Aa
Lot of cervical spine problems
Ok so im headed to see a nuerosurgeon in 2 days and im rather discouraged at what I know is wrong and what will be possible to be done. I have moderate to severe RA and recently they found FINDINGS:
History indicates neck pain and back pain. CT scan of the cervical spine demonstrates degenerative disc disease. No spinal stenosis. Small central disc protrusion is noted at C3-4 without impingement on the dural sac. Minimal annulus bulging is present at C4-5. At C5-6 there is some posterior osteophyte formation. Disc space cannot be evaluated at this level or more caudally because of shoulder artifact. There is no acute finding.
Incidental ossicle is seen in the ligamentum nuchae at the C5 level. Tiny mucus retention cyst left maxillary sinus.
IMPRESSION:
Mild Cervical spondylosis without acute pathology
They have also found endplate spurring
and this was from a myelogram vs regular CT
C4-5: Trace disc bulging with no substantial spinal canal or foraminal stenosis.
C5-6: Mild broad-based disc bulging and mild spinal canal stenosis. No substantial foraminal stenosis.
C7-T1: Minimal broad-based disc bulging with no spinal canal or foraminal stenosis. Cervical spinal cord would be better assessed with MRI if necessary.
IMPRESSION:
Minimal C5-6 spinal canal stenosis. No substantial foraminal narrowing or disc extrusion seen at any level.
That is alot of things not right. I am in severe pain, i have numbness and tingling in both arms to my fingertips. I get multipule major migraines due to this. my Nuerologist and pain dr both say i need surgery but the last doctor i seen said all i could do was get a stimulator.. I am on fentanyl 50 mcg patch and still hurt so much i cant lift my arms high, hold my head up with out head pain. What treatment exists for this? It has been monitored and no good change has occured it has gotten worse.
History indicates neck pain and back pain. CT scan of the cervical spine demonstrates degenerative disc disease. No spinal stenosis. Small central disc protrusion is noted at C3-4 without impingement on the dural sac. Minimal annulus bulging is present at C4-5. At C5-6 there is some posterior osteophyte formation. Disc space cannot be evaluated at this level or more caudally because of shoulder artifact. There is no acute finding.
Incidental ossicle is seen in the ligamentum nuchae at the C5 level. Tiny mucus retention cyst left maxillary sinus.
IMPRESSION:
Mild Cervical spondylosis without acute pathology
They have also found endplate spurring
and this was from a myelogram vs regular CT
C4-5: Trace disc bulging with no substantial spinal canal or foraminal stenosis.
C5-6: Mild broad-based disc bulging and mild spinal canal stenosis. No substantial foraminal stenosis.
C7-T1: Minimal broad-based disc bulging with no spinal canal or foraminal stenosis. Cervical spinal cord would be better assessed with MRI if necessary.
IMPRESSION:
Minimal C5-6 spinal canal stenosis. No substantial foraminal narrowing or disc extrusion seen at any level.
That is alot of things not right. I am in severe pain, i have numbness and tingling in both arms to my fingertips. I get multipule major migraines due to this. my Nuerologist and pain dr both say i need surgery but the last doctor i seen said all i could do was get a stimulator.. I am on fentanyl 50 mcg patch and still hurt so much i cant lift my arms high, hold my head up with out head pain. What treatment exists for this? It has been monitored and no good change has occured it has gotten worse.
I want to thank you so much for sharing your experience. You should always feel welcome in our community. Also feel free to 'rant" here anytime. We value all input. The best information and suggestions always comes from those that have personal experience with a condition and/or disease. Your comments are invaluable - and encouraging.
I don't need to tell you that you are blessed to have parents that could afford to help you - and that more importantly, obviously love you so much.
You've actually given me some hope - and eased my fears a bit. It's my C5 and C6 that are so diseased. Everyday I feel more and more of the effects. I know the time is fast approaching that I will no longer be able to tolerate my cervical spine issues. I am so frightened of surgery and treatments that I actually cancelled the appt my neurologist made for me to consult a neurosurgeon last August. It's not just the surgery I fear - but that fact that I am allergic to 90% of the antibiotics available to treat infections. So I suffer, mostly in silence.
Thanks again for sharing your experience. I am so very happy to hear that you found a solutions - and are feeling so much better. I wish you the best! Please be active in our community.
Happy 2016,
~Tuck
I don't need to tell you that you are blessed to have parents that could afford to help you - and that more importantly, obviously love you so much.
You've actually given me some hope - and eased my fears a bit. It's my C5 and C6 that are so diseased. Everyday I feel more and more of the effects. I know the time is fast approaching that I will no longer be able to tolerate my cervical spine issues. I am so frightened of surgery and treatments that I actually cancelled the appt my neurologist made for me to consult a neurosurgeon last August. It's not just the surgery I fear - but that fact that I am allergic to 90% of the antibiotics available to treat infections. So I suffer, mostly in silence.
Thanks again for sharing your experience. I am so very happy to hear that you found a solutions - and are feeling so much better. I wish you the best! Please be active in our community.
Happy 2016,
~Tuck
Hi again,
I'm just concerned and wondering how you are doing. I am so very sorry to hear about your level of pain and the issues associated with it. My heart goes out to you!!
As Remar said, changing the patch every 48 hours may be of beneficial. Discuss the possibility with your physician.
I have an aunt that has a SCS. She has had trouble with it "shorting out" and doing other strange things. It was implanted several years ago - and the longer it is in the more problems she seems to encounter.
Several physicians believe it is actually the SCS that is now causing some very troubling pain issue. They thought it should be removed. She has consulted three different neurosurgeons - all of them have said the SCS cannot be removed. It has "grown into" spaces that would make removal very difficult. She is forever - for lack of the right word -"stuck" with this device and the issues has caused. She tells me she wishes she had never agreed to having it implanted - and warned me against ever agreeing to one.
I believe my aunt is the exception rather than the norm - but it makes one think. Personally I will not agree to a SCS - for more reasons than my aunt.
I didn't mention that fact that Lyrica can be a great medication to ease some of the pain that accompanies cervical spine (or any portion of the spine) dysfunction. It added to your Fentanyl Patch it may be very beneficial. I use it with some relief.
Dilaudid is not one your list of allergies (it is mine). It is a Big Dog opiate and can be very effective in controlling pain. You might want to put keep this in mind for future reference.
Please let us know how you are doing. I'll look forward to your update.
My Best to You,
~Tuck
I'm just concerned and wondering how you are doing. I am so very sorry to hear about your level of pain and the issues associated with it. My heart goes out to you!!
As Remar said, changing the patch every 48 hours may be of beneficial. Discuss the possibility with your physician.
I have an aunt that has a SCS. She has had trouble with it "shorting out" and doing other strange things. It was implanted several years ago - and the longer it is in the more problems she seems to encounter.
Several physicians believe it is actually the SCS that is now causing some very troubling pain issue. They thought it should be removed. She has consulted three different neurosurgeons - all of them have said the SCS cannot be removed. It has "grown into" spaces that would make removal very difficult. She is forever - for lack of the right word -"stuck" with this device and the issues has caused. She tells me she wishes she had never agreed to having it implanted - and warned me against ever agreeing to one.
I believe my aunt is the exception rather than the norm - but it makes one think. Personally I will not agree to a SCS - for more reasons than my aunt.
I didn't mention that fact that Lyrica can be a great medication to ease some of the pain that accompanies cervical spine (or any portion of the spine) dysfunction. It added to your Fentanyl Patch it may be very beneficial. I use it with some relief.
Dilaudid is not one your list of allergies (it is mine). It is a Big Dog opiate and can be very effective in controlling pain. You might want to put keep this in mind for future reference.
Please let us know how you are doing. I'll look forward to your update.
My Best to You,
~Tuck
I don't have much more advice to offer because Tuck did a wonderful job with her advice.
I just wanted to let you know that we're here for you any time you want to talk because almost all of us on this forum suffer from chronic pain. So we do understand.
I agree that you should talk to your Dr about changing your patch every 48 hours instead of every 72 hours. You want to be careful with the Fentanyl patch and not up your dose too fast. Hopefully changing it every 48 hours will give you a lot more pain relief.
Please keep us up to date on how you're doing.
I just wanted to let you know that we're here for you any time you want to talk because almost all of us on this forum suffer from chronic pain. So we do understand.
I agree that you should talk to your Dr about changing your patch every 48 hours instead of every 72 hours. You want to be careful with the Fentanyl patch and not up your dose too fast. Hopefully changing it every 48 hours will give you a lot more pain relief.
Please keep us up to date on how you're doing.
HI Tuckamore,
I already have the Implant in my Lumbar spine but it does not cover my neck and right now due to the cord impingement it is cutting out when i turn my head to the right. I have seen 3 Osteo Surgeons 2 of them specializing in necks. I have also continued to see my neurologist for it he refuses to listen to the wack doctors that say there is nothing they can do to fix it at this point. I do not believe them. There is way to much wrong it cannot be good to have discs herniated and bulging at every level! Unfortunately i am allergic to alot of the oral pain medications including, tramadol, toradol, perocoset, vicodin, and morphine. Im on the 50 mg every 3 days as my PM perscribes. Im going to request it be raised at my next visit. im on muscle relaxers but they are not strong enough. Im tired of being in so much pain. I have had numerous visits to ER because of the migraines.. im an epileptic and they force me into convulsions. my longest migraine lasted 52 days wih pain exceding 10 on the scale i was rushed into a room because my blood pressure and heart rate was dangerously high in stroke levels. Glad my appointment is tomorrow. Im going to ask alot and hope he dont say i cant Help.
I already have the Implant in my Lumbar spine but it does not cover my neck and right now due to the cord impingement it is cutting out when i turn my head to the right. I have seen 3 Osteo Surgeons 2 of them specializing in necks. I have also continued to see my neurologist for it he refuses to listen to the wack doctors that say there is nothing they can do to fix it at this point. I do not believe them. There is way to much wrong it cannot be good to have discs herniated and bulging at every level! Unfortunately i am allergic to alot of the oral pain medications including, tramadol, toradol, perocoset, vicodin, and morphine. Im on the 50 mg every 3 days as my PM perscribes. Im going to request it be raised at my next visit. im on muscle relaxers but they are not strong enough. Im tired of being in so much pain. I have had numerous visits to ER because of the migraines.. im an epileptic and they force me into convulsions. my longest migraine lasted 52 days wih pain exceding 10 on the scale i was rushed into a room because my blood pressure and heart rate was dangerously high in stroke levels. Glad my appointment is tomorrow. Im going to ask alot and hope he dont say i cant Help.
Hello Fairywitch,
I am so sorry that you have so many issues in your cervical spine. I know the pain can be debilitating! My heart goes out to you! I too have Cervical Spine pain and issues.
I don't think you are on a very high dosage of opiates. Are you allowed to change the Patch every 48 hours instead of every 72 hours? The Fentanyl can be increased - and you should also have a break-through or "rescue" opiate that you can take PRN (as needed). Obviously opiates only mask the pain and do nothing to repair the problem(s). You deserve to be more comfortable during this decision making process.
What was the title did the "last doctor" you saw - the one that proposed a SCS (Spinal Cord Stimulator)? Was he/she a PMP - or a Surgeon - or a PCP? In my opinion that makes a difference.
I'm sorry there has been "no good change" as you have monitored your cervical spine problems. That's normal and there will probably never be an improvement in the structure of your spine without surgical intervention. The question is when is it the right time for surgery? Good surgeons will tell you that surgery is always the last option. It's considered when nothing else will be effective in reducing or controlling your SX (symptoms) and having surgery is better than not having surgery.
I'd ask questions, lots of questions - both of myself and the surgeon. Can you no longer tolerate the pain? Has everything that doesn't have the potential of making things worse been considered or tried? What happens if you wait, postpone the surgery? What are the complications of the procedure? What are the surgeon's statistics - meaning how many times has he preformed the surgery and what have been the out comes - good and bad?
The Cervical Spine is more difficult to manipulate that other areas of the spine - as it's much smaller, more complex. I'd hope the neurosurgeon specializes in the Cervical Spine.
Back to the SCS. I am probably not a good person to discuss these implants - because I've seen and heard of more problems with them than is normal. I don't want to frighten you so I won't say more. If you want to message me I will discuss it with you. I will tell you that a SCS means lots of dollars in a PMP pocket. I am not suggesting that most PMP are seeking money by implanting a SCS, that's not true. I do believe there are a very few that are motivated for several reasons to implant SCS when it's not in the patient's best interest. So think before you agree to the suggestion of one. Discuss it with your PMP and neurosurgeon.
Last but not least I highly encourage you to obtain a second opinion from a neurosurgeon - if he disagrees with the first surgeon than I'd get a third opinion. Once the surgery is done there is no going back.
I hope something I have said will be of help. Please feel free to ask additional questions. If I have not been clear I apologize.
Please keep in touch and let us know how you are doing. I'll be very interested to hear more about your decision - and how it all turns out. My future holds cervical spine surgery too.
Best of Luck and Take Care,
~Tuck
I am so sorry that you have so many issues in your cervical spine. I know the pain can be debilitating! My heart goes out to you! I too have Cervical Spine pain and issues.
I don't think you are on a very high dosage of opiates. Are you allowed to change the Patch every 48 hours instead of every 72 hours? The Fentanyl can be increased - and you should also have a break-through or "rescue" opiate that you can take PRN (as needed). Obviously opiates only mask the pain and do nothing to repair the problem(s). You deserve to be more comfortable during this decision making process.
What was the title did the "last doctor" you saw - the one that proposed a SCS (Spinal Cord Stimulator)? Was he/she a PMP - or a Surgeon - or a PCP? In my opinion that makes a difference.
I'm sorry there has been "no good change" as you have monitored your cervical spine problems. That's normal and there will probably never be an improvement in the structure of your spine without surgical intervention. The question is when is it the right time for surgery? Good surgeons will tell you that surgery is always the last option. It's considered when nothing else will be effective in reducing or controlling your SX (symptoms) and having surgery is better than not having surgery.
I'd ask questions, lots of questions - both of myself and the surgeon. Can you no longer tolerate the pain? Has everything that doesn't have the potential of making things worse been considered or tried? What happens if you wait, postpone the surgery? What are the complications of the procedure? What are the surgeon's statistics - meaning how many times has he preformed the surgery and what have been the out comes - good and bad?
The Cervical Spine is more difficult to manipulate that other areas of the spine - as it's much smaller, more complex. I'd hope the neurosurgeon specializes in the Cervical Spine.
Back to the SCS. I am probably not a good person to discuss these implants - because I've seen and heard of more problems with them than is normal. I don't want to frighten you so I won't say more. If you want to message me I will discuss it with you. I will tell you that a SCS means lots of dollars in a PMP pocket. I am not suggesting that most PMP are seeking money by implanting a SCS, that's not true. I do believe there are a very few that are motivated for several reasons to implant SCS when it's not in the patient's best interest. So think before you agree to the suggestion of one. Discuss it with your PMP and neurosurgeon.
Last but not least I highly encourage you to obtain a second opinion from a neurosurgeon - if he disagrees with the first surgeon than I'd get a third opinion. Once the surgery is done there is no going back.
I hope something I have said will be of help. Please feel free to ask additional questions. If I have not been clear I apologize.
Please keep in touch and let us know how you are doing. I'll be very interested to hear more about your decision - and how it all turns out. My future holds cervical spine surgery too.
Best of Luck and Take Care,
~Tuck
1 Comments
Hi Fairywitch!
I'm so very sorry to hear about all your neck problems! I also had pretty severe neck issues & after my C-5 disc completely herniated into my spinal cord I ended up having a disc replacement. It was amazing!! It was exactly the answer for me.
I had my original MRI w/many of the same results you had received except for the issue at C-5/6. I have osteoarthritis all throughout my neck/back/hip-I also have Ehlers Danlos which doesn't help.
I began having those cortisone/epidural injections in my neck & prayed they'd help. The first one did for over 6mos, the 2nd almost 3mos, & the 3rd did nothing. I saw 3 neurosurgeons & due to having EDS, which is a connective tissue disorder in which basically all of my joints are lax & sublux/dislocate, having a fusion was not an option. All 3 surgeons stated a disc replacement was my only option, but since I had went through 5 previous knee surgeries inevitably having both patella's removed, the idea of another surgery scared me to death.
I waited 18mos prior to deciding on having the surgery. Also there was the fact that both of my private medical insurance companies refused to cover the surgery cost...which was about $27K. I did not have any way to cover such a cost, but I have the most amazing parents on this earth who had offered to cover it from the get go. I flat out refused for 18mos.
Flash forward about 14-15mos from the initial injury & I was to the point that the thoughts in my mind were scaring me. The pain was horrendous & this was while I was on a 100mcg Fentanyl patch, ES Percocet, etc, for my EDS/knees/other pain issues. The biggest problem was the pain running down my arm-it felt like a knife stabbing me over & over. The hand & finger numbness, & what became the worse issue was my head. My neck no longer held my head up & my chin rested on my chest. I was staring straight down at the ground for months as my chin just kept dropping lower & lower as time went on. Honestly I was thinking about how many gas operated power tools in my garage I could turn on to end the nightmare & this was after I'd went through 5yrs of back to back knee surgeries & had my knee caps removed!!
Thanksgiving 2012 I went to my folks & after they witnessed me for over 5hrs going through all the pain, misery, & staring @ the ground, they pulled me aside for a chat. They took told me they were through seeing me this way, & that they'd rather have their daughter-FYI I'm an only child, have my life back & "spend their $ while their alive". I cried & cried & told them how very much I love & appreciate them, & that I needed to think about their offer.
The next day my Mom called & I told her I'd do it. She called the neurosurgeon I'd seen about a month prior after seeing him twice before the last appointment for a consult, & an ECG. I was scheduled for surgery on Dec 10th!
To say the surgery saved my life is an understatement. I was scared to death & believe it or not I had it done around 9am, went home around 4-5pm. The next morning after surgery I got up & unloaded the dishwasher! I only had very mild incision pain but the neck pain/agony & 80-90% of the arm pain was gone. It was completely amazing. I still have to take Neurontin for the residual arm/nerve pain, but other than that it's been a total miracle.
Good luck my dear & prayers. I'm sorry to rant & write so much but I just needed to share that there is hope. I know the pain you're describing & it's pure misery & I'm so very sorry.
I'm so very sorry to hear about all your neck problems! I also had pretty severe neck issues & after my C-5 disc completely herniated into my spinal cord I ended up having a disc replacement. It was amazing!! It was exactly the answer for me.
I had my original MRI w/many of the same results you had received except for the issue at C-5/6. I have osteoarthritis all throughout my neck/back/hip-I also have Ehlers Danlos which doesn't help.
I began having those cortisone/epidural injections in my neck & prayed they'd help. The first one did for over 6mos, the 2nd almost 3mos, & the 3rd did nothing. I saw 3 neurosurgeons & due to having EDS, which is a connective tissue disorder in which basically all of my joints are lax & sublux/dislocate, having a fusion was not an option. All 3 surgeons stated a disc replacement was my only option, but since I had went through 5 previous knee surgeries inevitably having both patella's removed, the idea of another surgery scared me to death.
I waited 18mos prior to deciding on having the surgery. Also there was the fact that both of my private medical insurance companies refused to cover the surgery cost...which was about $27K. I did not have any way to cover such a cost, but I have the most amazing parents on this earth who had offered to cover it from the get go. I flat out refused for 18mos.
Flash forward about 14-15mos from the initial injury & I was to the point that the thoughts in my mind were scaring me. The pain was horrendous & this was while I was on a 100mcg Fentanyl patch, ES Percocet, etc, for my EDS/knees/other pain issues. The biggest problem was the pain running down my arm-it felt like a knife stabbing me over & over. The hand & finger numbness, & what became the worse issue was my head. My neck no longer held my head up & my chin rested on my chest. I was staring straight down at the ground for months as my chin just kept dropping lower & lower as time went on. Honestly I was thinking about how many gas operated power tools in my garage I could turn on to end the nightmare & this was after I'd went through 5yrs of back to back knee surgeries & had my knee caps removed!!
Thanksgiving 2012 I went to my folks & after they witnessed me for over 5hrs going through all the pain, misery, & staring @ the ground, they pulled me aside for a chat. They took told me they were through seeing me this way, & that they'd rather have their daughter-FYI I'm an only child, have my life back & "spend their $ while their alive". I cried & cried & told them how very much I love & appreciate them, & that I needed to think about their offer.
The next day my Mom called & I told her I'd do it. She called the neurosurgeon I'd seen about a month prior after seeing him twice before the last appointment for a consult, & an ECG. I was scheduled for surgery on Dec 10th!
To say the surgery saved my life is an understatement. I was scared to death & believe it or not I had it done around 9am, went home around 4-5pm. The next morning after surgery I got up & unloaded the dishwasher! I only had very mild incision pain but the neck pain/agony & 80-90% of the arm pain was gone. It was completely amazing. I still have to take Neurontin for the residual arm/nerve pain, but other than that it's been a total miracle.
Good luck my dear & prayers. I'm sorry to rant & write so much but I just needed to share that there is hope. I know the pain you're describing & it's pure misery & I'm so very sorry.
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