Viewing 4 posts - 1 through 4 (of 4 total)
  • Author
    Posts
  • AvatarBetoWI
    Participant
    Post count: 2

    Hello Dr.

    I’m 48 male, exercise 4-5 days a week. In Feb 2016, I got a sharp pain down my left arm while doing sitting chest presses at the gym. I’ve been having tingling sensation down my left arm down to my index and thumb. Some times I have left shoulder blade ache, sometimes an echoing ache on my left forearm. There is a little loss of strength on my left arm in comparison to right, which I noticed doing push-ups or chataranga in yoga. I’ve been doing PT exercises with no major change. Then my PT therapist had me do some sessions of traction, that did seem to have helped. My Dr. ordered an MRI for me and the results were:

    MRI cervical spine without contrast
    The cord is normal in signal and caliber. The visualized posterior fossa is normal. No prevertebral soft tissue swelling. The vertebral body heights are maintained. No spondylolisthesis. There is minimal disk height loss at C5-C6 and C6-C7.

    Segmental analysis:
    C2-C3: Normal
    C3-C4: Normal
    C4-C5: Normal
    C5-C6: Shallow disk osteophyte complex without spinal canal stenosis or foraminal narrowing.
    C6-C7: Disk osteophyte complex with a left paracentral and intraforaminal disk protrusion (5 mm x 10 mm x 7 mm) impinging the exiting left C7 nerve root. The disk also indents the ventral cord. There is no right foraminal narrowing.
    C7-T1: Normal

    My Dr sent me to a neurosurgeon, who showed me the bulge in the MRI and the assessment is for artificial disc replacement. I want to make sure that surgery is the only solution and I am concerned with my quality of life when I’m older.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7288

    You have classic symptoms of a cervical radiculopathy. The nerve affected should be C7 (a C6-7 disc herniation affects the C7 nerve). If your symptoms are significant and you have motor weakness, surgery should be considered but if the symptoms are at this point tolerable and your motor weakness is not moderate-severe, you could consider conservative treatment including an epidural injection and physical therapy.

    If the symptoms or weakness are profound, you have two choices, an ACDF or an ADR (artificial disc replacement). There are risks and benefits with both. ACDF surgery is a one time surgery that never has to be repeated when a solid fusion occurs. The results are reliable. Would you lose some motion? Maybe but I bet if you had flexion-extension films of that level, you would have very little motion so the loss of motion would be negligible.

    The ADR is also a good choice but there are probable consequences down the road. ADRs will eventually wear out needing a conversion to a fusion. This might be in 2 years or 20, no one knows at this point. I have had 7 patients (from other institutions) with ADRs that needed conversion to fusion at this point. The ADR does allow motion to continue so that is the benefit. The ADR does not preserve the discs above or below.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    AvatarBetoWI
    Participant
    Post count: 2

    Hi Dr. Corenman,

    Thank you very very much, the information you provided gives me appropriate context on the decision I need to make. At this point I have the surgery scheduled for Nov. but I’m going to continue work on PT exercises and with the goal of improving my condition. I will reassess in the next two month wether or not to proceed with the surgery. I truly feel surgery should be the choice if the symptoms merit it. I feel that my symptoms are not at that stage yet. When ache levels increase I just take aleve and that seems to help. Again I am very grateful that you take the time and offer such good unbaised information.

    Best Regards!

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7288

    Please keep in touch with your treatment.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
Viewing 4 posts - 1 through 4 (of 4 total)
  • You must be logged in to reply to this topic.