MckellardjParticipantNovember 4, 2021 at 1:30 pmPost count: 2
I have an upcoming ACDF or ACDR next month. I’ve experience neck pain, soreness and achy at base of both sides of my neck. Also, my left arm and hand along with fingers have weakness, achy and numbness. I struggle with my phone in my left hand. As of recent, it’s slowly progressing to my right hand. I’ve had an EMG and nerve conduction study and MRI, which my doctor believes C5-C6 is the level that needs to be fixed.
My MRI reports below:
PATIENT HISTORY: Status-post trauma, neck pain.
TECHNIQUE: Axial and sagittal water-weighted and fat-weighted and proton density images were obtained in a closed 1.5 Tesla magnet.
FINDINGS: There is normal cervical lordosis identified. The cervicomedullary junction is intact. There is no compression fracture. Multilevel loss of disc hydration is noted. The nasopharynx is unremarkable. The visualized surrounding soft tissue structures of the neck are unremarkable, although the study is not optimized to assess the surrounding structures, and pathology may be missed as result.
Evaluation of the disc spaces demonstrates: At C2-C3, there is a right foraminal herniation abutting the right foramina. At C3-C4, there is a broad-based central posterior disc herniation indenting the thecal sac. At C4-C5, there is a disc bulge indenting the thecal sac. At C5-C6, there is a disc bulge indenting the thecal sac. At C6-C7, there is no disc bulge or herniation and the facet joints are normal. At C7-T1, there is no disc bulge or herniation and the facet joints are normal.
IMPRESSION: 1. Right foraminal herniation at C2-C3 abutting the right foramina. 2. Broad-based central posterior disc herniation at C3-C4 indenting the thecal sac. 3. Disc bulges at C4-C5 and C5-C6 indenting the thecal sac.Donald Corenman, MD, DCModeratorNovember 5, 2021 at 10:43 amPost count: 8465
Your symptoms are neck pain with left arm symptoms and you are planning a neck surgery to relieve these symptoms. Along with neck pain you note: “my left arm and hand along with fingers have weakness, achy and numbness”.
The nerves that descend into the hand originate from C5-T1 and your MRI report notes no foraminal root compression at these levels which would explain that complaint. The C3-4 level can cause local neck pain but the nerve root here does not descend into the arm and this is the only level noted to have root compression.
You might have a peripheral nerve compression causing the hand complaints but that should have been picked up by the EMG. As of this time, the information you have provided does not give a clear path to the level or levels needed to have surgery. What level(s) are being addressed surgically?
Dr. CorenmanMckellardjParticipantNovember 8, 2021 at 10:49 amPost count: 2
The EMG results, which the doctor has and told that I needed levels C5-C6 for surgery. From what I recall the Neurologist who conducted the EMG, stated results weren’t good. I joined this forum for an understanding and clarity.Donald Corenman, MD, DCModeratorNovember 8, 2021 at 11:18 amPost count: 8465
The radiologist noted no foraminal stenosis at C5-6 (“At C5-C6, there is a disc bulge indenting the thecal sac”-which is not the nerve hole exit). Maybe he did not feel the need to comment on narrowing of the C5-6 foramen-the hole that the nerve root exits but he did comment on the C2-3 foramen being narrowed.
You note that the EMG “results weren’t good”. What does that mean? Did he find problems or was the test results non-valid?
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