[Shankz]

#31924

I started feeling excruciating pain roughly 9 weeks ago and below are the findings from my MRI. Since the diagnosis I have completed 6 weeks of physical therapy, received 2 cortisone shots, and now I am scheduled to follow back up with the Neurosurgeon next week. I still continue to have pain in my neck/shoulder area (typically around 5 level), the radiating pain down the arm has been occurring less frequently, but now I am staring to feel a slight pain in the my chest (left side below collarbone). The two cortisone shots have not given any relief to daily pain and I don’t think going for the third shot makes any sense. Currently taking muscle relaxers and anti inflammatory pills. I am pretty sure the dr is going to recommend surgery but just wanted to know your thoughts.

Findings:
C5-6 the disc is mildly narrowed. There is ventral and dorsal endplate spurring with broad bulging of the disc and bilateral uncovertebral joint hyperteophy. There is mild spinal stenosis. There is mild bony stenosis of the bilateral C6 foramina, though no apparent impingement
C6-7. The disc is narrowed and degenerating. There is broad bulging of the disc with posterior midline annular tear and shallow disc protrusion. There is mild central spinal stenosis. Bilateral uncovertebral joint hypertrophic is worse on the left, with an associated left subarticulardisc protrusion. There appears to be bony and disc encroachment upon the left C7 root. The right C7 foramen and root appear normal.

[Donald Corenman, MD, DC]

#31933

I have many questions. What arm is involved? What is the percentage of pain in your neck vs shoulder and arm? Which pain is worse and want aggravates the pain? What activities have you stopped due to pain?

You note you have had “two cortisone shots have not given any relief to daily pain”. First, where were these injection located? Were they nerve blocks, epidurals, facet blocks or trigger point injections and where? Did you keep a pain diary for the first three hours or were you not asked to keep track of this 3 hour window?

Your culprit is probably the C7 nerve root. “C6-7…Bilateral uncovertebral joint hypertrophic is worse on the left, with an associated left subarticular disc protrusion. There appears to be bony and disc encroachment upon the left C7 root” C5-6 notes “There is mild bony stenosis of the bilateral C6 foramina, though no apparent impingement”.

You might need an ACDF or ADR of the C6-7 level.

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.

[Shankz]

#31940

My left arm is the one experiencing the numbness and radiating pain. It started with mostly the arm pain but now that has been reduced and I have been been experiencing the pain in my neck and shoulder blade area on both left and right sides. I would say 70/30 shoulders to neck, arm is periodic. I have stopped lifting anything, I used to play pickleball and basketball, I have not done either since. Standing or sitting for a long period of time leads to pain. For example, yesterday we were at a concert from 11:30-5 and by the end of the concert my left and right shoulders had level 7/8 pain. I had the epidural shots into the spine between the C7-T1 (this is the highest they can go). I did not do a pain diary as I was not asked to do this. I do know that both the Neurosurgeon and the pain Dr both said that my neck is pretty bad.
My Neurosurgeon did say that if the shots don’t work then my next steps would probably have to be surgery and I would be able to do the disc replacement vs fusion.

[Donald Corenman, MD, DC]

#31944

I will assume that your physical examination will point to the C6-7 left level as the pain generator based upon your complaints. No diagnosis measurements from the epidural is unfortunately commonplace so we can ignore that finding.

You probably are a candidate for a fusion or an artificial disc depending upon the findings on X-ray.

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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