[Jose]

#11721

Dr. Corenman:

I tried locate the last conversation we had but was unable to do so, so I am posting a follow- up here. As reference, this was my MRI report: Age 56.

c1-c2 mild arthrosis with normal alignment
c2-c3 no stenosis
c3-c4 disc space narrowing with decreased T2 nuclear signal but no central stenosis and the neural foramen are patent
c4-c5 decrease T2 nuclear signal with a mild bulge but no central stenosis. Slight left uncovertebral joint osteophyte change. Mild ligamentum flavum heperthrophy mildly indents the dorsal thecal sac.
c5-c6 degenerative central protrusion with mild flattening of the ventral thecal sac. Mild ligamentum flavum hypertrophy, greater on left with flattening of the dorsolateral thecal sac. Neural foramen are
patent.
c6-c7 decreased T2 nuclear signal with a small right parcentral protusion. Mild right c7 foraminal stenosis.

I remember you said these finding were not bad and could be managed. However, I have been repeatidly told by people who are NOT doctors, that I am headed for neck surgery down the road, because that is how they started and ended. So, my questions are:

1. Is this the case, or is it just as possible that even as one ages, that these issues do no lead to surgery.
2. I wake up in the mornings with neck, shoulder, left sided scapular pain but it much reduced during the day. Rainy cold days are worse.
3. Is there anything I can do to prevent surgery from this point forward.
4. Based on the above, what surgery would be indicated if needed…I understand that fusion of more than 4 levels is not really successful. I was reading about laminectony and laminotomy and they seem OK for cases where the disc is not herniated.
5. Do these seem to be a result of normal aging or some traumatic event years past?

I started Pilates, do Mc Kenzie neck excercises, and work standing up so I dont hunch over the desk on my laptop.
Thanks

[Donald Corenman, MD, DC]

#11730

I see very degenerative necks all day long and many of these individuals have lived with these disorders for many years before they have sought care. I also see patients in the ER who have had no symptoms until they have a cervical “strain”. They may also have severe degenerative changes but have had no symptoms and they become non-symptomatic after their “strain” resolves.

The need for surgery is dictated by symptoms and pathology. See the section “When to have neck surgery” to fully understand when surgery is required.

Based upon your radiological report (and I do not fully trust these reports without viewing the images), you have no necessary requirements for surgery. Do not worry about these findings if you are not a surgical candidate.

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.

[Jose]

#11738

That is a great link!!…”When to have neck surgery”

But, now I am abit confused:

“Flexion opens the canal and extension narrows it.”

Since I have been doing these McKenzie neck excersices as prescribed by my PT, am I making matters worse based on my MRI findings? The bulges and protrusion, and the osteophyte and the thicknenning ligamentum flavum, etc….it is best for me not to do these? I go back with the neck and then go side to side in that back position…I also do side to side, and I do down. Seems to me that maybe some or all of these 4 excercises are not good.

Thanks

[Donald Corenman, MD, DC]

#11743

Extension exercises without any significant compression of the cord or nerve roots is not a problem. If however you develop neck, shoulder or arm pain with extension, full extension should be avoided.

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.

[Jose]

#11746

You are a blessing! To give the time you do in order to help people on this board is such a great contribution!…Thanks for all you do.

[Donald Corenman, MD, DC]

#11751

Thank you

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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