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  • BRONCOFAN1
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    Post count: 42

    Hi Dr. Corenman,

    Also forgot to mention, I had another neurosurgeon consult…

    1’st Opinion: Thinks symptoms are due to 2 levels of disc lack of integrity/stability despite lack of compression, recommended either continuing PT / injections or 2 level Mobi-C replacement.

    2’nd Opinion: Believes there is an intermittent / dynamic nerve compression/irritation, recommends one more ESI followed by facet blocks. If unsuccessful, he recommended either 2 level ACDF or a partial laminectomy.

    Kevin

    BRONCOFAN1
    Participant
    Post count: 42

    Thanks Dr. Corenman,

    I appreciate all the help… this has been hard to figure out! My NCV was negative for Carpel Tunnel and showed no evidence of Brachial Plexopathy. Just had blood testing and no diabetes, and I have not had any tick bites leading up to these symptoms or other symptoms of Lyme.

    I’m kind of at a loss, essentially the symptoms are a gnawing pain at the back of my neck (relieved / prevented with muscle relaxants), burning pain at the base of the neck that will spread to either side, and shooting / burning pains in the arms. EMG shows evidence of subtle bilateral C6 radiculopathy and left C7 (triceps).

    I have read that some people get substantial pain from degenerative discs without nerve compression, potentially from the loss of disc integrity and resultant micro motion instability at that level.. could that cause inflammation that potentially impact the nerve root?

    Maybe I should ask my Dr. to order another MRI? Previous MRI was on 5/8 on a 0.6T machine – I know you are not a fan of those!

    Thanks again.. it is wonderful of you to give up your own personal time to help all of us on this forum!
    Kevin

    BRONCOFAN1
    Participant
    Post count: 42

    Hi Dr. Corenman,

    I took another look at my MRI, and it does state that at c5/c6 there is no neural foraminal stenosis despite the diffuse bulging disc… and c6/c7 mild left neural foramina stenosis related to uncovertebral hypertrophy along with the annular bulge. However, both the EMG and my symptoms seem to indicate a bilateral C6 nerve root irritation at a minimum. In your experience, does the irritation / compression sometimes happen dynamically in a way that a static MRI doesn’t capture?

    My experience has been strange all the way around… Spurling test is negative and I am not able to recreate the pain with any particular neck position.

    I will look into having the facet blocks done to see if that is the pain generator – wouldn’t it be unusual for the facet joint inflammation to cause radiculopathy though?

    Thanks!
    Kevin

    BRONCOFAN1
    Participant
    Post count: 42

    Dr. Corenman,

    A quick clarification, I have full range of neck motion without generating immediate pain. PT neck exercises and running both cause an increase in the burning pain from the side of the neck out toward the shoulders but this begins 30-60 minutes after the activity is completed.

    Thanks again!
    Kevin

    BRONCOFAN1
    Participant
    Post count: 42

    Hi Dr. Corenman,

    Thanks so much! On the MRI, the report did not indicate a nerve compression (I’ve seen that on some reports), but it makes sense that these bulges narrow the foramen and it certainly seems they are causing at least intermittent compression.

    I have not had facet blocks, but I have full range of motion in my neck without
    generating additional pain and only minor loss of disc height. The neck pain that I have is a gnawing pain at the back of the neck that is intermittent and relieved by muscle relaxants (I assume it is due to paraspinal spasms). I am 39 years old without a history of neck pain until now. Is it safe to assume that the facets are not the pain generator or would you suggest facet blocks to be sure?

    Thanks!
    Kevin

Viewing 5 posts - 37 through 41 (of 41 total)