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Neurology (Expert Forum)
Options for cervical spondylosis and other cervical problems
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Options for cervical spondylosis and other cervical problems
by Bonz, Jan 25, 2000 12:00AM
My MRI results came back. I have a prominent osteophyte formation which is producing severe encroachment on the left neural foramen, with mild central stenosis and compression of the cervical spinal cord. Also, at C5-C6 there is osteophyte formation with small disc herniation to the right of midline, and also the mild central stenosis and compression of the cervical spinal cord. At C3-C4 and C4-C5, there is a 1-2 mm. central disc protrusion. Could this be explained to me in layman's English?
What sent me to the doctor was severe pain in the left arm, with frequent numbing. I was almost totally incapacitated for two weeks, even with good pain meds. At the worse times, the arm felt like it was on fire. This week, it's eased off some, I can get about again, although I still need pain meds. I have some numbness still, though not to the degree of last week. There is significant improvement, but it's not gone by any means.
My rheumatologist sent me to an orthopedic specialist for his opinion. Right away, he wanted to do surgery. Isn't that a little drastic for this? I was surprised, I had thought he'd say "physical therapy, etc." first, and if it didn't work, then surgery. It seems like a serious surgery, and I don't want it, unless absolutely necessary. But on the other hand, I don't want to put off something necessary if it is necessary. Will this ease up, or will it get worse? Thanks for any help, I'm scrambling around trying to educate myself on this.
What sent me to the doctor was severe pain in the left arm, with frequent numbing. I was almost totally incapacitated for two weeks, even with good pain meds. At the worse times, the arm felt like it was on fire. This week, it's eased off some, I can get about again, although I still need pain meds. I have some numbness still, though not to the degree of last week. There is significant improvement, but it's not gone by any means.
My rheumatologist sent me to an orthopedic specialist for his opinion. Right away, he wanted to do surgery. Isn't that a little drastic for this? I was surprised, I had thought he'd say "physical therapy, etc." first, and if it didn't work, then surgery. It seems like a serious surgery, and I don't want it, unless absolutely necessary. But on the other hand, I don't want to put off something necessary if it is necessary. Will this ease up, or will it get worse? Thanks for any help, I'm scrambling around trying to educate myself on this.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Jan 25, 2000 12:00AM
Dear Bonz:
The segment of spinal cord in your neck has some boney changes. Encroachment of the foramen, what level? means that where the nerves exit the cord there is compromise (either inflammation or boney encroachment), usually this can cause sensory changes. The herniation just means that the discs are protruding from their usual location, out of the spinal canal. Several discs protrude enough to push on the spinal nerves running down the cord, but just alittle.
Surgery is the last resort, considered when PT, rehab fail. The results are still mixed. Some indications for surgery is severe cord compromise, severe pain, muscle atrophy, reduced nerve conductions down the nerve, and other EMG changes. I would seek a second opinion from a neurologist/neurosurgeon. Take all your films and tests and see what someone else indicates.
Sincerely,
CCF Neuro MD
The segment of spinal cord in your neck has some boney changes. Encroachment of the foramen, what level? means that where the nerves exit the cord there is compromise (either inflammation or boney encroachment), usually this can cause sensory changes. The herniation just means that the discs are protruding from their usual location, out of the spinal canal. Several discs protrude enough to push on the spinal nerves running down the cord, but just alittle.
Surgery is the last resort, considered when PT, rehab fail. The results are still mixed. Some indications for surgery is severe cord compromise, severe pain, muscle atrophy, reduced nerve conductions down the nerve, and other EMG changes. I would seek a second opinion from a neurologist/neurosurgeon. Take all your films and tests and see what someone else indicates.
Sincerely,
CCF Neuro MD
Can you explain what this is in my terms
What did your doctor tell you what these were? When there is irritation of the vertebrae there is ossification of the bone and boney protrusion can form from the vertebrae-osteophytes. When small, they usually do not cause any pain or cord damage. Small bulging of the discs (the smooth cartilage the allows movement of the vertebrae) usually is just a happenstance finding and does not usually cause pain. When the spinal cord is pushed against it compromises the cord. When major it can cause pain and loss of muscle strengh and numbness. Mild loss of lordosis can be the result of degeneration, either of the discs or the vertebrae themselves. Headache would be very, very unusualy coming from the lower cervical cord as these nerves go to the arms and the longer tracts to the legs. Neck pain is a possibility.
Ellen, you need to talk to your doctor. He/she needs to tell you what he/she thinks because they are the ones seeing the films and have done the physical exam. If you don't understand then you need to ask.
Sincerely,
CCF Neuro MD
I don't think I really can give you a percentage, but what you were quoted seems about right. The more levels that you immobilze, the greater change of having a swan neck. I hope that things work out well. At 57 you have just begun middle age, so you have a long way to go.
Sincerely,
CCF Neuro MD