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You apparently had an ACDF at C4-5 after your severe accident 11 years ago. Most likely, you also had some milder, non-surgical injuries to some other neck structures. Over the years with normal wear and tear, these levels might now be problematic.
Neck pain can originate from many structures including the disc, nerve and facet. Arm numbness and pain generally can originate from compression of the nerves in the neck or compression of the nerves in the shoulder or arm.
Inner arm pain with numbness into the 4th and 5th fingers is normally the domain of the C8 nerve (occasionally C7), thoracic outlet syndrome or cubital tunnel syndrome. If you feel the pain radiating from the neck, normally compression of the C8 nerve in the neck is the culprit.
Your MRI notes C3-4 “annular disc bulging and posterior ligamentous hypertrophy resulting in mild canal stenosis and mass effect to cord with bilateral moderate neural foramina narrowing”. This could cause some pain radiating only into the tops of the shoulders and chest wall.
“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” can cause pain to radiate into the shoulders and down the arm to the thumb side of the hand.
“C6-7: right paracentral disc protrusion resulting in right neural foramina narrowing. posterior ligament and hypertrophy” can cause the symptoms you are experiencing. “Mild bone marrow edema is present at superior endplate of c7” could also indicate one of the causes of neck pain.
“There is a cord signal abnormality at c7 level consistent with degeneration” is a confusing reading. Cord signal change could indicate a cord injury or the beginnings of myelopathy (see website for description). Cord signal change is not consistent with “degeneration”. Also, the radiologist notes canal stenosis (narrowing) “multilevel degenerative disc disease as described above worst at c3-c4 and c5-c6 with canal stenosis and mass effect on the cord” but he indicates that the signal abnormality is at C7 when the worst narrowing is at C3-4 and C5-6. This must be a misdictation on his part.
To summarize, it seems that your compressed nerve at C7 could be causing your arm pain. The cord compression is not clear as to the level involved or the symptoms generated. If we ignore the cord compression and signal change in the cord for now, a selective nerve root block (SNRB) of the right C7 nerve should give you excellent temporary relief of your arm pain (see pain diary on website) which will diagnose and possibly treat this pain.
If you have cord signal change at a level that compresses the cord, you need to think strongly about having surgery at this level. A consult with a spine surgeon is important at this point.
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: Spondylytis #7192Spondylitis is an inflammation of the spine, normally associated with a disease process like Ankylosing Spondylitis. You most likely mean spondylosis which is a degeneration of the spine similar to arthritis (which really should be called arthrosis).
I cannot comment on traction for this disorder as there is not enough information to comment on. Some degenerative disorders respond well to traction and in some, traction is contraindicated.
The medication “Vertin” is sold as an antivertigo drug and I cannot comment of its use for your father.
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. #7190Excellent. A fusion of this level would be the recommended procedure for a third disc herniation.
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: 4-level ACDF #7188Thanks for the comments. The level of service you experienced is what should be expected when you visit a physician or hospital.
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: Accident or Just Born with Damaged L5 Discs #7187Almost all individuals were born with “normal” discs. Degenerative changes occur with life experience and aging. Genetics does however play a significant role in the degenerative experience. Genetics cause the collagen fibers of the disc (in the annulus- see website) to have different tensile strengths in my opinion.
The more brittle the collagen, the greater propensity to tear. I have ten year olds in my practice with degenerative changes of the discs. I also have eighty year olds who have worked at hard labor with relatively normal discs.
You are talking about injury at work and causation. In many states, the workman’s compensation laws hold that an injury on the job or an aggravation of a preexisting condition caused by the occupation will be held to be compensable through workman’s compensation insurance.
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.Please describe why you had surgery and what your initial symptoms were. Also, please describe the disorder that surgery was intended for and what the procedure was.
Removal of the neural arch can have many connotations. Did you have a spondylolisthesis and the surgery was removal of the arch? Was there instability present? Was only a small portion of the arch removed as in a microdiscectomy?
How has the surgery affected you? Were you unable to walk prior to surgery and still cannot walk or is the lack of walking ability new since the surgery? How has your life been affected since 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. -
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