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  • Vjenkins
    Member
    Post count: 10

    Dr. Corenman:

    I wanted to ask you for a second opinion. Although I do feel confident in my neurosurgeons’ response, it has been recommended to me to obtain a second opinion. I am only asking if you would recommend surgery in my current condition. I’m hoping you will answer after reading the test results below.

    chief complaints: neck pain, numbness and tingling, headaches, etc.

    test completed: xray, MRI

    MRI findings:

    There is reversal of the normal cervical lordosis from C2-C7.

    Multilevel endplate spurring, disc bulging, uncinate spurring present.

    At C2-C3, there is mild central canal stenosis.

    At C3-C4, there is more pronounced spurring and disc bulge in the left paracentral and left lateral region with severe left foraminal stenosis. Cord flattening centrally into the left. Mild to moderate left-sided canal stenosis.

    At C4-5, there is a central disc protrusion superimposed on disc bulging spurring with cord flattening. Minimal increased signal in the cord at this level which probably related to chronic cord compression. Severe right foraminal stenosis and moderate left foraminal stenosis. There is at least moderate central canal stenosis with cord flattening noted.

    At C5-6, there is diffuse disc bulge with mild to moderate central canal stenosis. Cord flattening present. Mild left foraminal stenosis and moderate right foraminal stenosis.

    At C6-7, there is a more prominent focal protrusion superimposed on disc bulge and spurring with moderate central canal stenosis and cord flattening. Moderate to severe bilateral foraminal stenosis.

    At C7-T1, no abnormality.

    If I were your patient, would you recommend surgery? I have been told this is profound and severe and I need neck surgery. I have not been told what kind of surgery yet. I will be discussing this will my neurosurgeon next week.

    Please let me know your thoughts, just need some corroboration.

    Thank you for your time and response.

    I will check back here regularly to see what you have to say.

    Mrs. J

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The need for surgery is based upon the symptoms, the signs (on physical examination), the imaging and your own circumstances. I cannot strictly say that you do or do not need surgery.

    I will say that spinal cord compression is serious and should not be ignored. The interpretation of the images sounds significant but I also have to remind you that you are looking at the images through someone else’s eyes. His or her’s “moderate compression” could be “mild” or “severe” to me.

    Nonetheless, by the description of the images you most likely have severe degenerative disc disease and kyphosis (a degenerative bending forward of the neck) along with bone spurs which most likely are causing the spinal cord compression. I would assume you need surgery. I cannot tell you what you might surgically need without a thorough evaluation of your history, physical examination and imaging.

    Dr. Corenman

    Vjenkins
    Member
    Post count: 10

    Thank you Dr. Corenman. I appreciate your quick response.

    Vjenkins
    Member
    Post count: 10

    Dr. Corenman:

    I had my surgery consult with neurosurgeon yesterday and surgery will be ensuing Monday, Aug 12.

    He has recommended decompression from c3-c7, partial corpectomy at c4 and c6, reconstruction and fusion from c3-c7.

    As you can imagine to me it seems quite complex and scary. He explained the procedure well and I understand the purpose is to relieve pressure on my spinal cord.

    My question to you is, does this procedure sound reasonable to you for my problem?

    Please advise, thanks.

    V J
    41 years old

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    This surgical plan does not seem out of the ordinary for the MRI report that you had originally included. I cannot verify that I would have the same plan but with the information you included, it seems reasonable.

    Dr. Corenman

    Vjenkins
    Member
    Post count: 10

    Thanks again for your quick response. I have been having alot of dizziness and headaches, which I believe is also related to all of this.

    Is this due to the compression? Just curious about this aspect of the condition as it is driving me crazy. I’m hoping this will be resolved after the surgery.

    Please advise and thanks.

    V J

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