Read about Upper and Lower Crossed syndromes. This is probably what's wrong with you. Go to a website by Erik Dalton for this and read.
There, that's the most important stuff out of 3 years of research i did.
I know you have scoliosis and i don't know for how long you've had it, but it does not have to be the culprit here-- it may in fact be DUE to your muscle balance being so poor. I doubt your "anular tear" is causing pain. It may have happenned (and cannot heal) because the muscles are pulling on the vertebrae in a way that is stressing vertebral structures.
The computer is horrible for your neck. stay off it. when you are on it, you can't slouch. you must consciously sit up straight with your head properly balanced over your torso, and you scapulas pulled together. it's a good time to exercise them, and i'm sure your rhomboids are weak and stretched (part of Upper crossed syndrome).
That's enough to get you started. good luck.
Hi Mike,
Thanks for your offer to help.
I am amazed that you actually read that long post. I usually don't ramble like that. Poor CCF Doc.
I usually don't complain much to doctors about my symptoms anymore. I am getting tired of the labels. I guess I am learning to think like a doctor. Remember, I am a 45-year-old female.
Because I have an excellent neurologist who does not judge, I understand that I do not need surgery at this time. My cord is significantly compressed, but there are no true neurological deficits yet. My symptoms do not suggest a problem with a particular nerve root distribution.
That said, my most worrisome symptom at this time is relatively new onset back pain. This is because I have a known disk with an annular tear in it in my thoracic spine and my local neurologist thinks the pain is coming from the tear. The muscle relaxer she gave me is not working and I am wondering where this is going to lead.
Secondly, I am looking for help with my hip pain. I have scoliosis also and my left hip is 2 1/2 inches higher that my right. I believe an orthopedist may be able to help me with this. Something along the line of shoe insert maybe?
I am also looking to strengthen the muscles in my spine and would like an explanation regarding the intermittent crunching and popping sounds in my neck. This is called crepitus but I am not sure if it means that there is progression regarding the problems in the cervical spine. It is extremly annoying.
I am a secretary. I do spend much time at the computer, but when I am home, I usually use the laptop.
At any given time, I have had all of the symptoms you mentioned, and then some. One that is always there is a burning sensation throughout most of my body. Again, no particular nerve root distribution. I also frequently feel feverish. This has been going on for 5 years. It can really zap your energy.
My goal is to help myself as much as I can, educate myself so that I can make intelligent decisions and stay off the operating table.
I don't know if the minimally invasive surgery can help me or not, but I would love to find out. Where did you have this done?
Thanks again.
Thanks for your offer to help.
I am amazed that you actually read that long post. I usually don't ramble like that. Poor CCF Doc.
I usually don't complain much to doctors about my symptoms anymore. I am getting tired of the labels. I guess I am learning to think like a doctor. Remember, I am a 45-year-old female.
Because I have an excellent neurologist who does not judge, I understand that I do not need surgery at this time. My cord is significantly compressed, but there are no true neurological deficits yet. My symptoms do not suggest a problem with a particular nerve root distribution.
That said, my most worrisome symptom at this time is relatively new onset back pain. This is because I have a known disk with an annular tear in it in my thoracic spine and my local neurologist thinks the pain is coming from the tear. The muscle relaxer she gave me is not working and I am wondering where this is going to lead.
Secondly, I am looking for help with my hip pain. I have scoliosis also and my left hip is 2 1/2 inches higher that my right. I believe an orthopedist may be able to help me with this. Something along the line of shoe insert maybe?
I am also looking to strengthen the muscles in my spine and would like an explanation regarding the intermittent crunching and popping sounds in my neck. This is called crepitus but I am not sure if it means that there is progression regarding the problems in the cervical spine. It is extremly annoying.
I am a secretary. I do spend much time at the computer, but when I am home, I usually use the laptop.
At any given time, I have had all of the symptoms you mentioned, and then some. One that is always there is a burning sensation throughout most of my body. Again, no particular nerve root distribution. I also frequently feel feverish. This has been going on for 5 years. It can really zap your energy.
My goal is to help myself as much as I can, educate myself so that I can make intelligent decisions and stay off the operating table.
I don't know if the minimally invasive surgery can help me or not, but I would love to find out. Where did you have this done?
Thanks again.
i read your long posts. your history sounds like mine. i had severe mid /upper back pain/ neck pain/ even chest pain / hip pain/ arm pain/lower back pain etc. you did not mention your specific symptoms but your MRI report does not to me indicate the need for surgery. surgery is usually done when there is obvious compression of a nerve root or the cord itself, where there is myelopathy (which you do not seem to have) and/or loss of steength or numbness in a particular distribution (nerve root).
I had minimally invasive (c5/6,6/7) surgery for my neck pain and it did nothing for me..Not that it's a bad surgery- it's a wonderful surgery that can prevent the need for fusion if successful and if if the case selection is right.
Please tell me what your symptoms are. Again I've been down this road and I believe I can help you. Tell me how old you are, what you do for a living, do you spend alot of time on the computer etc. i'll then post again.
I had minimally invasive (c5/6,6/7) surgery for my neck pain and it did nothing for me..Not that it's a bad surgery- it's a wonderful surgery that can prevent the need for fusion if successful and if if the case selection is right.
Please tell me what your symptoms are. Again I've been down this road and I believe I can help you. Tell me how old you are, what you do for a living, do you spend alot of time on the computer etc. i'll then post again.
I also complained about the back pain that I
spoke of in my first post to you.
I asked him if the back pain could be caused by the annular tear in the thoracic spine and his answer was "Who said you have any problem in the thoracic spine, I thought your problems were with your neck". This was a little upsetting because when I first saw him, shortly after my initial diagnosis last year from an out-of-state clinic, I brought a cd containing all of
the pictures from the 2005 MRI and he would not look at it because he didn't want to wait for it to load onto his laptop that he carries around with him. He started to load it, but then stopped, telling me that it really wouldn't show well enough on his computer. Also, I gave him copies of all the reports that went along with the 2005 visit to the out-of-state facility. The information regarding the tear is clearly stated in one of these reports and he has had them for nearly a year. We had also previously discussed it.
Since I did not get a straight answer from him regarding the tear, I figured that I would ask the local neurologist when I
saw her in a few days. I then proceeded to ask him about the recent chest x-ray that had been done at his facility.
Specifically, I asked about the incidental finding of "mild left convex thoracic scoliosis" and if any additional testing
needed to be done. At the time, I did not know that the scoliosis, hip pain and bursitis could be related. He relunctantly looked at the x-ray films from 2002 and then had me bend foward. He said he could not see it and proceeded to offer me narcotics (the second time he has done so). I told him that I "did not wish to go down that road" at which time he prescribed Relafin, 1000 mg to be taken every morning.
Just to clarify, I am located 90 miles southwest of Chicago and my initial MRI from which the diagnosis stems was done at an
out-of-state clinic. At the time of the initial MRI and diagnosis, it was stronly recommended that I find a local
neurologist to monitor me for any early signs of myelopathy. So, I am dealing with both local doctors and out-of-state
doctors.
So, on to the local neurologist whom I had seen previously 6 months ago and who did briefly view the cd on her computer at
that time. She told me that yes, the pain in the back was coming from the known disk with the annular tear and kept asking me if I wanted to try the injections. She also viewed the standing x-ray from 2002 and pointed out the scoliosis throught the spine. She viewed the recent chest x-ray too and kept saying "look how straight your neck is". She did a physical exam and found very tender points along the spine and what I think she said was a muscle knot, a "bump". When I showed her the diagram from the fair, concerned mostly about the 2 1/2" difference in the hips, she stated that she would not doubt that the measurement was correct. I felt extremely rushed during my visit with her and left with my head spinning to some extent and a prescription for Zanaflax 4mg which I am to take at bedtime. I have been doing so for about a week with no relief.
To further complicate things, our local YMCA just opened a brand new, absolutely gorgeous aquatic center with 3 seperate
pools. One of the pools is a therapy pool that has underwater treadmills and bikes. It also has therapy chairs which are
built into the pool with each chair having water jets that target a different part of the spine. Since I love the water, I was one of their first visitors and have gone 3 or 4 times already. I think I may have overdone it, however, as I now have yet another new area of pain, in my back, just to the left of the lower spine. Could I have pulled or strained a muscle? I also aggravated my neck pain by doing the breast stroke. I have been careful about using the chairs with the jets as they are strong and there is no way to adjust their force like there is in my hot tub.
One of our local hospitals has re-located their physical therapy department adjacent to the aquatic center at the YMCA. They do not have a spine specialist or physiatrist, however, and there are none in our area. The most the local therapy
department has is a therapist with additional training in the McKenzie method. I spoke with the director of the department
and told him of my diagnosis. He had nothing to offer except a membership in their wellness program which is not covered by
insurance but is very affordable. He sent a form to the local neurologist a couple of days ago to get clearance. Hopefully,
this will help me attain my goals of trying to correct my posture, losing a little weight, and building my spinal muscles.
I apologize for the length of this post. Writing is therapy, you know. Anyway, you are probably wondering where this is all
leading.
I have some more questions which I hope that you can answer.
1. Does it stand to reason that the hip pain and back pain, since they both began about the same time, may both be
attributable to the scoliosis and the back pain that I originally wrote to you about is not coming from the tear? I
have actually had the hip pain, to some extent, off and on for 5 years. I only sought the injection when it became totally unbearable, although I always told my local doctors about it.
2. I have been told that there is nothing I can do to stop the progression of the compression in the cervical spine. Is
this also true for the scoliosis or can this be helped?
3. Will the loss of lordosis in my neck eventually lead to kyphosis?
4. What help is available for the hip pain? I am not ready to wear orthopedic shoes and don't think I will ever be, but are there shoe inserts that might help? Is it an orthopedist that I would see for this and the scoliosis? What
tests should be run for evaluating the current state of the scoliosis? Is the MRI that I am going to have in Mid November sufficient to evaluate this? What physical exams or tests should be done. I am concerned about the scoliosis because after doing some reading, I looked at myself in a full length mirror and the right hand hangs to my side about 2 inches lower than the left. Its pretty freaky looking and I probably won't look again for quite some time. I am afraid of what else I might see if I look too close.
5. I have been reading about minimally invasive surgery to remove bone spurs. There is a doctor in Chicago who is at
the forefront of these procedures. Would it be worth my time and effort to see him? Are minimally invasive procedures a possibility for any of my other known problems?
6. Am I putting myself in any danger by waiting until November to have the follow-up MRI?
7 I have suffered from a rather severe viral infection for a little over two weeks. The constant draining from the
nose into the throat is now mostly gone but I cannot seem to get rid of the coughing. I have frequent coughing spells that are uncontrollable and have had to leave the room in social settings several times because of them. This cold and the last one have been particulary severe. Is this something to worry about? I try to control the coughing with Day Quill and it works to some extent.
8. Is progression of spinal canal narrowing, without myelopathy, usually an indication for surgery? I could have taken this the wrong way, but my out-of-state neurologist, whom I really like, told me last year that he suspects that if I
came back this year with progression, the surgeon might recommend surgery. He made sure that I knew that I was "not
off the hook"
9. Do you have any additional suggestions for me as far as what I can do to help myself or what questions I should ask
about my future? I will be seeing the out-of-state neurologist just before he orders the MRI. There is already a spot open for it, but I believe it is only open for a cervical MRI, not entire spine again.
10. I have not yet started the Relafen as I did not want to start two different medications at the same time. Is the
Relafen right for me given the fact that 2 years ago I was diagnosed with a very tiny diaphramatic hernia?
11. For the last 6 months I have had intermittent problems with my ears. Most annoying is a strange whoosing sound in my
ears when I move my head. I really don't know how to explain this well. As I move my head from side to side, even slightly, it sounds as if there is dead air being pushed between the ears. Move right slighty, it happens, move left, it happens. Could this have anything to do with the effacement of the CSF in the cervical spine or is it most likely due to sinusitus? My hearing has gotten a lot worse over the past year. I am constantly misunderstanding people. When they say tie, I think they said pie, etc. Very annoying.
12. Have I mentioned anything in either of these posts that might account for the "burning" sensation throughout most of
my body that I have suffered with for the last 5 years? How about the "feverish" feeling that is there most days?
13. Can you tell me why, when lying on my back on a firm mattress, my entire left front thigh area almost immediately
develops severe pain? This initially happened last year when we switched mattresses and this is what drove me to seek an out-of-state opinion. Initially, when I would lie there for even a minute or two, I would then have to struggle to get over onto my right hip or to stand up and then the pain would go away. After several days of this, the pain would linger and I was prescribed Vicoprofin which I took very sparingly for about a month. We switched back to a pillow top and this has almost completely resolved the problem. It took about 6 weeks for the pain to subside after swithing the mattress back. I don't do too many things flat on my back anymore.
14> Is the scoliosis evident on the MRI?
Here's the radiologist's report:
Result: Report Date: 19 Oct 2005 6:06PM MRI of the cervical, thoracic and lumbar spine without IV contrast. Cervical spine: Congenitally narrow cervical spinal canal. Moderate spondylosis in the mid/lower cervical spine with associated degenerative disk disease and narrowing of the C5-6 andC6-7 interspaces. Disk osteophyte complexes at C5-6 and C6-7 cause marked narrowing of the spinal canal. No abnormal T2 signal identified within the spinal cord. Cervical neural foramen are widely patent. Thoracic spine: within the thoracic spine,there is an anular tear and small focal disk protrusion at the T7-8 or T8-9 level which partially effaces the ventral subarachnoid space and minimal deformity of the ventral spinal cord. No abnormal cord signal identified. Between the scout aquisition and the images of the thoracic spine, the patient appears to have moved slightly, therefore, prior to any surgical intervention within the thoracic spine, further imaging is recommended to definitively determine the level of the above findings. Lumbar spine: Lumbar spine normal with no significant spinal canal or nerve root compromise.
There is also a neuroradiologist's report, but I don't have it in front of me.
I visited the CCF website and was happy to see that Cigna International has partnered with you to provide remote second
opinions. My insurance is Cigna. Perhaps some time in the near future, I will utilize this.
On the other hand, if I am told I need surgery, I am going to want a face to face consultation. To that end, can you tell me
who your top neurosurgeon is?
Thanks so much. You guys are wonderful.
spoke of in my first post to you.
I asked him if the back pain could be caused by the annular tear in the thoracic spine and his answer was "Who said you have any problem in the thoracic spine, I thought your problems were with your neck". This was a little upsetting because when I first saw him, shortly after my initial diagnosis last year from an out-of-state clinic, I brought a cd containing all of
the pictures from the 2005 MRI and he would not look at it because he didn't want to wait for it to load onto his laptop that he carries around with him. He started to load it, but then stopped, telling me that it really wouldn't show well enough on his computer. Also, I gave him copies of all the reports that went along with the 2005 visit to the out-of-state facility. The information regarding the tear is clearly stated in one of these reports and he has had them for nearly a year. We had also previously discussed it.
Since I did not get a straight answer from him regarding the tear, I figured that I would ask the local neurologist when I
saw her in a few days. I then proceeded to ask him about the recent chest x-ray that had been done at his facility.
Specifically, I asked about the incidental finding of "mild left convex thoracic scoliosis" and if any additional testing
needed to be done. At the time, I did not know that the scoliosis, hip pain and bursitis could be related. He relunctantly looked at the x-ray films from 2002 and then had me bend foward. He said he could not see it and proceeded to offer me narcotics (the second time he has done so). I told him that I "did not wish to go down that road" at which time he prescribed Relafin, 1000 mg to be taken every morning.
Just to clarify, I am located 90 miles southwest of Chicago and my initial MRI from which the diagnosis stems was done at an
out-of-state clinic. At the time of the initial MRI and diagnosis, it was stronly recommended that I find a local
neurologist to monitor me for any early signs of myelopathy. So, I am dealing with both local doctors and out-of-state
doctors.
So, on to the local neurologist whom I had seen previously 6 months ago and who did briefly view the cd on her computer at
that time. She told me that yes, the pain in the back was coming from the known disk with the annular tear and kept asking me if I wanted to try the injections. She also viewed the standing x-ray from 2002 and pointed out the scoliosis throught the spine. She viewed the recent chest x-ray too and kept saying "look how straight your neck is". She did a physical exam and found very tender points along the spine and what I think she said was a muscle knot, a "bump". When I showed her the diagram from the fair, concerned mostly about the 2 1/2" difference in the hips, she stated that she would not doubt that the measurement was correct. I felt extremely rushed during my visit with her and left with my head spinning to some extent and a prescription for Zanaflax 4mg which I am to take at bedtime. I have been doing so for about a week with no relief.
To further complicate things, our local YMCA just opened a brand new, absolutely gorgeous aquatic center with 3 seperate
pools. One of the pools is a therapy pool that has underwater treadmills and bikes. It also has therapy chairs which are
built into the pool with each chair having water jets that target a different part of the spine. Since I love the water, I was one of their first visitors and have gone 3 or 4 times already. I think I may have overdone it, however, as I now have yet another new area of pain, in my back, just to the left of the lower spine. Could I have pulled or strained a muscle? I also aggravated my neck pain by doing the breast stroke. I have been careful about using the chairs with the jets as they are strong and there is no way to adjust their force like there is in my hot tub.
One of our local hospitals has re-located their physical therapy department adjacent to the aquatic center at the YMCA. They do not have a spine specialist or physiatrist, however, and there are none in our area. The most the local therapy
department has is a therapist with additional training in the McKenzie method. I spoke with the director of the department
and told him of my diagnosis. He had nothing to offer except a membership in their wellness program which is not covered by
insurance but is very affordable. He sent a form to the local neurologist a couple of days ago to get clearance. Hopefully,
this will help me attain my goals of trying to correct my posture, losing a little weight, and building my spinal muscles.
I apologize for the length of this post. Writing is therapy, you know. Anyway, you are probably wondering where this is all
leading.
I have some more questions which I hope that you can answer.
1. Does it stand to reason that the hip pain and back pain, since they both began about the same time, may both be
attributable to the scoliosis and the back pain that I originally wrote to you about is not coming from the tear? I
have actually had the hip pain, to some extent, off and on for 5 years. I only sought the injection when it became totally unbearable, although I always told my local doctors about it.
2. I have been told that there is nothing I can do to stop the progression of the compression in the cervical spine. Is
this also true for the scoliosis or can this be helped?
3. Will the loss of lordosis in my neck eventually lead to kyphosis?
4. What help is available for the hip pain? I am not ready to wear orthopedic shoes and don't think I will ever be, but are there shoe inserts that might help? Is it an orthopedist that I would see for this and the scoliosis? What
tests should be run for evaluating the current state of the scoliosis? Is the MRI that I am going to have in Mid November sufficient to evaluate this? What physical exams or tests should be done. I am concerned about the scoliosis because after doing some reading, I looked at myself in a full length mirror and the right hand hangs to my side about 2 inches lower than the left. Its pretty freaky looking and I probably won't look again for quite some time. I am afraid of what else I might see if I look too close.
5. I have been reading about minimally invasive surgery to remove bone spurs. There is a doctor in Chicago who is at
the forefront of these procedures. Would it be worth my time and effort to see him? Are minimally invasive procedures a possibility for any of my other known problems?
6. Am I putting myself in any danger by waiting until November to have the follow-up MRI?
7 I have suffered from a rather severe viral infection for a little over two weeks. The constant draining from the
nose into the throat is now mostly gone but I cannot seem to get rid of the coughing. I have frequent coughing spells that are uncontrollable and have had to leave the room in social settings several times because of them. This cold and the last one have been particulary severe. Is this something to worry about? I try to control the coughing with Day Quill and it works to some extent.
8. Is progression of spinal canal narrowing, without myelopathy, usually an indication for surgery? I could have taken this the wrong way, but my out-of-state neurologist, whom I really like, told me last year that he suspects that if I
came back this year with progression, the surgeon might recommend surgery. He made sure that I knew that I was "not
off the hook"
9. Do you have any additional suggestions for me as far as what I can do to help myself or what questions I should ask
about my future? I will be seeing the out-of-state neurologist just before he orders the MRI. There is already a spot open for it, but I believe it is only open for a cervical MRI, not entire spine again.
10. I have not yet started the Relafen as I did not want to start two different medications at the same time. Is the
Relafen right for me given the fact that 2 years ago I was diagnosed with a very tiny diaphramatic hernia?
11. For the last 6 months I have had intermittent problems with my ears. Most annoying is a strange whoosing sound in my
ears when I move my head. I really don't know how to explain this well. As I move my head from side to side, even slightly, it sounds as if there is dead air being pushed between the ears. Move right slighty, it happens, move left, it happens. Could this have anything to do with the effacement of the CSF in the cervical spine or is it most likely due to sinusitus? My hearing has gotten a lot worse over the past year. I am constantly misunderstanding people. When they say tie, I think they said pie, etc. Very annoying.
12. Have I mentioned anything in either of these posts that might account for the "burning" sensation throughout most of
my body that I have suffered with for the last 5 years? How about the "feverish" feeling that is there most days?
13. Can you tell me why, when lying on my back on a firm mattress, my entire left front thigh area almost immediately
develops severe pain? This initially happened last year when we switched mattresses and this is what drove me to seek an out-of-state opinion. Initially, when I would lie there for even a minute or two, I would then have to struggle to get over onto my right hip or to stand up and then the pain would go away. After several days of this, the pain would linger and I was prescribed Vicoprofin which I took very sparingly for about a month. We switched back to a pillow top and this has almost completely resolved the problem. It took about 6 weeks for the pain to subside after swithing the mattress back. I don't do too many things flat on my back anymore.
14> Is the scoliosis evident on the MRI?
Here's the radiologist's report:
Result: Report Date: 19 Oct 2005 6:06PM MRI of the cervical, thoracic and lumbar spine without IV contrast. Cervical spine: Congenitally narrow cervical spinal canal. Moderate spondylosis in the mid/lower cervical spine with associated degenerative disk disease and narrowing of the C5-6 andC6-7 interspaces. Disk osteophyte complexes at C5-6 and C6-7 cause marked narrowing of the spinal canal. No abnormal T2 signal identified within the spinal cord. Cervical neural foramen are widely patent. Thoracic spine: within the thoracic spine,there is an anular tear and small focal disk protrusion at the T7-8 or T8-9 level which partially effaces the ventral subarachnoid space and minimal deformity of the ventral spinal cord. No abnormal cord signal identified. Between the scout aquisition and the images of the thoracic spine, the patient appears to have moved slightly, therefore, prior to any surgical intervention within the thoracic spine, further imaging is recommended to definitively determine the level of the above findings. Lumbar spine: Lumbar spine normal with no significant spinal canal or nerve root compromise.
There is also a neuroradiologist's report, but I don't have it in front of me.
I visited the CCF website and was happy to see that Cigna International has partnered with you to provide remote second
opinions. My insurance is Cigna. Perhaps some time in the near future, I will utilize this.
On the other hand, if I am told I need surgery, I am going to want a face to face consultation. To that end, can you tell me
who your top neurosurgeon is?
Thanks so much. You guys are wonderful.
It was a hiatal hernia, not diaphramatic. Sorry.
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