signfeld36MemberMarch 8, 2013 at 5:51 amPost count: 1
Hello Dr. Corenman, I know your a busy person but,was wondering about my MRI report which states normal cervical lordosis no spondylosis bone marrow signal is normal for 53 year old male
c2-c3 no disc protrusion, cord compression or nerve root impingement
c3/c4 minimal posterior disc protrusion minimally effacing the thecal sac
c4/c5 minimal broad based based posterior disc protrusion left facet and uncovertebral joint arthopathy w/o spinal cord or nueral foramen stenosis
c5/c6 there is no disc protrusion cord compression or nerve root impingement
c6/c7 laft sided paracentral/foraminal disc extrusion w/ inferior migration by app 4mm encroaching in to l lateral recess and exerting mass effect on l lateral spinal cord
c7/t1 no disc protrusion or cord compression or nerve impingement
symptoms l sided shoulder pain tricep weakness numbness l index finger axial neck pain occiptal headaches i used to get inferior occipitalheadaches before disc herniation when si spoke w/ OS he pointed to the herniation regarding headaches wentthrough all conservitive measzures just wondering how you would approach this
thankyou so much for your time and this website. Don VanceDonald Corenman, MD, DCModeratorMarch 10, 2013 at 6:42 pmPost count: 8465
Your MRI notes a disc herniation at C6-7 left compressing the cord and the C7 root. This will cause the triceps pain and weakness (see section on website under “symptoms of cervical nerve injuries”).
Your occipital headaches can possibly originate from this herniation but I have typically found that inflammation of the C2-3 and C3-4 facets is the most common cause of these headaches. You might consider facet blocks with a pain diary (see website for explanation) to see if the source of these headaches is from the upper facets.
If there is no motor weakness present, I would consider first undergoing a program of physical therapy and epidural injections. This would also be appropriate for mild motor weakness. With profound weakness, you could be a candidate for an ACDF, an artificial disc or a posterior foraminotomy depending upon the location of the herniation and the quality of the disc space.
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