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Old 02-28-2011, 05:25 AM   #1
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diagnosis of cervical spondyolsis

MRI results can you tell me what this means. Her cervical cord shows degenerative disease worse at the C5/6 level but also present at C4/5 and C6/7. At the C5/6 level this indents the anterior aspect of the cord there is some cord flattening but not frank compression. At the C5/6 level there is marked right hand side foraminal narrowing. this is only mild on the left hand side.Given that there is no frank cord compression and that there are no symptoms corresponding to the marker C5/6 foraminal narrowing no surgical intervention is indicated at this time.

 
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Old 03-04-2011, 12:10 PM   #2
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Re: diagnosis of cervical spondyolsis

Sorry I didn't see this when you posted. I was in the hospital, sick. But I'm back and can help you understand this.

Degenerative disease means there is arthritis in the bones of the spine. In fact, spondylosis is a fancy word for just that...arthritis of the spine. The type of arthritis is usually osteoarthritis unless they say it's something else.

So they see arthritis at C4, 5, 6 and 7 and the areas in between. There is no mention of herniated disks so I am assuming that she has bone spurs(osteophytes) growing on the bones causing the compression. That is what osteoarthritis does, makes new bone where it shouldn't.

At each vertebra, you have the spinal cord going down through the middle and a pair of spinal nerves that peels off(like a banana peel) and exits the bone by small holes called foramina. If any bone spurs are pressing on the nerves either inside the bone or outside, they rate the amount of compression with the words minimal, mild, moderate or severe. They list the amount of compression as mild on the right hand side at C6 and "marked" on the left. I am assuming from the other comments, that this means somewhere between moderate and severe(term not used here in the US).

The other problem is that these same bone spurs are touching the spinal cord to the point of just indenting it and slightly flattening it. That happens a lot and the cord can take a lot of "indenting". Mine was indented to the point of being only half as thick as normal. Actually it went from being oval to flat as a pancake as it was being crushed from 2 sides.

These conditions will need to be watched as they don't get better and will slowly get worse. But you now know where she is with this and can be watched by the doctors until it gets bad enough to require surgery.

Be glad to answer any questions you have.

Jenny

 
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Old 03-07-2011, 10:10 PM   #3
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Re: diagnosis of cervical spondyolsis

This result sounds absolutely normal for mature person. Presumably some symptoms are being presented. Examination should be done to find out ranges of movement, muscle power and any changes in reflexes plus any changes in sensation. Posture and work habits should be evaluated. Remember it is what one finds on evaluation not from exray or MRI or other scans. So regain movement, correct your computer screen height etc and begin a compound exercise routine.
Slainte
PS As you get older and the exrays worsen the symptoms invairiably lessen.

Last edited by james079; 03-07-2011 at 10:12 PM. Reason: Added PS

 
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Old 03-21-2011, 06:30 PM   #4
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Re: diagnosis of cervical spondyolsis

Gee James, I guess you've never had cervical spondylosis because you haven't a clue. It is a major problem for older people and can cause paralysis and a lot of car accidents from slowly loosing feeling in ones feet so you can't tell if you foot is on the accelerator/brake or how hard. Hope you never meet a elderly person with cervical spondylosis that hasn't been diagnosed or treated because if they are driving, you might be killed. And I'm not exaggerating.

I have it....I know.

 
Old 03-21-2011, 10:06 PM   #5
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Re: diagnosis of cervical spondyolsis

Quote:
Originally Posted by jennybyc View Post
Gee James, I guess you've never had cervical spondylosis because you haven't a clue. It is a major problem for older people and can cause paralysis and a lot of car accidents from slowly loosing feeling in ones feet so you can't tell if you foot is on the accelerator/brake or how hard. Hope you never meet a elderly person with cervical spondylosis that hasn't been diagnosed or treated because if they are driving, you might be killed. And I'm not exaggerating.

I have it....I know.
Well jennybyc, you could be wrong on both points, I am almost sure I am older than most on this blog and my cervical spondylosis on xray is as bad as I have ever seen. On the other hand I have full neck ranges, strong muscles and no pain. As far as a major problem for older folks statistics show that cervical symptoms receede with age not worsen. Cervical problems are at their zenith in th late 30s and 40s. Cervical spodylosis is not even a diagnosis. It describes the disc spaces and joints and their relationships. The diagnosis might be say C7 root palsy or chord compression at C5/6.
Perhaps you are exagerating when you tell us about the potential of a car accident from losing sensation in their feet, many more serious signs and symptoms would be presented long before numbness in feet was complained of and by this time driving would be long out of the question.
Most foot numbness in the elderly is caused by such as dietary deficiency, low B12 and B1 and too much alcohol.
James

 
Old 03-22-2011, 03:08 PM   #6
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Re: diagnosis of cervical spondyolsis

I had cervical spondylosis with myelopathy. It was diagnosed by a top spine neurosurgeon some 5 years ago. I had no pain, no ROM problems, and could haul a 50 lb bag of corn for my deer when I needed to or a 50lb bag of flour for making bread. I had no idea until I was shoveling snow one day and I felt my entire body go numb from the neck down for a split second.

I told my doc who ordered an MRI and I had 4 levels of cord compression down to 6mms, 3 herniated disks, and bi-lateral foraminal stenosis in the severe range from C3 to C7. There was more but that was the highlights.

And my major symptom was numbness in my toes and feet thought to be from my type 2 diabetes. WRONG.

I searched out the best spine surgeon I could find and had a C3 to C7 laminoplasty. Woke up being able to feel my toes and feet again. And my trouble with my sometimes staggering gait went away. And my clumsiness that resulted in many dropped dishes stopped.

Cervical spondlylosis is used my many docs to just denote cervical OA but it is a particular diagnosis for a syndrome where there is often no symptoms other than some numbness along with changes in gait and ability to do things with the hands in older individuals. Statistically, it affects about 3% of the population of people with spine problems. It is extremely insidious. That is why it is so serious. Most docs, like you, blame other problems for the symptoms until it is too late. I had been complaining for several years about the numb toes. And the falls and dropped items....I was always told it was from "something else".

Had I waited much longer, I'd be dead as my cord would have been compromised above the level where breathing is controlled. I know how bad is was by the way my surgeon reacted. He normally has a 6 month+ wait for an initial appointment and another 6 month+ waiting list for surgery. I was in his office in 3 weeks and in surgery in 4 weeks. I was at the top of his cancellation list for surgery over many others. He didn't tell me that until after surgery as he didn't want me to worry but he called it "very close". Not an emergency but very urgent. Too close for me.

So check your references. Your standard Merck Manual will have cervical spondylosis in it as a syndrome of the elderly. Every home medical book designed for older folks has it. That was how I found it...the John's Hopkins Book of Health for People over 50.

I know you post your age as 77 and I'm a youngster of only 59 but I do know what is wrong with me when I have to undergo major spine surgery. I do my research. And I even had my surgeon checked out by a malpractice attorney to make sure he was as good as I had read(he was better). And he said it was cervical spondylosis with myelopathy.

Jen

 
Old 03-22-2011, 03:51 PM   #7
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Re: diagnosis of cervical spondyolsis

That was interesting that you checked out your surgeon as well as you did. Very few people do this. I had an interesting conversation with a woman who is a medical professional about her abdominal surgery. She related that she had consulted two docs and one was not that forthcoming, it was take it or leave it. She had it done by other and the operation went well. I asked why did you choose him and she relayed that he was very confident,charming and went over what he would do very clearly. I asked how many patients had died on the table from either and if either had been charged or reprimanded.
She told me that the one she had was too nice!! I think she got the picture. Another good way is if you know anyone in the operating theatre staff, they sure know who the good guys are. Keep well
James


James

 
Old 03-22-2011, 07:26 PM   #8
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Re: diagnosis of cervical spondyolsis

My neurosurgeon was not only forthcoming with the stats on spine surgery success(30% on relieving pain and 70% of relieving numbness) but his own personal stats on post-op infections(really low for his patient base). That was nice as I usually have to ask for that number.

The ortho who replaced my knees was the one who told me to ask about post-op infection rates with any surgery that involved bone as the trouble in getting rid of the infection is so bad. Mind you, at the time his post-op infection rate was 0%.

But I have always asked. I know what will kill me and good looks and nice attitude kills no one. But it can certainly disguise bad technique. The hospital I currently use for ortho and spine procedures has a post-op infection rate for all kinds of joint replacements of .24%. They do over 5000 a year so that is impressive.

I do my homework.

Jen

 
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