Aa
Cervical Spine MRI: pain/numbess/surgery
This is going to be a little long and I am sorry. I guess I am hoping that someone will either tell me I am completely over-reacting or if I have good cause to be scared. FYI: I did have a ACDF on C5-6 on 3/29/10. Due to some symptoms still being there and some of the old ones coming back along with constant headaches and neck pain.
MRI Findings only (long):
Exam reveals signal loss of the cervical discs on T2 sequences. At the C2-3, the disc is slightly diminished in height, with no focal herniation, central or foraminal narrowing. The C3-4 level reveals a small central disc protrusion causing some indentation upon the subarachnoid compartment and contact upon the ventral margin of the cervical cord., although no significant mass effect upon the cord or exiting nerve roots.
At C5-6 (already fused) an extrduded left paracentral herniated nucleus pulposus is present. This results in moderate compression of the cervical cord to the left of the midline. There is also resultant left C5-6 foraminal narrowing with potential to encroach upon the exiting left C6 nerve. At C6-7, rightward bulge results in some effacement of the ventral subarachnoid compartment without significant mass effect upon the cord or exiting nerve root. Evaluation of the cord raises question of some vague area of increased intramedullary signal on T2 sagittal sequence at C5-6. The findings are probably related to the compression from the adjacent disc herniation. No definitive mass or other abnormality is noted. The marrow signal is unremarkable. Visualized paraspinal soft tissues are unremarkable.
As I said, my doctor did the ACDF on C5-6 but advised that there would probably have to be surgery at a later date. From what I have research the protruding disc can herniated and/or rupture if pushed to their limits. Wouldn't it be smarted to take care of them before it happens. Also, no other tests were ran prior to surgery and just had an EMG done that now shows something abnormal with my muscles and nerves that are connected to C6-7 and C7-8.
I feel like I am going to have a nervous breakdown. I just don't know what to do.
MRI Findings only (long):
Exam reveals signal loss of the cervical discs on T2 sequences. At the C2-3, the disc is slightly diminished in height, with no focal herniation, central or foraminal narrowing. The C3-4 level reveals a small central disc protrusion causing some indentation upon the subarachnoid compartment and contact upon the ventral margin of the cervical cord., although no significant mass effect upon the cord or exiting nerve roots.
At C5-6 (already fused) an extrduded left paracentral herniated nucleus pulposus is present. This results in moderate compression of the cervical cord to the left of the midline. There is also resultant left C5-6 foraminal narrowing with potential to encroach upon the exiting left C6 nerve. At C6-7, rightward bulge results in some effacement of the ventral subarachnoid compartment without significant mass effect upon the cord or exiting nerve root. Evaluation of the cord raises question of some vague area of increased intramedullary signal on T2 sagittal sequence at C5-6. The findings are probably related to the compression from the adjacent disc herniation. No definitive mass or other abnormality is noted. The marrow signal is unremarkable. Visualized paraspinal soft tissues are unremarkable.
As I said, my doctor did the ACDF on C5-6 but advised that there would probably have to be surgery at a later date. From what I have research the protruding disc can herniated and/or rupture if pushed to their limits. Wouldn't it be smarted to take care of them before it happens. Also, no other tests were ran prior to surgery and just had an EMG done that now shows something abnormal with my muscles and nerves that are connected to C6-7 and C7-8.
I feel like I am going to have a nervous breakdown. I just don't know what to do.
They don't really like to do levels that are just bulging and really not having any impact, having said that, yes it is very likely that a bulge above and below your fusion could herniate, but its not a given. The more levels that they do, the more the chance of something going wrong and the less chance of a successful outcome.
I had a fusion back in 2005, I had 2 good size herniations and 1 small one, my surgeon told me only 1 needed to be operated on. 5-6 months after surgery when my recovery basically stalled I went and saw a couple other surgeons, and both of them said I should have at least had one more level done. So in my case, yes do as much as you can at one time so the patient doesn't have to go through it all over again like I do in 2 months. Your MRI doesn't indicate problems at other levels, if you think something's wrong you need to have another MRI, things can change rapidly.
Sorry about your pain, my fingers are still numb after 5 years, sometimes the feeling won't come back and a lot of times these surgeries will not eliminate all your pain. Like I said, if you think something is seriously wrong insist on a MRI.
Take Care
I had a fusion back in 2005, I had 2 good size herniations and 1 small one, my surgeon told me only 1 needed to be operated on. 5-6 months after surgery when my recovery basically stalled I went and saw a couple other surgeons, and both of them said I should have at least had one more level done. So in my case, yes do as much as you can at one time so the patient doesn't have to go through it all over again like I do in 2 months. Your MRI doesn't indicate problems at other levels, if you think something's wrong you need to have another MRI, things can change rapidly.
Sorry about your pain, my fingers are still numb after 5 years, sometimes the feeling won't come back and a lot of times these surgeries will not eliminate all your pain. Like I said, if you think something is seriously wrong insist on a MRI.
Take Care
Kalvin,
Yes this was my pre-operative MRI and no I didn't get a post operative one. They keep doing just x-rays. Before surgery my symptoms were tingly/numb hands (including fingers) and arms, pain and muscle spasms in the upper arms and shoulders, neck pain, and right before surgery my legs started having spots of numbness and balance problems. After surgery, constant neck and head ache, sometimes it's worse than other times. My left hand and 2 fingers are still numb with muscle spasms in my upper arms. Loss of strength in my left arm. I had an EMG done and I have issues with my muscles and nerves. And now 6 months later, I feel as if I am going back to the beginning. My shoulders and arms are starting to hurt again.
Plain and simple...surgery helped to ensure things didn't get worse (paralyzed) but I think if more was done with the other discs I wouldn't be going 2 steps back.
Yes this was my pre-operative MRI and no I didn't get a post operative one. They keep doing just x-rays. Before surgery my symptoms were tingly/numb hands (including fingers) and arms, pain and muscle spasms in the upper arms and shoulders, neck pain, and right before surgery my legs started having spots of numbness and balance problems. After surgery, constant neck and head ache, sometimes it's worse than other times. My left hand and 2 fingers are still numb with muscle spasms in my upper arms. Loss of strength in my left arm. I had an EMG done and I have issues with my muscles and nerves. And now 6 months later, I feel as if I am going back to the beginning. My shoulders and arms are starting to hurt again.
Plain and simple...surgery helped to ensure things didn't get worse (paralyzed) but I think if more was done with the other discs I wouldn't be going 2 steps back.
Have an Answer?
You are reading content posted in the Orthopedics Community
Find out if PRP therapy right for you.
Tips for preventing one of the most common types of knee injury.
Tips and moves to ease backaches
How to bounce back fast from an ankle sprain - and stay pain free.
Patellofemoral pain and what to do about it.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
