Mri radiologist eval vs Neurosurgeons evaluation

[emvici]

I was in a 50 mph tractor trailer accident,   After going to the hospital ect.. I tried to return to work, and work through the pain, that I hoped would go away.  After a few days I could no deal with the pain and after having an Mri done on my cervical and Lumbar.   I was consulted with a Neurosurgen that told me, that there was nothing wrong with my Cervical spine and that it was completely normal.    Here is the report of the cervical Mri  of the supposed important part of the Mri.
c5-6 level with degenerative changes including desiccation and loss of disc height.  There is a moderate sized annular disc protrusion causing deformity upon the thecal sac.  Disc protrusion extends into the neural foramina region with mass effect upon the exiting c6 nerve roots bilaterally.
c6-7 level with moderately sized left central disc protrusion causing deformity upon the thecal sac.  Disc protrusion with moderate with moderate narrowing of the left neural foramina.  Mild narrowing of teh right neural foramina at this level.
Impression:
Degenerative changes with disc protrusions c5-6 and c6-7 levels.
Question how can a neurosurgen that I met for the first consultation say that my cervical spine is normal, when the Mri says this??
Also the Neurosurgen says the report speaks of degenerative changes and doesnt seem to be something that would be accident related.  what should I be thinking ?  is it possible that a Radiologist can see something so differently from a Neurosurgen how can this be so ?
thanks in advance.  Eric

[fusedup]

I have had 3 separate discectomies with fusion - the first for extreme pain, the second for spinal cord compression at the level below the firs surgery, the third for another bulge below the first two levels.  Trust me, you don't want surgery until you absolutely have to have it!  I am now facing another surgery due to the narrowing of the spinal canal and some bone spurs at the levels I previously had surgery on.  Surgery may relieve intial problems, but it brings on a whole bunch more.
I agree you need to go for a second and even third opinion on your MRI - but if I were you, I would go through any other means possible to get pain relief before jumping into a surgery.  If it does come down to surgery, you may want to check out the minamally invasive micro surgeries that have been developed.  If it were available prior to my first surgery that is how I would have gone, and I'm checking on it now for my current issues.  They can just remove the parts that are bothering you and NOT do the fusion which in the long run creates so many more problems.  Good luck.

[zaking]

Is there any new technique surgery for the thoracic site ?

[emvici]

thanks for the help any addtional ideas or opinions are greatly appreciated.

[Jack54]

Your attorney is not a doctor and is wrong about the second opinion. My goodness, due to the fact that you have an attorney is a good enough reason for a second opinion. You are obviously seeking reimbursement for damages.

Had your PCP told you that he would not give you anymore pain medication?

You have all of the proof you need spelled out very well in the interpretation/findings of the Mri.

This neuro guy is a chukklehead that knows you are going for money, and is not sympathetic at all with this type of patient. Some doctors are like this, and they will not write down the words a judge needs to read, which will determine whether you win or not. Remember that they pay super high malpractice insurance premiums, because attorneys go after them for medical malpractice.

99.9% of whether you win or lose is based upon what your doctor says. Judges are not doctors, so they will rely on your doctor, and maybe an insurance companies doctor, if you let one examine you, to determine the outcome of the case.

Good luck and please do not live in pain,

Jack

[emvici]

As the consulation with the Neurosurgen went on,  his opinion of everything seemed to sway around.   As he said this Mri speaks only of degenerative changes,  and I said to him, cant these degenerative changes be a result of an accident.  He says "degenerative" means something that has been taking place over years of time.  I asked him at this point to re-read the Mri report, and as he was reading it, his opinion seemed to sway now, towards that I do have an injury, but seemed to still have a very minimal opinion that it was anything that was significant. I also told the Neurosurgen, that the radiologist secretary personally called me after the Mri, saying to me quote " Mr. ***** I want to tell you first we never call patients after an Mri, we simply pass the Mri report to your primary care Phyician and they go over it with you,  however the Radiologist requested that I call you before hand and warn you to be very careful of how you move your neck. I thanked her.  After telling this story to the Neurosurgen he said really,  and dictated some conservative PT.   I really could not seem to get a very good grasp of what his opinion was.  At the end of the consulation he goes to me,  MR. *****  if you get any numbness or tingling in your arms let me know.  I said well already have numbness in my left arm with some pain and slight tingling.   He goes well you didnt say that to me earlier.  I thought to myself, "well you placed me into a defensive posture from the start and we really didnt spend much time talking about symptoms, rather whether I even had an injury at all."  he requested that I return in 6 weeks for a follow up with him.  My primary care Phyician put my on oxycotin 15mg time release after recieving the Mri report.  I told the Neurosurgen this, and that I felt perhaps he was not getting a true impression of me, since I was on this medication.  He smiled as though it were a possiblity or maybe not a possibility, and continued walking me out to the secetary to reschedule.  My attorney warned me that if I looked for a second Doctors opinion that I could appear as though I was "Doctor Shopping" .  I know that I am in severe pain and I think PT as a treatment is to conservative,  My attorney said that is what all the Doctors are doing first.  Do you agreed with PT as an initial treatment?  I was hoping for surgery, so that I could get off this medicine and rid myself of the pain:)
Thank you for your first response,  you helped take away some of the depressed feelings I am dealing with.

[DrNoopurMD]

Hi,

How are you?
Your MRI is definitely not normal as it shows degenerative changes at C5-C6 with disc protrusion which is compressing the C6 nerve roots on both sides.
Do you have tingling numbness or pain in the arms? What symptoms do you have?
There is another disc protrusion at C6-C7 level and degenerative changes.
These degenerative changes in the spinal cord can be due to injury following the accident.
Please seek a second opinion on this.