[pheld3423]

#9585

Dear Dr Corenman, I was hoping you could explain what the conclusions of my MRI are. I am currently taking lortab 7.5/500 for pain, and tizanadine 4mg, and Neurontin 100mg. I cannot take NSAIDS to history of ulcers. The conclusion follows.

1. The cervical spinal canal is small on a congenital basis, 1.3cm.

2 At the C5-6 level, a mild to moderate degree, broad-based posterior disc protrusion lateralizes to the left, causing at least mild spinal cord compression. Moderate degree stenosis of the left intervertebral foramen is noted.

3. At the C6-7 level, moderate to severe degenerative disc disease is identified. A mild to moderate degree, broad based posterior disc protrusion causes posterior displacement of the spinal cord. Moderate to severe stenosis of bot intervertebral foramina is observed.

I continually have shoulder pain that radiates to my left arm and hand, with pins and needles in my hand that makes it difficult to pick up small objects. The pain in my neck burns like fire. I have noticed lately that my balance is not good and that I fall frequently. I have had the facet injections in my neck one time that did no good, and were very painful. I have tried trigger point injections in my left should to help with the pain. They only last a week and the pain comes back greater.

My question is, is my condition severe enough to have surgery or just try to live with it. I see no relief with the Neurontin, and I do get relief with the lortab but the dosage is low and only 3 times a day along with the tizanadine. I have to take a low dose of Xanax .050 once a day for anxiety, which does work, but the anxiety attacks are increasing as the pain now has increased. I take trazodone at night to sleep, it is the only way I can sleep due to the pain. Any suggestions that might help my case would greatly be appreciated. I wanted to send the whole mri report but it is long. Thank you for your help.

[Donald Corenman, MD, DC]

#9586

Your report of symptoms sounds like that of radiculopathy (see website for description). Balance problems certainly could be from myelopathy (compression of the spinal cord-see website).

At both C5-6 and C6-7, you have “Moderate degree stenosis of the left intervertebral foramen” at C5-6 and “Moderate to severe stenosis of both intervertebral foramina” at C6-7. This will cause significant root compression and arm pain. This reading also infers significant cord compression.

You do not state how long you have had symptoms or the findings on your physical examination. If you do have cord compression that is verifiable by examination or pain with motor weakness in your left arm, you could be a candidate for surgery. See the section on the website “When to have neck surgery” for a greater explanation.

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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