[7seas2go]

#11404

Dear Dr. Corenman,

First of all thank you kindly for taking time to read my post.
It seems that just maintaining this forum takes a considerate time and effort.

In short,
I am Navy veteran working in the Middle East as a defense contractor.
Past back problem (mostly L5/S1) with constant pain but manageable..

Past months considerable pain in my neck (when I band my neck backwards and sideways) and left arm (triceps area when I bend my elbow). I would need your opinion since before even seeing spine surgeon I will need to make arrangements to travel and see one in the States.

Anyhow, not to take much of your time:
1. My question is how serious I should take this attached MRI report and where shall I start first. Getting some relief (pain management) is next to impossible here since those are highly controlled substances so I use ibuprofen only with no any relief. For epidural injection and possible surgery I would need your kind advise.
Maybe I should plan trip back to States…

MRI report:

EXAMINATION: MRI OF THE CERVICAL SPINE

CLINICAL FEATURES: Neck pain radiating to the left arm.

TECHNIQUE: Multiplanar and multisequential MRI of the Cervical Spine was done following our routine protocol.

FINDINGS

The vertebral height and alignment are maintained. There are moderate osteophyte formations.

C5-6 disc demonstrates diffuse degenerative disc bulge with posterior and lateral osteophytes causing severe narrowing of the neural foramina bilaterally and early central canal stenosis.

C6-7 disc demonstrates diffuse degenerative disc bulge with posterior and lateral osteophytes causing severe narrowing of the left neural foramina and moderate narrowing of the right neural foramina. There is also moderate central canal stenosis.

Thank you kindly

[Donald Corenman, MD, DC]

#11419

First, your symptoms match up with a foraminal stenosis causing radiculopathy (see website), You don’t report where the pain radiates but see the section “Symptoms of cervical nerve injuries” to understand what certain symptoms mean.

You have significant narrowing of the C5-6 and C6-7 foramen on the left which would cause either a C6 or C7 root compression (or both) and radiculopathy (see website).

WIthout motor weakness, you could try injections (selective nerve root blocks-see website) and some therapy. Avoid bending your head backwards as this action further narrows the foramen and can make your symptoms worse.

You could try oral corticosteroids (I like decadron) to give some relief if you do not want to make the trip back to the states. This might only yield temporary relief but is the simplest thing to do right now.

If nothing else is effective, you would probably need an ACDF surgery (see website) or posterior foraminotomy (depending upon the X-ray and MRI findings).

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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