Bea491959

Dr. Corenman,

I got the results from the latest MRI for Cervical and Thoracic

Cervical:

C 2/3 – Disc desiccation, no herniation or spinal stenosis

C3/4 – There is disc desiccation, disc narrowing, posterior disc bulging and bony ridging slightly more prominent to the left of midline. There is effacement of the anterior subarachnoid space w/o cord deformity.

C 4 thru C 7, fusion

C 6/7 – Minor right and left lateral disc bulging and ridging is present (THIS IS NEW SINCE 2014 MRI)

C 7/ T 1 – Disc desiccation, no disc herniation or stenosis

Thoracic:
Findings:

There is disc desiccation and disc narrowing seen from T 1/2 through T 9 /10.

There is mild posterior disc bulging without cord impingement or stenosis from T 2/3 through T 7/8.

There is a small left paracentral disc herniation at T 8/9 without cord impingement or stenosis.

I went for my follow-up appointment with pain management doctor last Friday, and all he wants to do is increase my pain pills, add Valium, and offer me more shots. He wants me to think about BOTOX injections (set of 31 shots all the same day).

I am tired of being a human pin cushion and I do not want to be doped up all the time.

Can you please offer me advice on what to do, how to proceed?? Should I see another doctor for a 2nd opinion?? If so, do you know of any out here in central NY??

Thank you,

Bea

I just called my doctor to find out what levels he did the Radio-frequency injections on. He performed injections on C3/C4 and 3rd occipital nerve. I am not sure which one, but if i had to guess, it was the greater one because the headaches do sometimes go into the eye and have NEVER gone into the ear.

The SYMPTOMS PRIOR TO SURGERY were – severe headaches, pain between shoulder blade, going down right arm, numbness and tingling down right arm, right hand was always cold and pain in the thoracic region.

THE REASON FOR 3 LEVEL FUSION – Results of MRI PRIOR to being seen by neurosuregeon.

There is degenerative desiccation in the discs of the cervical spine, most prominent at C3 through C7. Disc space narrowingin noted at multiple levels wiith posterior changes at C3 through C7. Mild posterior changes are present on the right at T4 though T5. There is straightening of normal cervial lordosis.

At C3-C4, there is broad posterior convexity of the disc, likely due to degenerative changes and protrusion. There is encroachment on the thecal sac, flattening of the anterior spinal cord and narrowing of the AP diameter of the canal to 11 mm a the midline, Stenosisi is borderline. There is mild encroachment on neural foramina due to uncovertebral arthrosis and disc disease

At C4-C5, there is posterior convexity of the disc traversin the midlinen and on the left ssecodary to degenerative changes and likely old spondylitic protrusion. There is encroachment on the thecal sac, mild deformity of the spinal cord and narrowing of the AP diameter of the canal to 10.5 mm at the midline. Stenosis is borderline. There is encroachment on the neural forminea bilaterally due to unconvertebral and disc disease.

At C5-C6, there is broad posterior spondylitic protrusion at and to the right of midline encroaching on the thecal sac and deforming the mid and right anterolaterial spinal cord. The AP diameter of the canal measures 9.6 and stenosis is mild. There is encroachment on the right neural foramen secondary to uncovertebral athrosis and spondylitic disc protrusion. There is mild encroachment on the left neural foramen due to uncoverterbral arthrosis.

At C6-C7, there are posterior spondylitic changes due to degeneration with eccentric prominence to the right of midline causing encroachment on the thecal sac and flattening of the aterior spinal cord. The AP diameter of th canal measures 12 mm at the midline. There is uncovertebral arthrosis encroaching on neural foramina, left greater than right.

AFTER ACDF SURGERY – all symptoms in the right arm and hand went away. Still had headaches and pain between shoulder blades and in the thoracic region.

Yes, I had seen the surgeon for all of the follow-up appointments. Xrays were done with flexion/extension views? Everything looked good.

On the day of my last follow-up appointment, I seen the surgeon’s assistant – I had one of the severe headaches and I was given an injection into the back of my skull (lower right side), I think it was the occipital nerve. I was told to follow up with my pain management doctor from this day forward – which I have been seeing on a continuous basis.

When I had the diagnostic injections by my pain management doctor – I was told to go home and do things that would normally aggravate and increase the pain level. I vacuumed and mopped the floors, I carried groceries up 3 flighths of stairs to my apartment, I carried laundry up and down 3 flights of stairs, I dusted the furniture, I stood at the stove and cooked dinner, and I stood at the sink washing dishes. I DID NOT HAVE ANY INCREASED PAIN until after 3.5 to 4 hours when the numbness from the injections went away.

NOTE: Just doing ONE of these chores would always increase my pain, if I tried to do all of the chores listed above in any one day, my pain level would be a 10+, I would have to take pain meds or muscle relaxer and call pain management and get in for injections (which only provided short term relief).

You aske me to descirbe Symptoms above the fusion level (upper neck), below the fusion level (lower neck) and arm symptoms.

Symptoms above the fusion level–upper neck–constant headache, (varies in degree of pain), up to middle of skull, sometimes goes into the right side of the skull

Symptoms below the fusion level–lower neck–constant pain, left, middle and right side of neck, right side is normally the worst. Pain is achy, and burning. Feels like I have a weight on my neck (meaning my head feels like it weighs too much for my neck to support it. I just want to rip my head off to aliviate the pain in my neck.

Symptoms in Thoracic region, constant burning sensation, pain also in between shoulder blades – aching and burning sensation.

I have constant pain from my mid skull down to my thoracic region. I use ice pack intermittenantly to numb the spine. Only provides temporary relief. I can also sometimes get temporary relief in the thoracic area by laying across backwards on a large exercise ball.