exercise453

Hello again,

I have had c2-8 rhizotomy. The total effect was minimal. I am 63 and athletic. I suffer from a combination of chronic symptoms and levels stemming from a jogging fall and trauma doing an incline bench press five yeas ago. My appearance belies my age, and functionality belies my pain. Further elaboration on the board would unfairly consume your precious time.

You say a positive emg at cervical paraspinals is not terribly significant and positive at the bicep involves c6. So I understand, if the bicep (or another muscle) shows the same +1 fib +1 psw as the paraspinal but has full strength, then the root compression affirmed
by emg is not significant? Muscle strength and function overrule emg at all muscles?

You say 70-30 more neck pain indicates disc or facet…its not facet. I have posterior disc & spurs (along with lateral) encroaching the canal but no cord compression. Does this mean the neck pain comes from the disc and/or spurs pressing nerves within the canal, not the disc material itself?

You have mentioned cervical epidurals several times. If they give effective relief for a couple of months in chronic pain management cases how many of these do you consider safe each year in the hands of a board certified anesthesioligist? Are they equally effective for arm pain and neck pain?

Thanks again doc

PS (those excellent one liners “the bone is probably intact in your head” in anatomy and motion of the cervical spine and “you can’t ask your mother to stand up straight” in a tv interview, did not escape me)

Hello again Doc,

I do not understand the loss of motion with single and double ACDF. So much is trumpeted about motion sparing techniques but you suggest that surgical skill, not choice of surgery is most important. Just what are the motion and other long term consequences of a successful fusion and do the levels matter?….vs posterior.

What is the importance of a positive, year old and a repeated (current) emg test showing +1 fib and +1 psw at at c4-5 paraspinal, a painful neck level. (posterior disc-osteophyte complex with mild narrowing of the spinal canal and moderate bi-lateral neurofaraminal stenosis). Only one side is symptomatic. The deltoid is smaller than the other side but the shoulder and rotator cuff have suffered earlier traumas. Muscles are strong. Cord is fine. There is more neck than arm pain 70-30. Also when an ACDF relieves the pressure on the canal will the neck pain reduce or vanish?

The nerve test also was positive at the bicep. Can this be verification of c5 or is c6 positive as well?

I notice that as the legion of “coren ites” grows our medial jargon improves. Your generosity aside, does it not speak to the state of our medical system or the rampant, earned distrust of their own doctors that has 1000’s turning to Dr C.

Thanks