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  • mnjody
    Participant
    Post count: 19

    I have had left side shoulder to finger electrigying pain, numbness and weakness for over two months. Grip strength has weakened, hard to open doors, hold things at times. Positive for hoffmans sign and hyperreflexia in left arm.

    Can you help me decide if all of this is really needed, it feels like so much to me. Suggested c4-t1 ACDF with c6 corpectomy and possible c5-c7 corpectomy.

    MRI results:
    FINDINGS:
    Skull base-C2: No canal or neural foraminal narrowing.
    C2-3: No canal or neural foraminal narrowing.
    C3-4: Shallow posterior disc osteophyte complex without significant canal or
    neural foraminal narrowing.
    C4-5: Shallow posterior disc osteophyte complex without significant canal
    narrowing. Bilateral uncovertebral hypertrophy contributing to moderate
    bilateral neural foraminal narrowing.
    C5-6: Posterior disc osteophyte complex effacing the ventral aspect of the
    thecal sac with mass effect on the left ventral aspect of the cord best
    demonstrated on image 7 series 3/5, image 23 series 6/7, compatible with
    moderate to severe canal narrowing. Uncovertebral hypertrophy lateralizing to
    the left contributing to moderate left neural foraminal narrowing, mild right
    neural foraminal narrowing.
    C6-7: Posterior disc osteophyte complex effacing the thecal sac with slight
    mass effect along the ventral aspect of the cord compatible with moderate to
    severe canal narrowing. Mild left neural foraminal narrowing also noted.
    C7-T1: Left paracentral disc protrusion effacing the thecal sac with mass
    effect on the left ventral aspect of the cord best demonstrated on images 30 and
    31 series 6 contributing to moderate canal and left neural foraminal narrowing
    at this level. No right neural foraminal narrowing.
    Alignment: Slight loss of cervical lordosis as seen on prior CT.
    Bone Marrow: No fracture or suspicious marrow signal abnormality.
    Extra-spinal Findings: No significant incidental findings.
    IMPRESSION:
    1. Loss of cervical lordosis with degenerative findings of the cervical spine,
    disc pathology greatest at C5-6 and C6-7, more localized to the left paracentral
    location at C7-T1.
    2. Uncovertebral hypertrophy also contributing to moderate bilateral neural
    foraminal narrowing at C4-5.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Your complaints are: “I have had left side shoulder to finger pain, numbness and weekness for over two months. Grip strength has weakened, hard to open doors, hold things at times. Positive for hoffmans sign and hyperreflexia in left arm”

    Your MRI findings are”
    “C4-5: Bilateral uncovertebral hypertrophy contributing to moderate bilateral neural foraminal narrowing.
    C5-6: with mass effect on the left ventral aspect of the cord compatible with moderate to severe canal narrowing. Uncovertebral hypertrophy lateralizing to the left contributing to moderate left neural foraminal narrowing,
    C6-7: moderate to severe canal narrowing. Mild left neural foraminal narrowing also noted.
    C7-T1: Left paracentral disc protrusion with mass effect on the left ventral aspect of the cord contributing to moderate canal and left neural foraminal narrowing”

    With signs (and I assume symptoms) of myelopathy with cord compression, it sounds like you need to have the cord decompressed.C5-T1 would need to be addressed surgically (ACDF). The C4-5 level sounds like it in on the fence regarding surgery. It depends on how degenerative it is on X-ray and MRI. It probably will need to be surgically treated in the future so it might be OK to include it now. The left arm pain most likely stems from the C5-Tl levels. I would agree that a C5-T1 or a C4-T1 ACDF should be considered.

    Dr. Corenman

    mnjody
    Participant
    Post count: 19

    Thank you for your reply, much appreciated!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    Please keep in touch.

    Dr. Corenman

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