[ninja99]

#31873

Hi Dr.,

I’m so very pleased you have this website, it really can help many out there get more information about what they’re going through. Thank you. Hopefully you can give me some more insight…

My questions are:
1) Will replacement surgery for this really help my symptoms?
2) For a 44 year old man who’s in decent health (will cease any light vaping/drinking before and after surgery), what is recovery time? I work in an office (sitting at desk all day, some light walking). Physical/blood results are good.
3) Any link between cervical injuries and eye floaters/migraines?

Results below. Omitted any ok results in reports. Was active 3-4 times a week, 1/2 marathons, lifting, boxing. Things now feel ‘off’. Haven’t done a 1/2 marathon in over 2 years.

1.5 years ago, I fell backwards over a suitcase in dark room, fracturing left 9th rib.

5 months later, fell again on my left side (shoulder), scraping the left side of my head pretty badly (stitches). Thought was Rotator-cuff based, recently did spine check. Cortisone for cuff was done 3x. 2 a year ago, 1 a month ago. Has helped ease some pain (33%)

Symptoms w/2 bouts physical therapy (cables, door stretches, rowing, standard stuff):
1) Stretch band, cannot go beyond 45 degrees stretching horizontally on left shoulder without pain.
2) Sleeping on left side hurts in the morning, about a 3-4/10. With Cortisone 1-2/10.
3) Infra/supra sore with weights/running. When lifting shoulder out sideways, can feel pain on top left of neck to shoulder, pain radiates down to between thumb and index finger area. About a 5. Lifting up my left arm and doing various tests, feels like a pinched nerve extending into my biceps and triceps.
4) Running/spinning makes me dizzy, ocular migraines more often (1/5x). In my left eye I get auras, for 3 hrs. Before, was more of a once every other year thing, with cross-training and lifting heavy things quickly over my head.
5) A month after 2nd injury, developed a pretty big floater in the left eye, a few in right, and quite a few others on the peripheral. Some have subsided in a year, but when I look up I can see more of them in my field of vision. Had smaller ones before that didn’t bother me, these are very noticeable.

2nd fall:
Cervical Spine tests
MRI 12/11/19 (NO CONTRAST)
Discs: Moderate C5-6 degenerative disc disease
Symmetric disc bulge osteophyte with mild central stenosis. Uncovertebral spurring with mild bilateral foraminal stenosis.

XRAY 12/02/2019
Alignment: 2mm retrolisthesis of C5 on 6
Disc Spaces: Mild C5-6 Disc space narrowing.

MRI Shoulder: 10/31/18:
1. No rotator cuff complete tear.
2. There is a mild anterior insertional tendinosis of the supraspinatus tendon. Tiny arthroscopically occult rim-rent tear of the supraspinatus/infraspinatus decussation insertion. More posteriorly there is a moderate tendinosis of the infraspinatus. The subscapularis is normal.
3. Tendinosis of the infraspinatus and supraspinatus, greater involving the former.

1st fall:
XRAY 5/12/2018
Subtle undisplaced fracture of the left ninth rib without complication

[Donald Corenman, MD, DC]

#31877

It is difficult to differentiate between rotator cuff impingement syndrome and cervical radiculopathy from the information you provide. One of the ways to differentiate is through a simple test. If you keep your arm hanging down and still while you extend your head (bend the head back and to the left as far as you can) and the shoulder pain increases, this certainly could be cervical radiculogpthy. If however the pain does not increase in your shoulder, then you keep your neck still and raise up your left shoulder and this causes pain, more likely this is a rotator cuff issue.

You don’t have significant nerve root compression based upon the MRI reading (“Uncovertebral spurring with mild bilateral foraminal stenosis”) but do have moderate shoulder cuff findings (“moderate tendinosis of the infraspinatus”).

The best way to differentiate is with diagnostic blocks, shoulder and SNRB (see https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/ and https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/ and https://neckandback.com/conditions/rotator-cuff-syndrome-shoulder-impingement-syndrome/.

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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