Tagged: Cervical stenosis
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Hello, I was pointed in your direction by a family member that has surgery by you after alot of pain and frustration! You helped him tremendously!!
In April 2019, I fell out of our camping trailer with our 70lb dogs. I landed on my left side dogs.
Arm and shoulder blade started hurting on the left. Burning into my mid neck and shoulder. At that time we Thought it was rotator cuff. I had an MRI done and it was determined it Wasn’t that.
My Primary dr felt it was My neck, so I had an MRI of my neck. I seen Dr in May 2019, and he said my fusion looked perfect and to just do PT and pain meds. Symptoms were getting worse at this point so I wanted another opinion.
Went to 2nd Dr with the MRI, he ordered a Myleogram and CT of my neck and MRI of my lumbar just in case.
In the meantime we went on vacation and my issues got much worse!! Left arm pain into shoulder and back of neck is how it started. Noticed about this time stumbling.
After a couple hours upright my neck feels like it is shoving my spinal cord through my head!! My feet got tingly after walking. if touched on pinky toe side. Unsteady on feet stumble. Like Foot doesn’t pick up got worse.
Headache starts in neck and goes up to top turns into migraine. I have been Dropping things. If I Look up get very dizzy. Look up or down I get zingers. When I turn my head to the right I get instant pain.
When Myleogram was done. Saw him and he said evidence of Cervical stenosis. Just do cervical injections or pain meds. I Can’t work a full day. I Can’t sit up or stand that long. Have to lie down. Can’t drive.
All I keep getting is they can’t do anything for me because my symptoms don’t match the tests. I can’t live like this any longer. Help me to try to get the Neurosurgeons to listen to me!!
Results of all tests:
5/28 MRI results
At C3 – C4 there is a small posterior disc ridge complex with a lateral uncovertebral and facet hypertrophy resulting in mild central canal stenosis. mild right foraminal narrowing and moderate left foraminal narrowing.
At C4-5, there Is a small to moderate posterior disc ridge complex asymmetric to the right resulting in moderate central canal stenosis. uncovertebral and facet hypertrophy contribute to severe right and moderate left foraminal narrowing.
At C5-6, Postoperative changes at this level create artifact which limits evaluation for disc herniation and central canal stenosis. The right neural foramina appears patent. Left neural foramina is mostly obscured by artifact.
At C6-7, There is a moderate posterior disc Ridge complex resulting in moderate central canal stenosis. uncovertebral and facet hypertrophy resulting in moderate to severe bilateral foraminal narrowing.
Myleogram results 6/27/2019.
1. There is an anterior fixation plate present at C56 attached to those vertebral bodies via two screws at each level.
2. There are moderate anterior extradural defects at C3-4c c4-5 and C6-7 as well as mild posterior extradural defects at those levels. The thecal sac narrows down to an AP diameter of 10 to 11 mm at all three of these levels.
3. There are small lateral extradural defects bilaterally at C4 –5.Ct post Myleogram results
1. At C2-3 the central spinal canal and neural foramina are well-maintained.
2. At C3-4or there are moderate degenerative changes involving the left facet joint. There is very slight anterolisthesis. There is a moderate broad based posterior disc bulging, slightly more prominent on the right. The thecal sac measures 10 MM in AP diameter at the midline. The neural foramina are well-maintained.
3. Artifacts arising from the anterior fixation plate and screws at C-5-6 partially degrade image quality through this region.
4. At C4-5 level there is moderate disc space narrowing with anterior and posterior marginal spurring. No disc herniation is seen. The thecal sac measures 10 mm in AP diameter at the midline. The spurring is causing moderate bilateral foraminal narrowing.
5. At C-5-6 six the disc space is fused. There is minimal residual posterior spurring. The central spinal canal and neural for Ramano are well-maintained.
6. At C6-7 there is a laminectomy defect on the right. There is moderate disc space narrowing with anterior and posterior marginal spurring. There is mild posterior disc bulging. The thecal sac measures 9-10mm in AP diameter at the midline. The spurring is causing mild bilateral foraminal narrowing at this level.
7. No significant posterior disc Bulger protrusion is seen at C7- T1. the central spinal canal and neural foramina are well-maintained.Impression:
1. Precious anterior spinal fusion and instrumentation’s at c5-6, and right partial laminectomy at c6-7.
2. Moderate multilevel degenerative changes which is created at the c4-5 and c6-7 disc levels, resulting in borderline central spinal stenosis and mild to moderate foraminal encroachment at those levels as described above.C-spine 7-19
4 views the cervical spine without comparison for spondylosis, postop.
FINDINGS: There is been prior ACDF at C5-6, with complete fusion of
these vertebral bodies having been achieved. Prevertebral soft tissues
are grossly unremarkable. Severe narrowing at C4-5 and C6-7 is present
with anterior and posterior osteophytes in both locations. This
results in some straightening of the normal cervical lordosis. The
atlantoaxial articulation is intact.IMPRESSION:
1. No fracture or acute osseous or alignment abnormality.
2. Postsurgical and degenerative changes from C4 through C7 as
described.C spine X-ray with flexion 7/25
C-spine 2 views.
HISTORY: Cervical spondylosis
Lateral flexion-extension views were taken of the cervical spine.
Patient a previous cervical fusion at C5-6. There is disc space
narrowing and spurring at C4-5 and C6-7. There is minimal anterior
subluxation at C3-4 with flexion. Alignment at other levels is
unchanged. There is facet arthritis at C7-T1.IMPRESSION:
1. Previous fusion C5-6.
2. Disc space narrowing and spurring at C4-5 and C6-7.
3. Slight anterior subluxation at C3-4 with flexion.My prior surgeries were due to a car accident in April 2000.
in April 2002 I anterior discectomy with cage done at C5-6 by orthopedic surgeon.
6 weeks later same symptoms and it was determined cage had slipped.
10-2002 dr did a fusion revision at C5-6 with allograft, plate and screws.
In approximately 2007 started having arm pain and weakness again. Dr went in and did a c6-7 discectomy posterior.
Had no problems with my neck until I fell out of trailer with dogs in April 2019.
History: “10-2002 did a fusion revision at C5-6 with allograft, plate and screws. 2007 started having arm pain and weakness again. did a c6-7 discectomy posterior. April 2019, I fell out of our camping trailer. Arm and shoulder blade started hurting on the left”. My feet got tingly after walking. if touched on pinky toe side. Unsteady on feet stumble. Like Foot doesn’t pick up got worse.
Radiological review
C4-5; “spurring is causing moderate bilateral foraminal narrowing.
C6-7; “thecal sac measures 9-10mm in AP diameter at the midline. The spurring is causing mild bilateral foraminal narrowing”.Some of your right neck and shoulder pain symptoms could be from the foraminal stenosis at C4-5 radiating into your shoulder. You can help diagnose this radiculopathy by a selective nerve root block at C4-5 right with a pain diary. See https://neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic-neck/, https://neckandback.com/treatments/diagnostic-therapeutic-neck/, https://neckandback.com/treatments/pain-diary-instructions-for-spinal-injections-neck/.
Your imbalance and symptoms of foot drop could be from the lumbar spine or from myelopathy (compression of the spinal cord) See https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/
The physical examination can help to differentiate these conditions.
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.Here are the answers to your questions about exam.
the quality of the pain is Horrible.
the pain is burning, stabbing, sharp, shooting, electrical.
* Does the quality of pain change with activity? Gets worse
* Is the skin hypersensitive to touch? My feet on outside are.
* What is the percentage of pain in the neck vs. shoulder and arm? 85%neck 15% shoulder
* Intensity of pain is described as a 10 on neck and an 8 on shoulders.
* Are there now some noticeable problems with coordination and walking? Yes stumble like feet don’t pick up sometimes.
* Do you find yourself unbalanced when you walk? Yes.
* Do you “misstep” unintentionally much more than you use to do? Yes.
* Do you have trouble keeping your balance in a pitch black room? Yes.
* Has your handwriting changed? No.
* Do you now have trouble picking up a dime off a counter, zipping a zipper or buttoning a button? No
* Do you find lightening type electrical charges down your spine if you tilt your head backwards? Yes.
* Have your bowel and bladder function substantially changed in association with any of the above symptoms? No.
*
Activities
* What activities increase or reduce the pain? Amy activity being upright walking or sitting upright
* Think carefully about this question as the information produced is very valuable. Is it sitting that increases the pain where standing reduces the pain or visa versa? Both increase pain
* Can you sit for 15 minutes or one hour before you have to get up? How far can you walk? No. Can’t walk far.
* Does prolonged exposure to the activity cause more pain? Yes
* What does bike riding, sitting, standing, walking, lifting, jumping, computer work, driving or flying do to the pain? More pain
* Does the neck pain become worse with bending forward vs. backwards? Both are bad.I was told that these symptoms don’t match what the testing says which is Myleopathy. Which was diagnosed by a Chiroprator that o went to to try to get relief from. I tried PT, yoga, massages, can’t do epidurals due to not helping before. So I’m constantly told nothing they can do for me.
You need a meticulous physician examiner who has intimate knowledge of spinal disorders to evaluate you. Your symptoms could be from many disorders including but also excluding spinal origin.
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.I have made an appointment to see you September 3rd. I have not found a dr locally that will do a thorough exam to figure out what is going on! So we are making the trip to see you
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