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Your C4-5 is not too bad. It is slipped (degenerative spondylolisthesis) but does not move in slip severely based upon flexion/extension X-rays. I would call the slip “mild to moderate”. The reason for this slip however is the severe kyphosis (anterior angulation) at C5-7. It appears that you most likely had an injury years before that caused this severe angulation. C4 is simply now responding to the anterior stress of the angulation due to the tilt of the C5 vertebra due to the C5-7 kyphosis.
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.Hello Dr.Corenman,
First Thank you for reviewing my X-RAYS for me. Dr.Corenman are you saying that the Instability at C4-5 level is still Mild to Moderate ,Is that good that it hasn’t changed? Dr. Corenman if I don’t participate in dangerous activities or put my neck at risk should I be OK(Please let me know) ? Dr Corenman in one of your past post (#28449) that you said it is possible over time, if the degeneration continues and the level might need to be stabilized, Do you still feel that might be a possibility in the future?
Dr. Corenman did my Facets at C4-5 level get any worse ?
How does the C1,2,3, levels looks to you ? I hope in good shape !!Dr.Corenman my main concern is the C4-5 level with the Instability so if I don’t participate in dangerous activities or put my neck at risk should I be OK ? Because I’m really not looking forward to having surgery down the line.Thank You again for taking the time out of your busy schedule to review my X-RAYS and answer my questions for me and you’re a great Doctor.
Thank You,
“How does the C1,2,3, levels looks to you”? Those levels look fine by X-ray.
C4-5 (based upon images that are somewhat small) does not look significantly worse.
“over time, if the degeneration continues and the level might need to be stabilized”. Still possible. I worry about the levels below angled with significant kyphosis causing increased wear of C4-5 due to the tilt.
You probably will be OK without dangerous loading of your neck.
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.Hi Dr. Corenman,
Thank you again for answering my questions for me,I really appreciate it. Dr. Corenman I have a couple more questions for you.1) Is my C4-5 level Unstable? If it is what’s causing it to be Unstable?
2)Dr. Corenman this is what you said in the last post ( I worry about the levels below the angled with significant kyphosis causing increased wear of C4-5 due to the tilt.) Can I ask why you’re worried about the levels below the angled ? What can happen to the levels below the angle with significant kyphosis ? Would they become UNSTABLE ? Please let me know !!
Thank you,
The C4-5 has some mild instability due to wear of the facets. This instability is probably due to the tilt of the kyphosis from the angulation below. Nothing should happen to the levels below but the slip at C4-5 is the result of the angular tilt of C5.
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.Hello Dr.Corenman,
Thank you for answering my questions for me.
Dr.Corenman I injured my neck in 1988 from a fall down a flight of stairs.My injury was a Compression fracture of my C5 vertebrae and tore my Ligaments away from my vertebraes at C4-5 level. Dr. Corenman the only treatment that I had was I was placed in a Halo brace for three months.And after the three months the Doctor that was treating me removed the Halo brace and took new X-rays of my cervical spine and told me that my Ligaments had healed on a angle and that I was going to have mild to moderate instability for the rest of my life at C4-5 level and to be careful what I do for the rest of my life.Dr Corenman do you agree with the Doctor that treated me in 1988 about my Ligaments healing on a angle and having mild to moderate instability for the rest of my life and lots of Arthritis when I got older ? Could you please let me know your Opinion because you reviewed my X-RAYS!!Thank you,
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