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  • justenough
    Member
    Post count: 12

    I am editing this message as the board doesn’t accommodate the image file, and I sent the images to your email instead and received a response from your assistant that you will be looking over them as time allows, and understand how busy you are and the amazing service you provide to all of us. you are a remarkable Doctor & surgeon….I think they broke the mold after you !

    Donald Corenman, MD, DC
    Moderator
    Post count: 8660

    Your symptoms could certainly be from myelopathy but this disorder requires significant cord compression.

    Your notation “my last MRI before this one showed the C5-6 disc actually slightly indenting the spinal cord and in this more recent MRI of my neck- I do not see the disc actually touching, yet the spinal cord is more pushed in now then it was last year” is difficult to understand. You might have a more deformed spinal cord from instability of this level. Flexion/extension X-rays would be helpful to rule this in or out.

    There are other disorder that can cause imbalance including “inner ear” disorders, metabolic disorder and other (MS, etc..).

    If you do have myelopathy, a physical examination would demonstrate long tract signe (hyperreflexia, clonus, Hoffman’s sign, Positive Rhombergs sign among others). You need to see a good spine surgeon for these symptoms.

    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.
    justenough
    Member
    Post count: 12

    “Your notation “my last MRI before this one showed the C5-6 disc actually slightly indenting the spinal cord and in this more recent MRI of my neck- I do not see the disc actually touching, yet the spinal cord is more pushed in now then it was last year” is difficult to understand.”

    The cervical spine images on the MRI from last December ( not the recent one you viewed ) showed the C5-6 Disc actually making contact with the spinal cord at that level, and the cord itself was slightly indented.

    This recent Cervical spine MRI that you were able to view does not show the C5-6 region making actual contact with the spinal cord in that area, however, the spinal cord at C5-6 region looks more deformed / compressed NOW, then it did in last December, and yet the recent images ( the ones you viewed ) do not show the C5-6 disc making contact with the cord.

    I just wondered how the spinal cord could look so much more / indented compressed NOW in recent films with no actual cord contact. I hope I explained well.

    “If you do have myelopathy, a physical examination would demonstrate long tract signe (hyperreflexia, clonus, Hoffman’s sign, Positive Rhombergs sign among others). You need to see a good spine surgeon for these symptoms.”

    I do have hyperreflexia ( no clonus in the feet, but my hands and fingers shale when my wrists are bent – whatever that is? I do not have hoffman’s sign, but a side note- my Father has myelopthy and does not have babinski, or hoffman’s sign ) I definitely have positive rhombergs sign- and also feel vibration, electricity like feeling and weakness in arms and legs. ( I don’t know what that could mean, or where its from- and I understand I could have disequilibrium from inner ear- I also want to mention- a long with this recent cervical spine MRI you viewed, I had thoracic and lumbar spine as well……the Lumbar dictated report said:

    Findings:
    Thoracolumbar dextroscoliosis is demonstrated. Vertebrae have normal height and marrow signal.

    T12-L1 level: Disc herniation extends superiorly from the disc space posterior to the T12 vertebra over a distance of 2.1 cm, seen in sagittal T1 #5/11 consistent with large extrusion of the disc
    herniation indenting the anterior thecal sac producing mild central stenosis.

    Axial slices are not available through this level.

    L1-2, L2-3, L3-4 levels: No herniated nucleus pulposus or significant central spinal canal stenosis.

    The neural foramina appear essentially patent. The facets appear unremarkable.

    L4-5 level: Loss of disc hydration. Disc bulge effaces ventral epidural fat indenting the anterior thecal sac. Posterolateral disc bulge in combination with facet arthropathy narrows the neural
    foramina.

    L5-S1 level: Disc bulge effaces ventral epidural fat. Facet arthropathy is noted bilaterally. Neural foramina are patent.
    The conus medullaris and paraspinal tissues appear unremarkable.

    The cervical spine dictated report said:

    Findings:
    There is upper cervical dextroscoliosis and cervicothoracic levoscoliosis.

    Vertebrae have normal height and marrow signal.

    C2-3, C3-4 levels: No herniated nucleus pulposus or significant central spinal canal stenosis. The
    neural foramina appear essentially patent. The facets appear unremarkable.

    C4-5 level: Posterocentral disc herniation indents the anterior thecal sac extending across the disc space over a distance of approximately 8 mm, seen in sagittal T1 image #8/13. Neural foramina are
    patent bilaterally.

    C5-6 level: Broad based disc bulge indents the anterior thecal sac producing mild central stenosis and cord deformity. Hypertrophic facets and ligamentum flava indent the posterolateral thecal sac.
    Neural foramina are patent.

    C6-7 level: Diffuse circumferential disc bulge indents the anterior thecal sac. Neural foramina are
    patent.

    C7-T1 level: No herniated nucleus pulposus or significant central spinal canal stenosis. The neural
    foramina appear essentially patent. The facets appear unremarkable.
    The cord signal, posterior fossa structures and paraspinal tissues appear normal

    I wish I could get a flex- extension MRI of the cervical spine- because I do feel there is an instability there- but I’m afraid to ask for one……” the neurologist I was seeing who did the EMG’S which were abnormal – the EMG’s he performed himself. he said the upper extremities showed chronic C5-6 radiculopathy…

    The lower extremtities showed L5-S1 chronic radiculopathy ( that EMG was before the T12-L1 disc issue as shown in the recent MRI I added the report to here above ) also it showed periphreal neuropathy.

    I also wish someone would measure in mm the C5- 6 regions and the stenosis at that level…….I have a plastic mm measuring device and if I knew what points to measure I would …..thank you so much for any further info.

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