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Old 05-02-2011, 03:12 PM   #1
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neck, shoulder blade area and right arm pain

I have degenerative disc disease and have had 2 cervical fushions(2 metal plates and 8 screws) at C5-6 and C7-T1. Last surgery was 4 yrs ago. 3 months ago the severe neck, shoulder blade area and down my right pain came back. I have a different doctor now and she sent me for a cervical myelogram and CT. I got the results today but do not see the Dr til Thurs.
I am a little concerned with what what I am reading.
At C4-5 there is dengenerative disc disease with a small anterior osteophytic spur. There is mild facet joint arthropathy. A small central protrusion slightly indents the anterior aspect of the thecal sac without significant spinal canal stenosis. There is no significant foraminal narrowing.
At C5-6 there has been prior anterior discectomy and fusion. There is good osseous fusion across the C5-6 disc space. No spinal canal stenosis. Nor foraminal narrowing.
At C6-7 there is degenerative disc disease with moderate disc space narrowing. There is an anterior osteophytic spur. There is a central disc protrusion measuring 4 x 10 mm. The protrusion effaces the anterior aspect of the thecal sac and abuts the anterior aspect of the cord. There is mild flattening of the anterior aspect of the cord. There is mild spinal canal stenosis with the spinal canal measuring 8 mm in AP diameter. Uncovertebral osteophytes result in foraminal narrowing bilaterally.

Impression:

1. There has been prior anterior discectomy and fusion at C5-6 and C7-T1. There is good osseous fusion across teh disc spaces at these level.
2. Central protrusion at C6-7 results in mild spinal canal stenosis. The protrusion abuts and flattens the anterior aspect of the cord. There is mild bilateral foraminal narrowing at this level.

I am in constant pain. I cant turn my head to the right. I have pain shooting from my neck down into my right shoulder blade area and down my right arm. My right arm and hand doesnt want to work all the time. Can someone put this into English that I can understand. Thanks.

 
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Old 05-02-2011, 04:12 PM   #2
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Re: neck, shoulder blade area and right arm pain

Hi Alinta, I'm Jenny and I do interpreting of spine MRIs for a lot of people. I've also had 2 cervical surgeries and am fused from C3 to T1. Since you've had 2 surgeries already, I'll get to the basics.

Your fusions are fine. But you have trouble in between them. My understanding from my doc is that once you fuse, it puts lots of pressure on the vertebrae above and below and makes you more likely to develop problems. Since you have 2 already, you would eventually end up with them being combined....did they bother to tell you that?

At C6-7, you have bone spurs form arthritis on a tiny joint on the outside of the vertebrae(uncovertebral joints) and those bone spurs have closed up the hole in the bone where the spinal nerves go out to the body. They rate the amount of closing with the words minimal, mild, moderate and severe.....they rated yours mild. But your symptoms sound more like moderate.

And the disk there had ruptured and is pressing on the spinal cord but only slightly. Your spinal canal is closed up to 8mms when normal is 10-11mms. I was down to 6mms. at 4 levels when I had my surgery so the cord can take a lot.

Cord compression doesn't cause pain but it can cause all sorts of numbness and muscles that don't work from that level down so it could affect your hands and even your legs and feet. The mild "foraminal" narrowing on those spinal nerves, will cause lots of pain into your arms.

Most docs won't operate until you reach "severe" levels but since you already have the 2 fusions, they might decide to just get it over with and fuse you from C5 to T1. You might want to consider having it done from the back(what I have). More painful after surgery but more stable in the long run. And they wouldn't have to remove the hardware in the front.

All I have is 2 rods and 10 screws in my 6 vertebrae fusion and it's not that bad. Minimal pain. But my doc watches it carefully as I am at great risk for problems above it and below it. So far just some small changes below it. But, I am developing more bone spurs inside the fusion and they are hitting the nerves at C4 and hitting my cord. How they fix that I have no idea and will wait and see if they have to.

Once a bad neck, always a bad neck!

Hope this helps. I'm here if you have questions.

hugs.............Jenny

 
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alinta1970 (05-02-2011)
Old 05-02-2011, 05:41 PM   #3
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Re: neck, shoulder blade area and right arm pain

Thank you. I have also had a double lumbar fusion ending with 2 rods and 6 screws just this past summer. My 2 neck surgeries were 2 yrs apart almost to the day. One thing I didnt mention cause it was found on the MRI in March is that I have straightening of the cervical lordosis as well. I am only 40 yrs old and my body feels like its 80.

 
Old 05-02-2011, 05:57 PM   #4
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Re: neck, shoulder blade area and right arm pain

I hear you. I had a reversal of lordosis due to dislocating 5 vertebrae and breaking 3 of them. And that was after having a bunch of them operated on. Won't happen again! All titanium now.

BTW, we all lose the lordotic curve in our necks as we age...you're just beating everyone. Sorry you are so young with all these problems.

hugs............Jenny

 
Old 05-02-2011, 07:44 PM   #5
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Re: neck, shoulder blade area and right arm pain

Bad thing on my part is that mine wasnt caused by an accident or injury. I woke up at 3 in the morning screaming in pain and couldnt move my right arm at all. By the time they got me into surgery for the first herniated disc in my neck the disc itself had broken apart and embedded itself in my nerves and muscles. So I told this to my new doctor that handled my back and her response was "well that didnt happen with me did it?" I completely feel like she is dismissing it as not that bad and go to pain management. I am hoping with this new test and results that she will see without a doubt that it needs to be fixed. I am thinking of getting a second opinion if she doesnt want to fix this cause I cant live like this any longer. This is affecting my everyday life. My back isnt doing much better, there is a protruding disc in my lower back that is causing issues also but my neck has jumped into the MUST BE taken care of now.
I want to thank you for explaining a little more to me. I just want to be as informed as I can before I go see my surgeon.

 
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