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#5171Topic: my nick c5&c6 in forum NECK PAIN |
hi doctor
how are you ?
i am from saudia
A year ago
(((( doctor All the symptoms came after the neck pain step by step))
I feel numbness in both hands and knees on the
Weakness in the right hand and right leg as well as
I feel numbness in the tongue and difficulty to speak, sometimes
I feel tingling in different locations of my body
I am also a small muscle in my hand shaking for 15 seconds more or less
I have (MRI) of the neck and brain Can I send you by e-mailTest result (mri) as follows
1-+++++++++++++++++++++++++++++++++++++++MRI CERVICAL SPINE WITH CONTRAST ENHANCEMENT.
Spin Echo T1 weighted and gradient rephased T2 weighted images were obtained in axial and sagittal plane. T1 weighted images were obtained after contrast enhancement in axial, sagittal and coronal planes.History: Sensory symptoms.
Mild straightening is seen involving the cervical spine.
Mild disc bulge is seen at C5/6 indenting the thecal sac.
There is no evidence of disc degeneration or disc herniation.
There is no spinal stenosis.
The spinal cord shows no abnormal signal.
The paravertebral soft tissues are normal.
The vertebral bodies show no evidence of abnormal signal to indicate bone marrow replacement.
No unusual enhancement is seen after contrast injection.CONCLUSION:
Mild straightening is seen involving the cervical spine.
Minimal disc bulge is seen at C5/6 indenting the thecal sac.2-+++++++++++++++++++++++++++
MRI OF THE BRAIN WITH & WITHOUT CONTRAST ENHANCEMENT:
Clinical History: Sensory symptoms.
Comparison: None.
Technique: T1 and T2 weighted images were obtained before contrast enhancement in axial plane.
Flair images were obtained in coronal view. T1 weighted images were obtained after contrast enhancement in axial, sagittal and coronal planes.Findings:
There is no evidence of abnormal signal in the brain to suggest intracranial mass, bleed, area of infarction or hydrocephalus.
The ventricles are normal size.
Brain stem and cerebellum shows normal signal intensity and morphology.
There is no midline shift.
The sellar floor and bilateral cavernous sinuses are normal.
The vestibulo-cochlear nerve complexes are normal.
Visualized parts of calvarium and skull base appear normal.
No unusual enhancement is seen after contrast injection.IMPRESSION:
There is no evidence of abnormal signal in the brain to suggest intracranial mass, bleed, area of infarction or hydrocephalus.
finly
Thanks doctor for evry thing in advance30 nov.2011
Tests are very important but in context.
For example, if a patient has spinal stenosis and significant back pain only with standing that would be relieved with bending forward or sitting, I would order an epidural steroid injection to temporarily “numb” the spinal canal. Pain relief may lead me to consider a decompression.
If there was buttocks and leg pain as the symptom, a selective nerve root block would help to diagnose which nerve was causing the pain.
Back pain with standing and loading of the spine might require a discogram to determine if the disc is causing pain.
Finally, if there is pain with extension (bending backwards) as well as standing, consideration of facet blocks needs to be in the discussion.
A patient with isolated disc resorption at L5-S1 with Modec changes, endplate fractures and absolutely normal discs above with the appropriate history and physical examination might not need any diagnostic testing for a surgical discussion.
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.#5147 In reply to: Cervical Stenosis |I assume that your friend’s father had cervical stenosis and not lumbar stenosis. Both can make walking difficult but cervical stenosis can lead to myelopathy (see website for description of that disorder)- compression and dysfunction of the spinal cord.
When a radiologist uses the term “mild” or “mild to moderate”, compression is in the eye of the beholder. It is difficult to know how much compression is present as every radiologist has a different set of criteria for those terms.
It is important to know if there is at least some cerebral spinal fluid (CSF) around the cord at the level of constriction. CSF is the cushioning around the cord and the more the better.
Two problems to be concerned with in the case of cervical stenosis. One is myelopathy and the other is central cord syndrome (see website for description). Normally myelopathy is a slowly developing problem with warning signs associated and can be carefully watched for occurrence of those signs.
The problem with central cord syndrome is that it occurs immediately in the face of a specific blow to the head. The spinal canal changes in volume with flexion and extension. Flexion widens the canal and extension narrows it. A fall onto the face or forehead that forces the neck to bend backwards can pinch the cord causing this cord injury.
Central cord syndrome is more prevalent in an active population. Activities such as snow skiing or boarding, mountain biking, horseback riding and even wrestling can cause this injury in a person with cervical stenosis. I see about 10-20 central cord syndromes a year in the active population and about 1-2 in the non-active population. You can see that your risk drops substantially if you have cervical stenosis and drop at risk activities.
I agree that an epidural steroid does not fix any mechanical problems and your stenosis is a mechanical problem. If however, you have symptoms from the other problems in your neck (disc tear and bulge or nerve root irritation), the epidural should yield relief.
Will the stenosis become worse? I cannot answer that question. Most patients with stenosis from a disc bulge will have further degeneration in those discs and most likely, advancement of the bulge or spur. This could make the stenosis worse. I have also seen patients who get no worse after following them for 20 years.
Shoulder dysfunction can cause neck pain but the normal pattern is pain that starts in the shoulder and radiates to the neck. I have seen a handful of patients with unilateral neck pain that originated from the shoulder.
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.Let us assume that you have a degenerative L5-S1 segment and that all your other segments are normal. The L5-1 segment is now painful and a fusion will be beneficial.
More likely than not- your range of motion now is limited by pain at endpoints of motion (flexion and extension). In addition, this degenerative segment is also very limited in motion by the significant loss of disc height and wear of the facets.
What is surprising is that your motion may improve with a fusion of this segment. The loss of motion from fusion is normally minimal because of the preexisting limited motion of the degenerative segment. In addition, the reduction of pain with fusion may allow greater motion of the segments above than previously existed without the fusion.
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.#5121 In reply to: Herniated Disc |The MRI findings always need to be correlated with your symptoms. If you have no symptoms, the findings might not matter.
The MRI demonstrates a disc bulge or herniation at C5-6 which compresses the left spinal cord and the left C6 nerve root but there is not signal abnormality of the cord.
A C6 nerve compression on the left could cause left sided neck pain radiating into the arm down to the thumb. The pain would be worse with certain neck maneuvers such as looking up (extending the neck) or bending the head to the left side (lateral bending). Weakness could be noted in the biceps (lifting a heavy object) and the wrist extensor (weaker grip strength). Paresthesias might radiate down the left arm (pins and needles). You might also have neck pain as your primary complaint.
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.#5118Topic: Spondylolysis pain for 5 years! Should I be worried? in forum BACK PAIN |Hello,
I am a university student majoring in a fine arts dance program. Five years ago I was diagnosed with unilateral spondylolysis on the right sides of my L4 and L5 vertebrae. When I was first diagnosed I was put in a back brace for 3 months and was in physiotherapy for 4 months. I was told that the healing process would take a long time and, because my pain had greatly reduced over the course of the 4 months I was in physio treatment, I was released to do home exercises on my own. I did exactly that and waited for the day I would be back to normal but that day never came. I have had chronic back pain in the same place (localized around the L4-L5 and S1 region) for the past 5 years with extension and even flexion!
Now that I have started dancing about 16 hours a week in school, my back pain has only increased. I am in physiotherapy once again and an MRI has been ordered for me. I was just wondering how it could be that I have never been pain-free for all these years! I am only 22 and on some days it feels like I have the back of a 70 year old. I will not get my MRI for another couple months, but in the mean time, should I be worried about my condition?
I have not been doing any back extension bends for the past three weeks and it looks like I will not be allowed to do any jumps either since my pain has increased. I have to take it day by day. Some days the pain is at a 1, 1 being only slightly painful, and other days it is at a 7. It seems I do not even have to do anything to set the pain off! What should I do because if I cannot participate in my dance classes my grades will go down? :(
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