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in reply to: MRI scans and signal #7247
I am unclear as to what has an increased signal. Is it the spinal cord? Cord signal changes are worrisome as this may indicate some prior injury to the cord and potential future injury.
Long tract signs (signs of cord irritation) are hyperreflexia, Hoffman’s sign (see website for description), clonus, balance and incoordination signs (Rhomberg’s, adiadochokenesis, imbalance with quick direction changes, triangle test).
Read the radiologist’s report of the MRI findings. You might find some valuable information there. You might also get another consultation for more information.
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.in reply to: SI Joint: Update and Question #7246Joints are typically filled with synovial fluid and are distensible. This means that no matter what the position of the joint, there is always synovial fluid that fills the entire joint. When the joint (or disc space for that matter) wears out, there will be certain positions that increase the joint space that the synovial fluid cannot fill. This will create a vacuum and something has to fill that vacuum.
What fills the vacuum is nitrogen gas. This gas is pulled out of solution similarly to opening up a can of soda and watching the gas bubbles form out of the liquid.
Good luck with the surgery. Please report your progress to allow forum members to see your progress.
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.The approach side for the neck does not matter regarding which side the pathology is on regarding the spine itself. There are general factors that decide which approach side the surgeon prefers.
One is the anatomy of the neck. There is a very small nerve called the recurrent laryngeal nerve. This nerve supplies the vocal cords and there is one on each side of the neck. On the left side, the nerve consistently does not cross the surgical field. On the right side, the nerve crosses the surgical approach dissection about 5% of the time.
Interestingly enough, spine surgeons choose the left sided approach almost all the time and neurosurgeons choose the right sided approach most of the time. You can almost be sure that a spine surgeon performed the surgery by the left sided scar on the neck.
Previous surgeries in the neck require some prior preparation. Scar can make the dissection more difficult. If there has been a significant prior neck surgery or prior radiation treatment (for cancer), I will have my Ear Nose Throat (ENT) colleague assist me with the surgical approach. Ask your surgeon if this is something he would consider. The ENT surgeon typically has experience with these type of revision neck surgeries and should be able to safely dissect out the scar and gain access to the anterior neck.
Posterior decompression and fusion can be effective but is typically less effective than an anterior surgery and takes much longer to heal.
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.in reply to: L5-S1 DISC HERNIATION, TWO BACK SURGERIES. #7238Please keep in touch so forum members can obtain a better understanding of your progress with surgery.
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.in reply to: previous C4-5 discectomy with fusion. #7235Sorry about the delay. I responded to you but the return post must have become lost in the ether.
After a near fatal MVA and the need for a one level ACDF, there were probably other non-surgical neck injuries that after some years start to become more degenerative.
“Mild bone marrow edema is present at superior endplate of c7. there is a cord signal abnormality at c7 level consistent with degeneration”. Bone marrow edema is typically associated with significant degenerative disc disease and is commonly a neck pain generator. Cord signal change is typically an injury to the cord from compression. Why the radiologist called it “consistent with degeneration” does not make sense to me.
The cord does not typically “degenerate”. Normally, stenosis or narrowing of the canal causes cord compression and signal change but the radiologist notes the worse canal narrowing is at C3-4 and C5-6; “canal stenosis and mass effect on the cord”. The MRI report does not make much sense to me. Maybe the radiologist misdictated the levels.
Your arm pain could be generated by compression of the right C6 or C7 nerves; “c5-6: annular disc bulging posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate to severe neural foramina narrowing.
c6-7: right paracentral disc protrusion resulting in right neural foramina narrowing. posterior ligament and hypertrophy”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.in reply to: 40year old with 80 year old back #7234Nerve blocks can be valuable to reduce symptoms until a surgical procedure can be performed. I do not think that RF (radio-frequency ablations of the facet nerves) would be valuable.
By the way, I have two PAs, both named Eric (one spells his name Ehrich).
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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