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  • carolns
    Participant
    Post count: 88

    I have severe arthritis in my neck and was in a car accident about 40 years ago and had whiplash . Of course back then I signed of . For the last year I have been having severe pain in my neck going up my head. Had physio with acupuncture and stretching. They want me to see a surgeon before they will put me in traction. They are scared of it.
    I am to the point that if I need surgery I will do it.

    There is 5mm anterolisthesis of c2 on c3 unchanged. There is multilevel facet oa, with severe facet oa at c2 -c3. Multilevel degenerative disc disease most severly c4-c-5,c6-c7 with maqrked disc space narrowing & marginal osteophytosis. No fracture is seen. moderate neural foramina narrowing of the right c5-c6,& mild neural foramen narrowing of the left c4-c5 and left c6-c7 and right c4-c5. no significent spinal canal stenosis.
    Depending on patient’s condition. patient may require surgical intervention to stabilize the anterolisthesis of c2 on c3
    Do you think surgery would help? Thank you carol

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Surgery for your neck is predicated on many different conditions. Since you have no significant central canal stenosis, your spinal cord is most likely not in jeopardy. You then have to compare symptoms to the problems in the neck including disc degeneration, facet degeneration (degenerative spondylolisthesis) and nerve root compression. See the section under “When to have neck surgery” to obtain a better understanding of what surgical conditions look like.

    Your question on the stability of the 5 mm anterolisthesis of C2-3 (which is a degenerative spondylolisthesis by the way) is a good one. Is this level stable with flexion/extension X-rays or does it move? Also, what activities are you involved with? If you have a sedentary lifestyle, then the risks are significantly lessened. If you are an avid mountain biker or jump horses, your risk increases.

    Degenerative spondylolistheses are also typically found above and below significant degenerative discs. These degenerative disc segments increase the load on the levels above and below. The facets wear out and the vertebra slips on the one below.

    Dr. Corenman

    carolns
    Participant
    Post count: 88

    Thank you so much……I am 72 and have a lot of arthritis…..I walk a lot and can only bend and lift 2 litre of milk etc….have bursitis in my hip…..lots of health problems…118 lbs and eat well….
    Do I need a MRI or is a Cat scan good enough for the doctor to see what is going on?
    Acupuncture which I never thought would work took 90%of the pain away but only if I had it once a week. The pins and needles started to come back with acupuncture but would stop quickly. Without it the pins and needle go up on the right side of my neck to the top of my head. Have a hard time to get it to stop. When I sit or drive is when it is worse.
    Maybe nerve block or something? This started after I went of celebrex for 10 weeks ….This started 13 mts ago….back on celebrex 8 mts or so.
    I want to thank you so very much. Carol

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Since I doubt you are a professional mountain biker or bump skier at this point, it does not appear that you put your neck at too much risk. The questions for C2-3 are two. One is stability and the other is pain. A set of X-rays with flexion/extension views would be helpful to determine stability. An MRI would look at the health of the disc, joints, nerves and spinal cord.

    The C2 nerve is right next to the degenerative facets and can be compressed or irritated by these facets. This nerve (also known as the greater occipital nerve) travels over the back of the head and stops right above the eyes. Irritation to this nerve will cause pain and paresthesias (pins and needles) in this distribution. A nerve or facet block might be helpful to diagnose and possibly treat this disorder.

    Dr. Corenman

    carolns
    Participant
    Post count: 88

    Thank you again…..you are amazing…I understand some of what is going on…wish you were my doctor….my appointment in Halifax N.S. is May 6 and I will let you know how I make out…..thanks Carol

    carolns
    Participant
    Post count: 88

    I did have one epidermal injection in my neck in the OR a few months ago but it didn’t do anything…made my nose and eye funny for a few days ….is this a nerve or facet joint injection please? Are facet and nerve injections different?
    Maybe before I have surgery I should do the 3 I was suppose to do?
    thanks so much Carol

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