[aaawar]

#27104

Hi Dr. Corenman,

Few weeks ago i had severe pain in my left shoulder and arm. I have got a MRI scan with these finding.

Neck pain radiating to left arm and left deltoid weakness. Multiplanar and multi-sequential images were acquired through cervical spine without IV gadolinium contrast. No prior examination is available for comparison.

Findings: Mild straightening of the cervical spine is noted. There is evidence of disc osteophyte complex and diffuse disc bulge at C3-C4 level resulting in contour deformity and causing mild thecal sac indentation and moderate right neural foraminal stenosis. At C4-C5 level, there is combination of disc osteophyte complex, diffuse disc bulge causing mild thecal sac indentation and mild left neural foraminal stenosis. No significant disc bulge or protrusion at any other level is noted in the cervical spine. No evidence of spinal cord compression. No abnormal signals within spinal cord. Cranio-cervical junction appears normal. Vertebral body heights and intervertebral disc spaces are preserved. Pre and paravertebral soft tissues appear normal. No evidence of marrow replacement in vertebrae.

Impression: There is evidence of disc osteophyte complex and diffuse disc bulge at C3-C4 level resulting in contour deformity and causing mild thecal sac indentation and moderate to severe left neural foraminal stenosis. At C4-C5 level, there is combination of sic osteophyte complex, diffuse disc bulge causing mild thecal sac indentation and mild neural foraminal stenosis.

I met neuro-surgeon and he has recommended me a surgery. I would highly appreciate your advice, would you recommend cervical physiotherapy exercises or surgery.

Thanks

[Donald Corenman, MD, DC]

#27119

You could have a C5 radiculopathy from “mild left neural foraminal stenosis” causing deltoid weakness (see https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/) but your compression is very mild and not likely expected to cause enough compression to cause your current symptoms (at least according to the radiologist). You could have developed Parsonage Turner syndrome (See https://neckandback.com/conditions/parsonage-turner-syndrome-neck/) which might make more sense. A nerve conduction study (NCV/EMG- see https://neckandback.com/treatments/emgncv-electromyograms-and-nerve-conduction-studies-neck/) might help differentiate these two diagnoses.

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.

[aaawar]

#27125

Thank you doc for the quick reply highly appreciated.

Since couple of days the pain has decreased but now it has lead to progressive weakness in my body.

In both the cases you mentioned above, would you recommend a surgery?

Many Thanks.

[Donald Corenman, MD, DC]

#27128

Parsonage Turner Syndrome is not a surgical disorder. Progressive weakness is something that needs to be attended to. I would advise an immediate trip to your PCP or even the emergency room as there are disorders where weakness can progress.

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.

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