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  • Jrowlander
    Participant
    Post count: 2

    Hello Dr. Thank you for this wonderful forum. My wife has been having severe neck pain radiating to her arm and thumb. We saw a orthopedic surgeon and conducted a MRI. Below is the report could you please advice on what this means and what the specific issues and if there is a medical term for it. We have been advised epidural and facet joint injections. Your feedback will be much appreciated. Thank you.

    Imaging Report
    Clinical History:
    6/52 right neck pain. Referred right shoulder
    Report:
    There is mild reversal of the cervical spine.
    The alignment is otherwise maintained.
    At C5/6, there is a prominent right sided disc-osteophyte bar which distorts the right
    ventral cord and severely narrows the proximal aspect of the right C6 neural foramen.
    The remaining cervical levels are unremarkable.
    The craniocervical junction and the intramedullary signal are normal.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Most likely, your wife’s neck and arm pain is from the C6 nerve (see https://neckandback.com/conditions/symptoms-of-cervical-nerve-injuries to understand a C6 nerve presentation). The MRI reading notes “severely narrows the proximal aspect of the right C6 neural foramen” which is the cause of the “pinched nerve”.

    You do not need facet joint injections as this will not go to the root of the problem. Your wife needs a selective nerve root block of C6. This along with physical therapy (by a good therapist) is the initial treatment. If this treatment fails, she might be a candidate for an ACDF (see https://neckandback.com/treatments/anterior-cervical-decompression-and-fusion-acdf/).

    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.
    Jrowlander
    Participant
    Post count: 2

    Hello Dr. Corenman,

    Appreciate your help and response. I wanted to update you on my wife’s situation.

    After conducting 3 epidural injections with very limited improvement, we had to get the ACDF surgery in Dec. They placed a PEEK cage and did a fusion. Recovery has been good so far. All pain in the neck and arm has gone. Xray conducted 3 months post surgery is normal.

    However since the last 2 weeks my wife’s thumb and index finger and nearby areas have been swollen and in pain. The GP is suspecting inflammed tendons. There is no pain the neck or radiating arm pain. I am very nervous and hoping its nothing as serious as before or spine related. Could you please advice what our next steps should be?

    Thanks again for your wonderful forum.

    James

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    There are common hand and finger disorders that can cause local pain such as intersection syndrome or De Quervain’s tenosynovitis. Examination by a hand surgeon (orthopedist with speciality hand fellowship) with help to deduce this disorder. If present, an injection normally resolves the 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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