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  • appleannie
    Participant
    Post count: 129

    Hello Dr. Corenman, I had a Flexion and ExtensionX-ray done in 2015 here’s what radiologist report said:

    Impression/ Findings:Stable unchanged Kyphosis at the lower cervical level. Mild Anterolisthesis at C4-C5 that demonstrates mild increase upon Flexion and decrease upon extension indicating slight instability. Stable Degenerative changes C4-T1 with disc space narrowing, Endplate Sclerosis, and Osteophytosis.Stable mild left neural foraminal narrowing at C4-C5.

    Dr. Corenman here’s my recent Flexion and Extension x-ray results I just had done in 2017 here’s what the radiologist report said:

    Impression/Findings: Unchanged Kyphosis curvature at the lower cervical spine. Unchanged Grade 1 Anterolisthesis of C4 on C5 which is slightly more prominent on Flexion.Severe spondylotic changes of the cervical spine most notable at C4-C5, C5-6 and C6-7,where there is anterior and posterior Osteophytosis. Stable Moderate/Advanced left neural foraminal narrowing at C4-C5.

    Dr.Corenman I had bad neck injury from a fall down a flight of stairs in 1988 and pulled the ligaments away from the vertebraes at C4-C5 level and a compression fracture at C5-6 level and had to wear a Halo brace for three months.Dr.Corenman when the spine doctor who was treating me in 1988 took the Halo off me and told me that I’m going to have mild to moderate instability at my C4-C5 level for the rest of my life because my Ligaments at that level healed crooked. Dr.Corenman do you think the results above are from the injury that I had back in 1988 ?? Could you please explain these results for me. Thank You !!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    You have a typical degenerative spondylolisthesis below the C5-7 levels where you probably have multilevel disc resorption. See both https://neckandback.com/conditions/degenerative-spondylolisthesis-cervical/ and https://neckandback.com/conditions/isolated-disc-resorption-cervical-spine-idr/ to understand this condition.

    Whether you have to do something about this depends upon your symptoms. Do you have any significant pain or dysfunction?

    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.
    appleannie
    Participant
    Post count: 129

    Dr.Corenman, Yes I do have aching pain in my neck area that goes along my shoulder blades also I been having spasms in my neck area to.My orthopedic spine doctor I seen said that the Autofusion I have at C5-6 LEVEL will help to stabilize my cervical spine at C4-5 level and the neurosurgeon spine specialist I seen said that the Autofusion I have at C5-6 LEVEL is nothing but severe arthritis and it won’t stabilize my cervical spine at C4-5 level if I was in a car accident or have another bad fall. What is Endplate sclerosis ?? What is Facet arthropathy ??

    Thank You !!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    I would most likely agree with the neurosurgeon. It is very rare that a disc space will fuse but very common that the disc erodes away and ends up bone-on-bone. The loss of disc at C5-6 will not help the C4-5 level but load it even more and is most likely increased the wear of the C4-5 facets.

    Your question of endplate sclerosis is answered by the section on IDR (This delayed pain is caused by fractures that occur within the vertebral body in small structural web-like bones called the trabecula. These tiny bones are like a honeycomb inside the vertebra that reinforces the walls. The trabecula are normally protected by the shock absorption capacity of the disc). When the disc no longer absorbs shock, the bone endplates of the vertebra absorb more force than they are designed to handle. They subsequently develop overt and stress fractures. Wolfe’s law states that bone that suffers undo stress will form more bone. Hence, the endplates become thicker (sclerosis).

    The slip at C4-5 could not occur without facet arthropathy, a fancy way to say facet arthritis.

    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.
    appleannie
    Participant
    Post count: 129

    Hello Dr.Corenman, I been having alot of tightness feeling in my cervical spine area when I bending over to pick up something or look up to the ceiling. Dr.Corenman I know I have alot of Arthritis in my cervical spine could that be causing the tightness feeling ??

    Thank You !!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Typically, the “tightness felling” in the neck is caused 70% by disc pain and 30% by facet pain. I would assume that the combination of IDR of discs C5-6 and C6-7 along with the degenerative spondylolisthesis of C4-5 are causing your 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.
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