[gabi69]

#11613

hello!
I was diagnosed having slap in my left shoulder three months ago. I have neck pain almost one year and low back pain several years already. Today I received the result of my MRI test for cervical spine. Can you explain, Please, if I need some surgery at this moment or further evaluation? I feel numbness in my 4th and 5th fingers of left hand (the hand with the slap problem), is this numbness caused from slap or from the problem in neck? The movements with the left hand are very painful. Can I continue with swimming and walking?
My doctor wrote (before MRI) that Hoffman and troemner tests are negative, movements with neck are limited and painful; radial weakness 4/5 in left, Shporling test is positive. Thanks a lot in advance for the answer!
MRI of the cervical spine was performed without contrast.
A mild kyphosis is seen with the apex at the C5 level. A suggestion of a scoliosis to the right is noted involving the upper thoracic region. Degenerative decreased disc height and T2 disc signal is noted at C5/6. Modic type II changes are noted at C5/6.
A broad-based shallow central and right paracentral C5/6 herniation is noted with right uncinate hypertrophy narrowing the associated right c5/6 foramen and most likely touching the exiting right c6 nerve root. A small posterior central 6/7 disc protrusion is seen without associated neural compromise. The sagittal sequences include the superior aspect of the thoracic spine and a posterior central T5/6 herniation is noted hitting the underlying anterior aspect of the cord. A dedicated thoracic MRI can be performed for further evaluation if clinically needed.

[Donald Corenman, MD, DC]

#11616

A SLAP lesion of the shoulder is a tear of the capsule on the top of the shoulder blade. This will cause shoulder pain especially with motion but should not cause any symptoms below the elbow and no paresthesias (pins and needles or numbness) below the elbow.

A positive Spurling’s test generally is present with nerve compression in the neck. I am not sure what “radial weakness 4/5 in left” is but I assume this is some weakness of the radial (thumb sided) muscles in the hand or forearm.

Your image report notes right sided C5-6 nerve compression (the C6 nerve). “A broad-based shallow central and right paracentral C5/6 herniation is noted with right uncinate hypertrophy narrowing the associated right c5/6 foramen and most likely touching the exiting right c6 nerve root”.

There is no report of any left-sided compression and that seems to be the side of your complaints. Do I have that right? As I have said before, I generally do not like to take a radiologist’s report verbatum but like to see the films myself.

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.

[gabi69]

#11618

Thank you very much!
Do I have disk herniation in T5/6 level too? I have neck pains in my right side. Is there protrusion in C6/7 level?
I live in Israel, so unfortunately, I can show you films only by sending the whole MRI disk somehow.
Do I need a surgery at this moment?
Thanks a lot in advance!

[Donald Corenman, MD, DC]

#11619

You do have a disc herniation according to the report at T5-6 but this will not cause arm or neck symptoms.

You have a small central disc herniation at C6-7 but it is not compressing any neurological structure (“A small posterior central 6/7 disc protrusion is seen without associated neural compromise”).

Neck pain and shoulder pain can be generated by degenerative discs without nerve compression but numbness and paresthesias are generally nerve compression generated. You can have multiple areas where nerves can be compressed in the shoulder and arm. See “Nerve entrapment and compression” on the website.

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.

[gabi69]

#11660

Thank you very much!

[Donald Corenman, MD, DC]

#11663

You are welcome.

Please keep us posted of your diagnosis and treatment.

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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