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#6288 In reply to: Cervical Lateral Flexion Extension X-ray |
The technique used could theoretically make a difference in looking for instability but instability is typically somewhat obvious by looking at even a standard lateral X-ray.
The FONAR MRI is something that I am not a big fan of. The images are not great and all the information can be obtained by the FONAR MRI can also be obtained by a good set of X-rays and a good MRI.
Please review the section under “Conditions”- “How to describe symptoms” and let me know what your history is. That way, I can give you an idea of what origin your pain could possibly be from.
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.#6286 In reply to: Cervical Lateral Flexion Extension X-ray |Thank you very much for your response. I did not do them like that at all–could it make a difference in checking for instability which is what, as I understand, my neuro is checking for? I have a “retrolisthesis of C5 on C6.” I have read about an MRI made by FONAR that can allow for an MRI of the neck in flexion and extension. Is that a good study to measure for instability or is the flexion and extension x-ray better? I had a myelogram with a CT scan that shows nerve root compression at C5-6, 3 injections without a great deal of success (continued arm weakness, continued neck pain that can increase astronomically with movement.). Thank you for any response in advance.
#6284 In reply to: Cervical Lateral Flexion Extension X-ray |Normal technique for flexion/extension cervical X-rays is to literally bend forward from the head as far as possible keeping the shoulders in the neutral position. It is the exact reverse for the extension view again keeping the shoulders in the same position but extending the head backwards as far as possible (but creating no significant pain).
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.#6283Topic: Cervical Lateral Flexion Extension X-ray in forum GENERAL |I just had a cervical lateral flexion extension x-ray. I kept my neck very straight and bent only my chin down for this for flexion and kept my neck very straight and looked straight up for extension. Was this the right way to check for instability? HAd it done at chiro office. Neuro ordered it.
#6282 In reply to: Risks of ACDF? |Your symptoms could be from a demyelinating disorder or from myelopathy. Most individuals with your intensity of symptoms and stenosis have cord signal changes but not all. If the brain MRI is normal, then more likely than not, these symptoms would be from the cord compression. Nonetheless, there are other neurological disorders that can cause these symptoms. A thorough neurologist can help to differentiate this.
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.#6280 In reply to: Neck & Shoulder Pain w/ MRI Results |Based upon your symptoms and “findings” of weakness and especially imbalance, you most likely need surgery of C6-7. It is interesting that as a general rule (with some exceptions) the cervical nerve roots are more forgiving than the lumbar nerve roots (a later surgical decompression can still allow recovery in the cervical spine). The exception is cord compression. The cord is part of the central nervous system (CNS) and does not recover well. If you have symptoms of cord compression along with some signs (hyperreflexia, Hoffmans’ sign, imbalance signs), surgery should not be ignored.
The disc tears/herniations in your cervical, thoracic and lumbar spines indicates a genetic weakness of the discal collagen fibers. There is nothing you can do for that but just learn better spinal biomechanics and take greater care when loading your spine.
You can get a block of both the lumbar and cervical spine at the same time but in regard to your cervical spine, this would be a mistake in your case. The epidural will relieve your pain but not remove the compression of the spinal cord. You are then lulled into the belief that you are “better” because the symptoms are not as disabling but that conclusion would not be accurate. The cord compression would continue, possibly leading to further damage.
Sealants for the disc really do not seal the discal tear. The biology of the annular wall of the disc is that it is avascular. Without a blood supply, there is no ability of the disc wall to repair itself. In addition, the fibers of the disc wall are under great tension. When they tear, these fibers retract so they cannot be approximated again.
Some of the injections you mention reduce the inflammation of the pain fibers in the disc wall and that is what reduces the back pain. Unfortunately, these injections are only a temporary fix.
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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