Chronic neck pain for over 20 years - successful C5-6 disc fusion in Dec01 (age39). Nov02, new C4-5 hernia with disc space narrowing. Neck pain on both sides with burning in both shoulder blades, caps, triceps, and neck. Both outer forearms and hands are mild to moderately numb. Simple neck movements frequently bite soft tissues with constant grinding/crunching. Aggresive PT and pain mgt has determined the pain is strictly related to the disc degeneration and resulting inflamation to soft tissues/disc/nerves. Steroid injection unsuccessful beyond a few days.
1. Please explain the following diag results in layman's terms:
- Myelo/CT: C4-5 central disc protrusion with anterior CSF space effacement; C2-3, C3-4, C6-7 central disc bulges with anterior CSF space mild effacement; C5-6 minimal central bony ridging; diffuse facet hypertrophy; no evidence of spinal stenosis.
- NCS: normal; EMG: Mar03-normal; Jul03-evidence of ongoing/chronic neurogenic process affecting multiple arm muscles, suggestive of chronic cervical polyradiculopathy involving C5,6,&7 root levels. Acute denervation in the left ECR and paraspinal muscles is further evidence of mild ongoing involvement at or proximal to the left C5 root level.
2. Based on these results - is surgery necessary at this time to prevent permanent nerve damage and if surgery is indicated, is disc replacement the only option? I'm hoping to hold off for flexi-disc FDA approval after clinical trials wrap up. Can a surgeon clean up the hernia and bone spurs (noted on x-ray) w/out removing the disc?
The changes described on your myelo CT indicate that there are several discs and bony changes which are pushing on the fluid sac around the spinal cord. However they do not mention compression or pushing against the cord or nerve roots.
The EMG test in July 2003 indicates that you have both active and chronic nerve damage to the nerves in your cervical spine.
Based on the description you have provided, I would recommend an evaluation at a large academic spine center. They will be able to evaluate you and then determine if any additional testing needs to be completed. After checking your neurologic examination and reviewing your prior imaging the decision regarding surgery could be made. It is also important that other conditons which could result in nerve damage be ruled out prior to surgery.
i have been diagnosed with failed back surgery after receiving a fusion from l4-s1. My doctor says i have nerve damage and would be a good canidate for a intrathecal pump. My question is what does this Emg actually maen here is the electrodiagnostic impression:1) Bilateral moderate l5 radiculopathy, chronic in nature with ongoing component.2) mild s1 radiculopathy on the right,chronic in nature.3)Moderate s1 radiculopathy on the left with ongoing signs of acute injury. Comments would be greatly appreciated. I'm wondering if I would benefit from another kind of surgery to relieve some of this pain it is worse than before surgery I had the surgery back in jan of 2003 thanks
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