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#34640 In reply to: Losses sensation in feet |
dr corenman i see yesterday neurosurgeon in local (and say him my symptoms all my symptoms )
i want to say also this dr see me before 3 months (and write me a paper i will not have a problem in future in cervical spine (because i do not have not normal structure ( i have normal e lordosis , but when i talked him a bout: *** the disc degeneration and say him for example about what MRI SHOW IN 2016 (that my disc in cervical spine from c2 to c5 are degeneration and also thin disc IN LEVEL C4-5 for example JUST 2 MM (AND SAY HIM THE DISC ITS LIKE HALF OF THE DISC BELOW AND ALSO DISC C3-4 AND 2-3 ARE IN PROBELM (i say him its happen because my special trauma unit in the pool (swimming backstroke and all the way down to central of the end of the pool and boom into the wall (also say me like what happen to the skull (not cant come from my a collision with a wall because the skull are very hard bone (but u know what is wall of pool who is more hard and with speed of 1.5 meter of second this not happen (he give me some of not true things (i do a lot of research and i know that very well )
also one great lecture on cervical stenosis (dr cantor one surgeon open my brain also to this potential problem (also i read the same things in your excellent website (not see a lot of spine surgeon have website like this (on website 0 other have great YouTube channel like one profesor great lecutre (on hi, channel how to read MRI (LECTURE OF MORE ONE AND HALF OUR and on cervical anatomy (lecture of 1 hour and 40 minutes i read a lot and listen a lot from person average from the street .(but i need dr are special expert can help me with the progress of pinching the cord from posterior (i have a lot symptoms from sensation .
MAYBE I COULD DEVELOPED (STARTED OF MYOLPATY FROM POSTERIOR SO I DO NOT have : (MOTOR FONCTION LIKE USE button button or hand writing problem .
but see this please my symptoms (very contact to compression from posterior on the cervical spinal canal .
(Cervical myelopathy does not typically cause symptoms until the spinal cord is compressed by at least 30%.1 Anterior (front) spinal cord compression tends to cause motor dysfunction, and posterior (back) spinal cord compression tends to cause sensory deficits.2 It is possible for the cord to be compressed in both the front and back (this from this website :https://www.spine-health.com/conditions/spinal-stenosis/symptoms-cervical-stenosis-myelopathy ) and see my
symptoms :
1.heavy legs start before 2 mounts
2 .neck pain for long period of time (also in the back of the neck )
3.degenrative disc from multi level (from c2-to c5 dd in c2-4 and c4-5 thin disc 2 mm
this measurement from MRI IN 2016 (WHEN I WAS 26 NOT I M 31 )
I WILL BE in problem in past and i m arrived to this point of developed stared pinch cord (and started early processes of myelopathy from (posterior )
i do not how to call this but in little area from posterior i have pinch the cord (it svery see this also in the axial cut (very little area )
hope i find the the men expert help me after the MRI .
‘Meni
#34406 In reply to: Cervical neck mri results |This would be a snapshot of your current problems but here we are.
At “C4-5, there is severe loss of disc height with a central disc herniation mobile grade 1 degenerative spondylolisthesis with 7 mm of space available for the spinal cord consistent with severe central stenosis with compression and deformation of ventral aspect of the spinal cord as well as severe bilateral foraminal stenosis with compression of the exiting bilateral C5 nerve root”.
This means that you have an unstable degenerative spondylolisthesis at C4-5 (https://neckandback.com/conditions/degenerative-spondylolisthesis-cervical/) with central stenosis (https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/) and foraminal stenosis (https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/).
“At C5-6, there is severe loss of disc height with a central disc herniation with 7.5 mm of space available for the spinal cord consistent with severe central stenosis with compression and deformation of the ventral aspect of the spinal cord as well as right greater than left foraminal stenosis with compression the exiting right greater than left C6 nerve root”. The two lower hyperlinks above apply to this level. This is the level that corresponds to your biceps weakness (compression of the C6 nerve root).
Finally, “At C6-7, there is a broad-based disc bulge with 8.5 mm of space available for the spinal cord consistent with severe right greater than left central stenosis and moderate bilateral foraminal stenosis”.As a general rule, you will more likely than not need surgery- a 3 level ACDF as you have severe disc disease with the superior level instability (C4-5) and severe compressive changes at the two levels below. You are not a candidate for artificial disc replacements. See (https://neckandback.com/treatments/anterior-cervical-decompression-and-fusion-acdf/)
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.#34356Topic: C2-C5 Laminoplasty in forum BACK PAIN |Hello, Dr Corenman. You assisted some time back (Pre Covid) with a lumbar issue.
I also have cervical issues that will likely require surgery. In 2019, I had an ACDF of my C5/C6, with good results. Over the past year and a half I have developed periscapular pain on my right side, as well as tricep pain and occasional weakness. Interestingly, I have little, if any neck pain or stiffness.An MRI from July was read as:
C1/2: mild degenerative changes, craniocervical junction is normal in appearance.
C2/3: Minimal endplate spurring. no central canal stenosis, no neural foraminal stenosis.
C3/4: broad based right paracentral disc protrusion and mild endplate spurring. mild central stenosis and no neural foraminal narrowing.
C4/5: central disc protrusion. mild endplate spurring. moderate central canal stenosis. moderate bilateral foraminal narrowing.
C5/6: prior fusion with minimal central stenosis. no foraminal narrowing noted.
C6/7: broad based disc protrusion. minimal endplate spurring. mild central stenosis. no foraminal stenosis.
C7/T1: no central stenosis. no foraminal stenosis. mild endplate spurring.Interesting a PA for a neurosurgeon consulted with feels that I do have right side foraminal stenosis at C6/7.
I have had a consult with neurosurgery and he has proposed an ACDF at C6/7, with a cervical laminoplasty from C2 to C5. He feels that the central stenosis will be progressive and lead to a spinal cord injury at some point. As such, he has advised against higher risk activities such as mountain biking, horseback riding, skiing, etc. At this point I have not had any symptoms of myelopathy, but I’m aware that the risk is there. I will seek a second opinion to see what other treatment options are available. However, it seems that this would be the best approach for long-term stability, and to prevent myelopathy.
Does a laminoplasty with fusion seem to be a reasonable solution? If so, will I be able to return to somewhat higher risk activities such as biking?
As a side note, I have had multiple steroid injections into the C6-7 space. These have been very effective in relieving discomfort and pain. However, I am aware that this only used to treat pain, thus more of a “band-aid.” All of my imaging is recent and will be making a decision shortly after second opinion visit. Hopefully surgery to follow this Fall, depending on Covid. So, second question, what is the typical average range in recovery from a procedure such as this? Thanks for your time.
#34170 In reply to: MRI Cervical Spine 2021 |Your right and left arm pain/numbness most likely stems from your C5-6 level (“Severe right to moderate left foraminal narrowing”) causing nerve root compression.
See; https://neckandback.com/conditions/radiculopathy-pinched-nerve-in-neck/
You note no complaints of cord compression so that should not be a source of symptoms. (https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/).
Headaches can originate from the lower cervical spine but not commonly. The potential sources are multiple.
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.#34160 In reply to: Trying to understand my post op problems and work-up |Hi Dr Corenman,
I may have used the incorrect terminology, I was diagnosed with Functional neurological disorder after the first surgery and now again. Another name for this disorder that has been used in the past is conversion disorder. The neurologist cannot find a neurological reason for my symptoms on exam nor on mri. I was under the impression that a person could still have cervical myelopathy even after their spine had been surgically corrected??
I have pasted a copy of my latest mri below. The neurologist has ordered an mri of my brain to verify I don’t have MS. I was checked for that after my first surgery as well, but he wanted to confirm that it is still negative. I will have the mri in a couple of weeks.MRI CERVICAL SPINE WITHOUT CONTRAST,
04/10/2021 at 1348 hours.
HISTORY: Spinal stenosis, cervical region.
TECHNIQUE: Multiplanar multisequence imaging was obtained of the cervical spine on a 1.5 Tesla magnet. Images were obtained without IV gadolinium.
COMPARISON: MRI cervical spine dated 9/11/2020, cervical spine radiographs dated 3/9/2020, and CT myelogram, cervical spine dated 10/28/2019.
FINDINGS: Postsurgical changes of prior anterior cervical spine fusion are redemonstrated from C4 through C6, with a ventral surgical plate, vertebral body screws, prior corpectomy at C5, and vertically oriented strut graft from C4-C5 through C5-C6.
Additional postsurgical changes of prior posterior decompression and fusion are demonstrated from C4 through C7, with pedicle/facet screws connected by vertical rods, new compared to the prior exams. The surgical hardware would be better assessed on the
prior CT/x-ray exams. Susceptibility artifact related to the metallic surgical hardware degrades images and limits evaluation of the surrounding structures.There is persistent straightening of the normal cervical lordosis. No new abnormalities of sagittal alignment are identified. The vertebral body heights are maintained. The marrow signal is notable for mild endplate degenerative signal changes that
are most prominent at C6-C7 outside of the postsurgical levels.The cervical cord has a normal caliber. There are no areas of abnormal cord signal. No masses or fluid collections are seen in the spinal canal or paravertebral soft tissues. The craniocervical junction is unremarkable.
Multilevel degenerative changes are identified with diffuse degenerative disc desiccation and disc space narrowing, most prominent at C6-C7 outside of the postsurgical levels, where there is moderate loss of intervertebral disc height (slightly more
pronounced ventrally).C2-C3: Negative
C3-C4: Negative
C4-C5: This is a postsurgical level. Evaluation on the axial images of limited due to the susceptibility artifact related to adjacent surgical hardware. No definite high-grade spinal canal or neural foraminal stenosis is identified.
C5-C6: This is a postsurgical level. Evaluation on the axial images of limited due to the susceptibility artifact related to adjacent surgical hardware. No definite high-grade spinal canal or neural foraminal stenosis is identified.
C6-C7: This is a postsurgical level. Evaluation on the axial images of limited due to the susceptibility artifact related to adjacent surgical hardware. No definite high-grade spinal canal or neural foraminal stenosis is identified.
C7-T1: Evaluation on the axial images of limited due to the susceptibility artifact related to adjacent surgical hardware. No definite high-grade spinal canal or neural foraminal stenosis is identified.
IMPRESSION:
1. Postsurgical changes of prior anterior cervical spine fusion are redemonstrated from C4 through C6, with interval posterior decompression and fusion from C4 through C7. Susceptibility artifact related to the surgical hardware degrades images and
significantly limits evaluation of the surrounding structures.
2. Mild multilevel degenerative changes of the cervical spine, without definite evidence of significant spinal canal or neural foraminal stenosis.Thank you for your reply. I just can’t seem to believe that my symptoms would be all in my head. It doesn’t make sense to me.
#34158Topic: Trying to understand my post op problems and work-up in forum NECK PAIN |Hello,
I had a C5 corpectomy with C4-C6 arthrodesis in 9/18 for cervical kyphosis with radiculopathy and myelopathy. These were all upper body symptoms. Right after surgery I developed leg weakness to the point of needing a walker and my arms were still very weak and pain still went down my right arm as before. They did an extensive work up with EMG’s, CT Myelogram, cervical facet injection, . . . I was unable to have an mri due to having a medical device for my bladder for interstitial cystitis. I. Saw a neurologist who looked at my past history from 20 years ago where I had some trauma with losing family members and diagnosed me with functional movement disorder. I got a second neurologist to do another EMG/NCS and he found an abnormality in the NCs showing radiculopathy and suggested I could have cervical myelopathy but would need an mri. I had to wait about 6 -8 months for a new lead wire to come out that was mri compatible so I could have another surgery to have it replaced. Then I could have an mri.
In the mean time I was diagnosed with this functional movement disorder. I mean no disrespect to anyone who has it, I was going to just go on and work hard and try to get better, but I was given the impression that “this was all in my head”. I was treated with a lot of disrespect by PT/OT and physicians from other disciplines because of this diagnosis.
I decided to go to the Cleveland clinic for another opinion after getting the mri compatible device. The mri and the Cleveland clinic diagnosed me with cervical myelopathy, pseudoarthrosis, cervical kyphosis below my surgery, congenital spinal stenosis, and cervical cord compression. I underwent a posterior cervical fusion from C4-C7 with rods and pins and laminectomies as C6 and C7. Needless to say I had a rough go of it. I was in rehab there for a month. I am still using a walker and the surgery was in 10/2020. I am Back to square 1 because the neurosurgeon believes I should be much better by now. I am not. I can barely hold my head up after walking 200 ft. I have nerve pain down both arms if I move my arms in a certain direction. I feel like I am walking in quick sand. mRI shows fusion is starting and good placement of hardware. A neurologist cannot find anything on exam, but did bloodwork. The only thing that came back low positive was an RNP antibody index. The ANA was negative as well as the rest of the ENP panel. He has now diagnosed me with functional neurological disorder. I’m devastated. In your opinion, can you think of anything else that would cause my symptoms? I have trouble raising my arms, my hips are week, I can walk now about 235 feet and then I have to sit down and I can barely hold my head up. This is after months of physical and occupational therapy including 2 inpatient stays in rehab. I am trying really hard. I want to get better! -
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