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#7719Topic: C3-C4 Anterolisthesis and C4-C5 Retrolisthesis? What Does This Mean? in forum GENERAL |
I had recently receive my medical records from my chiropractor. It has a lot of stuff in there about my neck and maybe my back and I was wondering if someone could tell me what it all means.. Below is some of the topics in my medical records.
Motion in the neutral lateral projection to full extension shows mild anterolisthesis at C3-C4.
Motion in the neutral lateral projection to full extension shows mild retrolisthesis at C4-C5.
1. Ligamentous instability with Anterolisthesis at C3-C4.
2. Reversal of the cervical lordosis.I have alot of pain in my back and neck. My head feels heavy alot and causes strong headaches. My head also tilts back. It is extremely hard for me to sit or stand for long periods of time. I also have alot of pain going from my lower back around to my hip and down my right leg.
I would really like to get some suggestions on what to do about making a doctors appointment and what kind of doctor I really need to see.
Thank You!By the sounds of your symptoms, you have cervical stenosis and compression of the spinal cord at C5-6. Myelomalacia is a thinning of the diameter of the cord due to injury. There is no question that this level (C5-6) needs surgery.
The C6-7 level is somewhat degenerative but is not compressing the cord. There is foraminal narrowing but your report does not note how severe. Normally, radiologists will place a modifier in the report (mild, moderate, severe) which can occasionally be helpful in determining if this level needs to be included in the surgery.
The physical examination can also reveal if the C7 related muscles are not functioning (triceps, wrist flexors, finger extensors-see website under cervical nerve injury). If the exam does not reveal C7 nerve disfunction, then it is probably safe to leave this level out of the surgery.
Good luck with surgery.
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.#7694 In reply to: Cervical Foraminal Stenosis |Thank you so much for your quick response. I have been able to persuade them to do a nerve block in that area. I will be getting it done on Tuesday. I have already failed conservative therapy (PT, medications, tens unit, trigger point injections) and I do have symptoms of root compression. It is to the point now where the condition is disabling. I can’t brush my hair, cut my food, etc…
Should I ask for a referral to a neurosurgeon if the nerve block is positive?
#7682 In reply to: Exercise post C5 foraminal stenosis surgery |Extension or bringing the head backwards (looking up) causes the neuroforamen to narrow. The neuroforamen is the exit hole for the nerve root. Activities that induce this maneuver are swimming, road and mountain bike riding, the serve and overhead in tennis among other activities.
You can take steps to reduce this extension. Putting a shorter and higher angled stem on your bike will reduce the amount of extension. Using a snorkel to swim will reduce extension.
Strengthening the SCM muscles can help. Look for the video on this site (neck sit-ups) to understand how to strengthen these muscles. Careful with reverse neck sit-ups as you do not want to extend your neck too much.
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.#7647 In reply to: Questions About The Mechanics of Pars Fracture |Question one-“Can a motor vehicle accident cause pars fractures?” Answer-yes but only very rarely and under dire circumstances-ejection from vehicle (no seat belts) or severe impact with body encroachment. The disc will not show signs of degeneration for at least three months and more likely six months or more. The typical mechanism is an extension moment (severe bend backwards).
Question two-“How immediate would be the onset of symptoms?” Answer-immediate. This would be an acute fracture with the subsequent inability to stand upright without significant pain and muscle spasm. No matter what medications you were on, you would notice the pain and dysfunction.
Question three-“How likely is it that the degenerative process could occur and be asymptomatic (painless)? Answer-This is the most common scenario. Most individuals develop this stress fracture when young and don’t develop symptoms until a relatively minor injury causes a tear of the fibrous pannus. You symptoms that have developed after a motor vehicle accident are typical. This does not mean that this preexisting condition precludes you from causation.
Forth question-“How long does it take from pars fracture to degenerative disc disease?” Answer-many years. I am currently researching this and anecdotally, it appears to take at least 10-15 years with some exceptions.
Last question-“If bilateral pars fractures are noted without a slip and with a normal disc, is it recommended to repair the pars fractures?” The answer is still under investigation. If the gap between fragments is large, I don’t think a repair can be effective. Also, the older the patient, the less natural healing response is possible, even with BMP. I can also argue the opposite side. I have repaired multiple adults under this condition successfully. Only time will tell if repair will be effective to prevent degenerative disc changes and what the fracture separation distance is for a successful repair. I have turned down patients for repair with a 5mm fracture separation (they need a fusion) and successfully repaired 3mm separations.
Will repair prevent the degenerative process? Logic and reasoning says it will but only the test of time will answer this question.
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.#7645 In reply to: Lumbar 3 scyatica |BODY=Report Dictated By: Blake,Meghan MD||EXAMINATION: MRI LUMBAR SPINE WITHOUT CONTRAST|HISTORY: Chronic back pain radiculopathy.|COMPARISON: None.|TECHNIQUE: Sag T1/T2, Ax T1/T2.|FINDINGS: There is a moderately severe rotary levoscoliosis of the |lumbar spine with apex at L2-3. There is prominent endplate bone |edema and peripherally directed spur rightward along the concave |margin of the curvature and the disc at this level is markedly |degenerated and narrowed. Conus and cauda equina are normal.|Level by level analysis:|L1-2: Minimal bulge.|L2-3: Moderate to moderately severe right-sided foraminal stenosis |from right lateral endplate spurring. Remodeling and edema-like |signal change along the bony endplates suggests active motion segment |instability.|L3-4: There is a 2 mm broad-based protrusion, very mild facet |hypertrophy and mild foraminal narrowing.|L4-5: Thickening of ligamentum flavum and facet capsular tissue with |mild left subarticular and left foraminal narrowing. There is a 1 mm |broad-based protrusion.|L5-S1: Disc is desiccated and significantly narrowed, facets are |overgrown and there is moderate to moderately severe left and |mild-to-moderate right foraminal narrowing, disc desiccation and |height loss with vacuum disc phenomenon and more limited reactive |marrow change than seen at L2-3 here left at midline. There is also |a small annular fissure. Overgrowth of the left facet is associated |with mild capsulitis.|IMPRESSION:|1. There is degenerative change along the concave margin of |scoliosis at L2-3 with disc desiccation, large lateral endplate spurs |and reactive endplate change which suggests motion segment |instability. The right L2-3 neural foramen is stenotic.|2. At L5-S1, there is leftward endplate spur and lesser reactive |marrow change also with significant disc dehydration and height loss |and a moderate-to-moderately severe left foraminal stenosis.|CREATED=01-16-2012 04:20 PM
I have tried physical therapy, inversion table, pain meds and muscle relaxers, just recently tried acupuncture and it did not work. I get really bad pain in my lower back, left hip down to my foot, for the past two days my lower back and hip has felt like they are actually on fire, the burning feeling gets so intense.
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