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#5886 In reply to: Cervical Spinal Stenosis? |
MRI findings are important but need to be compared to your symptoms and physical examination findings. All the symptoms you note are “Weakness of grip and strength bilateral arm”.
I can tell you what symptoms you could have based upon the MRI findings. You have no real central cervical stenosis per the radiologist so myelopathy should not be present (see website for description). The most significant findings you have are moderate to severe foraminal stenosis on the left of C5-6 and C6-7.
This would cause left arm pain and paresthesias (pins and needles) that radiate down to the thumb and fingers on the thumb side of the hand. You might have a weak left triceps and biceps muscle. You might have problems with strong grip in your left hand. Bending your head backwards (extension) could cause the pins, needles and pain to increase down your left arm.
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.#5882 In reply to: Cervical Spinal Stenosis? |Hello Dr. Corenman. I have the written report of the MRI but not the disk. I imagine if I ask our doctor for it I could get a copy. Our doctor said he’s not that good at reviewing MRI’s. This is the report from the radiologist if you don’t mind reading. I just don’t know how to interpret what it is saying, and thank-you for your time.
Clinical History: C6-C7 foraminal steniois less so on right. Weakness of grip and strength bilateral arm.
Technique: Saggital T1W and T2W images of the cervical spine have been obtained, as well as axial ED T2W images.
Magnetic Resonance Image Findings:
No subluxation is seen.
No disc herniation or stenosis is noted at C2-C3 and C3-C4.At C4-C5, moderate broad-based anterior endplate marginal osteophytes with diffuse disc bulging are noted. However, there is no disc herniation or stenosis.
At C5-C6, minor broad-based anterior and posterior endplate marginal ostoephytes with diffuse disc bulging (i.e. osteocartilaginous bars) are noted. There is encroachment of the canal, but no cord abutment or deformity is seen. There is moderate left foraminal stenosis due to encroachment by moderate marginal osteophytes at the left uncovertebral joint. Minor osteophytes are noted at the right uncovertebral joint with mild right foraminal stenosis.
At C-C7, disc space narrowing and fatty endplate changes are noted. Minor anterior and moderate posterior endplate marginal osteophytes with diffuse disc bulging (i.e. osteocartilaginous bars) are noted. There is encroachment of the canada, but no cord abutment or deformity is seen. Marked osteophytes are noted at the left uncovertebral joint with marked left foraminal stenosis. Minor osteophytes are also noted at the right uncovertebral joint with mild right foraminal stenosis. No disc herniation or stenosis is noted at C7-T1.
The cervical cord is normal in size and configuration. Nor abnormal signal intensity is seen.Interpretation: Endplate osteophytes with diffuse disc bulging (i.e. osteocartilagnious bars) at C5-C6 and C6-C7, osteophytosis at the uncovertebral joints at C5-C6 and C6-C7. Canal stenosis with no cord abutment or deformity and bilateral foraminal stenosis at C5-C6 and C6-C7 (moderate at C5-C6 and marked at C6-C7 on the left at both levels).
Thanks Dr. Corenman.
At C5-C6, minor broad-based anterior and posterior endplate marginal osteophytes with
#5877 In reply to: L5 S1 and rowing |Rowing or crew sports with back pain in a teenager always makes me think of a spondylolysis due to the repetitive extension in the sport. Make sure on the MRI that there is not an unrecognized spondylolysis.
If the pain is not from a spondylolysis but from the degenerative segment, the pain could originate from the disc or the facet. Does the pain become worse with flexion (bending forward) at the initiation of the stroke or with extension (bending backwards) during the power portion of the stroke?
She may be a candidate for facet injections (see website for this). More rehab with focus on strengthening extensor muscles and increasing range of motion in extension may be helpful. Possibly an epidural injection may give relief.
Dr. Corenmna
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.#5872 In reply to: Review of MRI results |Dr. Corenman,
I appreciate the time you take to provide this forum. You have my mri results above and I have now been twice to rehab at physical therapist.
Rehab consists of 20 minutes stretching include prone arm extensions arching backwards, 20 minutes traction table with harness/electrical motor contracting and expanding. Finish with 20 to 30 minutes of deep massage in low back and electrical stimulation of nerves. 3 days week.
I am taking Zipsor 25 mg four times a day with reduction of approximately 85% of pain for about 4 to 5 hours with each pill.
I cancelled my third rehab visit today, because I am afraid the traction may further damage one or both of my extruded discs.
As I stated earlier, I have had low back pain for years but about two to three months ago I think I overdid it moving a freezer. The left leg pain began a couple of days later and has continued. Oral steroids gave a little relief. If I quit the zipsor the full pain returns.
My questions are: Is the traction table appropriate for my type of extrusion? In general what type of rehab would be appropriate and for how long should I attempt rehab before I risk damage to the nerve permanently? Do injections reduce inflammation or just deaden nerve and risk permanent nerve damage from normal daily activities?
Please forgive me if I have asked to much at one time. I am willing to pay and would like to send you a copy of the cd with mri images if possible. Thank you Dr. Corenman.
#5871Topic: Anomaly with Atlas/Axis vertebrae in forum NECK PAIN |Hi there,sorry to bother you but id love to speak with someone like yourself.Iv had extreme dizziness for around 3 years,had loads of tests done like bloods,brain mri,vestibular assesement,hearing and eye checks,adrenal gland test,urine test,EEG,24 hour ecg,all fine.I decided to get my neck checked as i couldnt put up with this anymore and was hoping it would at least rule out the neck.I went to a chiropractor and had a side x ray and a front x ray with my mouth open.they came back shocked saying my side x ray was normal,but my front x ray showed a considerable anomaly.They said it looks like iv been dropped directly on my head as a child.they tried manipulation for a while but said they carnt fix it,they didnt even charge me at all,it was all free,guessing they felt sorry for me or something lol.chiro sent a report to a gp and he sent me to a neurosurgeon,he requested 2 side x rays,even though we said side x rays at the chiro were clear.Neurosurgeon did a Flexion xray and a Extention x ray of my cervical spine,first he said its completely normaly.then he checked it again and said theres a small abnormality but its fine,wont cause any symptoms and its just the way i was born,and to go back to the gp,they didnt even checked a open mouth xray :(. Do the flexion and extension xrays show you everything you need to know? and could a open mouth x ray show a problem thats not detectable from the side? my chiro was really anooyed and is sending his xrays to the surgeon now.im not sure the exact name of what the injury is,he showed me useing one of them plastic spines,and he moved the ondontoid into the corner instead of at the centre back :S Would it be better for me to see a orthopedics instead of a neurosurgeon?
heres the chiropractic report.
“This young man has recently consulted ourselves regarding his ongoing
dizziness/vertigo. Onset occurred some 2 ^ 2 years ago after turning his head quickly. I
believe MRI scans of his cranial area were clear. However plain x-rays of his cervical spine
have revealed a considerable anomaly with his Atlas/ axis vertebrae on the left side.
This is confirmed on the MRI scan which just brings this area into view and I suspect has
not been flagged up before. This would certainly affect his balance and is identified as a
contraindiction to anv routine manipulation. This may be a congenital anomaly or
traumatic in origin from a very early age which now remains unstable.”#5866Topic: L5 S1 – over a year now in forum BACK PAIN |Doc. I’m 36 years old and up to this point a very fit man. My back problems started in 2005 when I was moving a couch and my back locked up and had me on the couch for several days. In 2006 I had a riding mower fall and I caught the full blunt of the mower while bending with my back. I felt it pop in the back and I had to crawl to the house in agony and again was on the mend within several days. From those 2 episodes I continued to re-injure the same area every 8-10 months with some type of movement causing my back to tighten up and have me out on the couch for 2-3 days.
Last April (almost 1 year ago) I started to get extreme sciatica and after an MRI, found out that I had a herniated disc in my L5, S1 with extreme degenerative disc disease. My pain was a 9-10 and I started extensive treatment through chiropractic care, ice, heat, exercise and decompression. My pain level has dropped to a 3-4 level but I can’t seem to get over this last hurdle. I have tried shots with only minimal effect that wears off within a couple weeks. I do have an inversion table that gives me temporary relief and I walk daily. I don’t know what else to do and every time I try to push myself a little further in excerise, things flare up again.
At this point, I wonder if surgery is the only option left? I’m fearful of it and have heard some people say that DR’s tell them…it could help, worsen or stay the same after the surgery. My thoughts were to get another MRI next month to see where I have progressed and then proceeed from that. Thoughts, suggestions, would be VERY helpful!! Thanks!!
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