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  • mocka300
    Participant
    Post count: 7

    My primary (NP) called me and said the fusion looked good. I didn’t see your comments until after I spoke with her.I also thought it was interesting that there was no mention of the decompression. I sent a note to the NP asking her about it and she called the radiologist who then wrote an addendum to the report. See below. I am guessing the facet blocks and the nerve root blocks are still good diagnostic tests for me. I also wanted to share the data imaging review that the pain management doctor put together, from past MRI reports, when I was seeing him.

    ADDENDUM TO ORIGINAL REPORT

    MRI is superior to evaluate spinal canal and neuroforamina.

    C2-C3: Tiny broad-based disc bulge. No significant bony spinal canal or neuroforaminal narrowing.
    C3-C4: Tiny focal central disc bulge. No significant bony spinal canal or neuroforaminal narrowing.
    C4-C5: Tiny focal central disc bulge. No significant bony spinal canal or neuroforaminal narrowing.
    C5-C6: Evaluation is limited due to extensive streak artifact from orthopedic hardware. No significant bony neuroforaminal narrowing. Estimated mild bony spinal canal stenosis.
    C6-C7: No significant bony spinal canal or neuroforaminal narrowing.
    C7-T1: No significant bony spinal canal or neuroforaminal narrowing.

    DATA/IMAGING REVIEW:
    MRI lumbar spine 1/2/2020 report and film reviewed compared 2014 MRI–motion artifact. Back pain since September 2019. At L1 -2 there is minimal broad-based left paracentral disc protrusion. At L3-4 there is disc bulging with a broad-based left lateral disc protrusion producing mild left L3 and L4 nerve root impingement. There is a perineural cyst on the right. L4- 5 there is an annular tear on the left which is stable. L5- S1 there is disc bulge with facet arthropathy with small perineural cyst.

    MRI thoracic spine 1/2/2020 report and film reviewed–indication is Hyperreflexia left greater than right lower extremity. Previously described small central protrusion C7-T1 is nearly resolved. Small central disc protrusion at T3-4 without cord impingement. At T5-6 is a perineural cyst. At T7-8 there is a focal right paracentral disc protrusion without cord impingement or central stenosis. There is also perineural cysts at T9-10 and T10-11

    MRI cervical spine with and without contrast 11/4/2019 compared to 2018 MRI–Indication was numbness in hands and legs for 5 weeks: at C4-5 there is a small central disc protrusion which very minimally narrows the spinal cord. At C5-6 there is central and right paracentral disc protrusion and increase indentation on the ventral cord with mild to moderate narrowing of the canal. C6-7 there is no disc herniation. C7-T1 there is a new shallow left paracentral disc protrusion which effaces the ventral see CSF and very minimally narrows the cord. Postcontrast images demonstrate no abnormal enhancementof the cord
    MRI cervical spine 10/26/2018–patient with neck pain rating down left arm since motor vehicle accident August 2018–broad-based central and right paracentral disc protrusion at C5-6. See 7 T1 there is a 6 mm perineural cyst on the left

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    Well, you have no significant compression of the cord or roots based upon the radiologist’s interpretation and you have a solid fusion. Your arm and neck symptom source can be determined by the injections I earlier outlined. Your lower back has some issues that would not affect the neck or arms but certainly could affect your back and legs.

    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.
    mocka300
    Participant
    Post count: 7

    Thank you so much Dr. Corenman for all your feedback. It is greatly appreciated!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    Please keep the Forum updated on 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.
    mocka300
    Participant
    Post count: 7

    I will definitely keep the forum updated. I am unsure what I will do next. I am thinking about the diagnostic injections, but I need to call around to find a place that does it. In the mean time my neck is throbbing in pain daily. Working on the computer makes it worse and the heating pad makes it better. 80% of the pain is directly in the area of my fusion but whenever my neck hurts I also feel pressure in my throat and have trouble swallowing.I had the problem with swallowing right after surgery and was given a round of steroids. It got a little better for a short period of time. My doctor said I would have to see a specialist for it if it continued. I have yet to do that. It feels like my neck is being squeezed, almost like being choked.

    I also choke on liquids, approximately 3 to 5 times a week. This was happening before surgery, but I have not told my doctor about it. I’ve been concentrating more on my pain.

    Because of the fibromyalgia diagnoses, I don’t know what to think… Is the fibromyalgia making everything worse or what. My doctor said that people with fibromyalgia often have neck pain.

    I had Chronic Fatigue Syndrome (CFS) in the early 90’s and was literally unable to work for three years, so I am not surprised that the doctor diagnosed me with fibromyalgia since they have overlapping symptoms. I eventually got better but continued to have some symptoms, for instance, my feet ache after only being on them for a short period of time.

    The new symptoms I have in my feet and now hands is numbness and tingling, although I did have it when I had CFS in the 90’s as well.

    If I were to describe where I have the most prominent “pain”, it would be 80% in my neck with 20% elsewhere. At this point I am having a very hard time doing my job, which is a desk job.

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