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  • spirit
    Member
    Post count: 2

    Dear Dr. Corenman,

    Could you please give me your opinion on how I should proceed based on the following cervical MRI results? (Thanks)

    At C3-4, there is facet arthropathy. There are small uncovertebral osteophytes. The canal is broad.

    At C4-5, there are uncovertebral osteophytes. There is facet arthropathy. The spinal canal is broad.

    At C5-6, there is a broad-based central osteophyte. It measures 5 X 14 mm in size. The thecal sac is flattened. AP dimension of the sac is about 8 mm. There is facet arthropathy.

    At C6-7, there is an osteophyte narrowing the left foramen. The AP dimension of the canal is about a centimeter. There is mild facet arthropathy.

    IMPRESSION: Central disk protrusion with central canal stenosis at C5-6. There is a small left uncovertebral osteophyte at C6-7 causing left foraminal narrowing but no central canal stenosis at that level.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    MRIs by themselves are generally not useful until the patient’s symptoms (and physical examination) are added to them. See the section “How to describe symptoms” to better convey what you are experiencing.

    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.
    spirit
    Member
    Post count: 2

    Symptoms as follows:

    Deep aching in the “hump” at the back of my neck
    Pressure, as if the structures in my neck are compressed
    Headaches that seem to originate from the back of my head/neck
    Foggy headedness–Don’t feel grounded or centered when walking
    Sometimes trouble with eyes focusing properly
    Heart starts to pound when neck is in certain position (wake up with neck hurting and heart pounding–this seems to subside when I then switch sides)
    Nose and shoulder blades intermittently numb
    Deep aching between shoulder blades.
    Middle back muscles constantly knotted up between shoulder blades
    Occasional vertigo
    Restricted range of motion in neck–neck feels unstable and cracks/pops
    Burning sensation along eyelash line–both eyes–when neck is in certain position
    Occasionally skin on forearm feels wet (like a drop of water has dropped on it) when it is not (this happens with my legs too)
    Occasional numbness in last two fingers of left hand
    **Sometimes when I lay down, it feels like my brain is shutting down and if I don’t open my eyes back up something will happen–pass out or pass on?. I have to struggle to open my eyes and when I do it takes a few seconds to focus them. This has been occurring episodically for 2 years now and is a rather frightening experience.

    Have tried physical therapy, acupuncture, TENS unit, heat, massage (with deep massage my neck feels unstable and I get dizzy).

    Is there any increased danger of spinal cord injury (with the central stenosis) with impact?

    THANK YOU FOR YOUR WONDERFUL SERVICE TO PEOPLE. THE EDUCATIONAL MATERIALS ARE A BLESSING.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    I can tell you that some or your symptoms can be related to the neck but others are more cranially mediated (these can only originate from the brain and not the spinal cord).

    These are cranially mediated;
    Foggy headedness–Don’t feel grounded or centered when walking
    Sometimes trouble with eyes focusing properly
    Heart starts to pound when neck is in certain position (wake up with neck hurting and heart pounding–this seems to subside when I then switch sides)
    **Sometimes when I lay down, it feels like my brain is shutting down and if I don’t open my eyes back up something will happen–pass out or pass on?. I have to struggle to open my eyes and when I do it takes a few seconds to focus them. This has been occurring episodically for 2 years now and is a rather frightening

    There is a syndrome of vertebral artery insufficiency where the artery in the vertebra that supplies blood flow to the base of the brain has intermittent compression and can cause some of the above symptoms. I have looked for this disorder in many patients and have yet to find my first patient with this syndrome.

    The other symptoms could originate from the degenerative discs or facets in your neck. The stenosis (narrowing) of the spinal canal could cause some others (see myelopathy under cervical spine).

    Anxiety can also cause some of your symptoms. If you have a “revved up” nervous system (which is really what anxiety is), you can become hyper-vigilant and typical everyday symptom “noises” that everyone experiences becomes something that you become focused on and might worry about.

    Seek some answers from an experienced spine surgeon. Get a consultation.

    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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