New member intro - cervical

[rfane]

Hi everybody. My name is Roger, and I'm glad to have found this site. I'm here to learn more about my spine, and treatment options. Background on me is that I was involved in a fairly severe auto accident in June, which was caused by other drivers. I began seeing a chiropractor right away to help with some of the pain in my neck, back, and shoulder. It helps in the short term, but isn't curing anything. Have had neck pain that goes down my left arm, both hands are numb, and have had severe pain in left shoulder. Also have some lower back pain.

A cervicle MRI was done at the end of August.

Impressions:
1. At the C6-C7 intervertebral disc level, a right foraminal disc extrusion is noted with mild-to-moderate central stenosis and moderate right articular recess stenosis. There is severe right neuroforaminal stenosis. Correlation with the C7 dermatome is recommended.
2. At the C3-C4 level, a 3mm central disc protrusion is noted without evidence of stenosis.

Articulations:
C3-C4: Low signal intensity is noted. A 3 mm central disc protrusion is noted with left unconvertebral osteophytic activity and mild left neuroforaminal stenosis.
C4-C5: Low signal intensity is noted. A 1.5 mm posterior disc bulge is noted with a bilateral unconvertebral osteophytic change and mild osseous neuroforaminal stenosis bilaterally.
C6-C7: Low signal intensity is noted. Mild decreased disc spacing is noted. A right foraminal disc extrusion measuring 4 mm in the A to P dimension is noted. There is 5 mm of cephalic and caudal migration of disc material noted. Effacement of the central spinal cord and right articular recess is noted. Severe right neuroforaminal stenosis is noted.
C7-T1: Low signal intensity is noted. There is no evidence of intervertebral disc herniation or stenosis. Severe facet arthrosis bilaterally is noted.

Began to see an orthopaedic surgeon a week and a half ago, who wants to attempt other treatments on my neck for the next 2 months. He estimates a 40-50% chance of needing surgery on C6-C7.

The pain in the shoulder was very extreme, and motion of my shoulder was limited. I could barely lift my arm to have x-rays done on the spine, and it hurt very bad when the ortho was moving my shoulder during the exam. X-rays showed no shoulder fracture or seperation, but some arthritis in the shoulder. Ortho stated that the AC joint was sprained. The evening after the exam, majority of the pain disappeared in the shoulder, and mobility returned, so I think there was some soft tissue caught in the joint that dislodged with his manipulations. Certain movements pinch something, which hurts like hell, but it's a lot better than it was.

I see the Ortho again in 2 days.

I think it's kind of strange that the MRI shows severe nerve stenosis on the right, but the majority of my pain is on the left. My right hand is more numb than the left, but there is no pain in right shoulder and arm.

I have been unemployed for quite a while, and have no medical insurance. I have an attorney who is working with the other parties insurance to cover my medical care.

[Cindylou]

Welcome Roger, glad you found us.....I'm sorry to hear about your auto accident. It sounds like it was a pretty bad one. Amazing your shoulder is doing so much better. I guess that's the good news here. We usually recommend getting several opinions from other docs on your condition; some folks get 3 and 4 and 5 opinions. But he helps to see if some of the docs line up on the same page for your treatment options. Prepare yourself that you'll get a number who all think something different should be done, but eventually you should see a pattern for treatment. You didn't mention how old you were. I always think that is good to factor into the equation. What type of surgery is this ortho doc recommending? I didn't see you mention it. (or it could just be that it's 6 in the morning, and I need that second cup of coffee....hehe) In any event, welcome again. And hope we can help you sort things out. Cindylou

[ajj1001]

Welcome to the forum Roger.

alison x

[rfane]

Cindylou,

I'm 48 for a few more weeks. Ortho just mentioned Disctectomy, but didn't elaborate. I will definitely be pushing to get additional opinions, and have no problem continuing conservative treatments if there is hope that some of the issues will resolve, as this ortho thinks. I would have more hope of that if it was sooner following the accident, rather than 3 months after. The pain and numbness is increasing, rather than decreasing. I would rather not have surgery, but if it's needed, I don't see the point in putting it off only to have more damage done to nerves, etc.

After reading some of the posts here, I feel I'm lucky to just have what I do. It seems pretty minor compared to what a lot of you have gone through, or are going through. I'm taking Aleve primarily for pain, and ice helps when things are inflamed. I was given Loratabs, but prefer not to have to take them.

[rfane]

Hi all,

I had a follow up visit with the Ortho doc today. He did the full exam on me again, and basically said that I am presenting well. Good strength, reflexes, etc. He is pretty convinced that with regular use of anti-inflammatories that I will improve. Said I can have the steroid shots if I need it, but he believes that overdoing it on those will cause increased likelihood of degeneration in the future. Revised his opinion to 20-30% chance of needing surgery within a year, but stated that both C3-C4 and C6-C7 might need to be done, based on my pain and numbness issues.

I do have new symptoms though, which are numb lips, left jaw, and my chin got numb for a while yesterday. He will be referring me to both a Neurologist and a Neurosurgeon for more opinions and testing.

The shoulder pain that has improved is due to Arthritis in the AC joint. Said that it's pretty common for arthritis to flare up badly with the trauma that my shoulder would have experienced from the seat belt. Xrays and exam support this, and after doing further research, I concur that is what it is. I will be treating that on my own for now. Exercises and regular use of the anti-inflammatories will help that as well.

I left his office feeling a lot better, and scheduled to go back in 6 weeks for the next exam. Then I got a call from him late this evening. He was working on dictating my report, and in further study of my MRI is concerned that I have some spinal cord edema at C6-C7, that was not reported by the Radiologist. He is going to have them relook at my MRI tomorrow, and will be getting some other opinions as well. Said that it appears to be slight, and that they will likely just monitor me more closely, but is concerned. Probably will need to go have a high quality MRI shortly to look at it further.

[ajj1001]

sounds like he is being thorough. hope it proves to be nothing and a conservative plan works for you.

[KBear]

rfane- It sounds like you are doing everything right. I wish I had become educated about my condition early on. Instead I just blindly trusted the doctors for almost 3 years. You are really early into your injury and still have a great shot at recovery without surgery. I believe it is 90% of people will heal without surgery.

[rfane]

I spoke to the Ortho doc again this evening. He is sending me in for a new MRI next week, which will be a higher quality one. Said he saw signs (Hoffman's) yesterday that I might have some myelopathy. Signs were not noticed on first exam two weeks ago. Sending me to a Neurosurgeon next week following the MRI.

Will keep you posted.

[Justin]

I spoke to the Ortho doc again this evening. He is sending me in for a new MRI next week, which will be a higher quality one. Said he saw signs (Hoffman's) yesterday that I might have some myelopathy. Signs were not noticed on first exam two weeks ago. Sending me to a Neurosurgeon next week following the MRI.

Will keep you posted.

Thanks for the update, Roger. I do hope your next MRI is able to help guide your care. It sounds like you have a great surgeon in your corner.

[Gilbert P]

Roger

You have found a great support family.

Sounds like you have found a good doc and doing all the test.

All The Best

Gil