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Old 01-17-2007, 08:09 PM   #1
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MRI results from neck and shoulder....freaked out !!!

Hey guys, I am kinda well.......really concerned about this mri. Here goes....will try to keep it short.

Shoulder...
1. Tendinosis or partial tear in the deltoid tendon insertion in the acromion.
2. Tendinosis or partial tear in the conjoined supraspinatus/infraspinatus tendon.
3. Acromioclavicular Arthritis.

Have no idea what all that means....but NS said to see an ortho...nows heres the real kicker...he also said my cervical spine was fine.
I picked up the report to take to the ortho and the report from my neck was with it....now you guys be honest......does this sound "fine" to you????
mind you...this is the same disc that I had ACDF on in june 06.

At C4-C5, there is anteroposterior narrowing of the neural canal, effacement and deformity of the thecal sac and spinal cord by spondylosis with bilateral neural foraminal narrowing. There is a prominent posterior central osteophyte.

At C5-C6, there is a similar pattern of anteroposterior narrowing of the neural canal, effacement and deformity of the anterior margin of the thecal sac and spinal cord by spondylosis, with bilateral neural foraminal narrowing. There is a prominent posterior central osteophyte.

1. Moderate cervical stenosis at the c4c5 and c5c6 levels as described above.
2. Status post anterior surgical fusion at the levels mentioned above.

Ok.....what should I do? I am having left shoulder pain, probably from the rotator cuff....but the neck pain, occipital headaches, burning pain in both arms and shoulders...and down the center of my cervical and some of the thoracic spine areas, muscle twitches and some irregular numbness.... arms, legs and feet. I'm just not sure that all this is "fine".....any ideas or suggestions would be greatly appreciated. Thanks, Robin

 
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Old 01-18-2007, 07:31 AM   #2
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Re: MRI results from neck and shoulder....freaked out !!!

I cannot believe either that your doc stated your c spine was 'fine'.i would honestly consider seeing a different primary.geez,thats pretty in depth to say everything is just ducky there ya know?what else does this doc think is actually 'fine" with you that you have never been informed of????my primary would not have stated fine,when looking at that c spine report.

you really do need to see an ortho about the shoulder but you should also seek out a neurosurgeon for an eval on that c spine.i just personally wouldn't trust anyoone other than a good neurosurgeon to do anything on my c spine.it is alot different from the rest of the spine mostly because of the very high innervation this specific area has and the fact that you have some cranials coming down from the head and brain that you just dont have further down.i personally have one of the best orthos in our area who has done extensive work on my knee,and i would let him do something with anywhere from the T spine on down,but anything in my c spine,as much as i really love this guy,that would be strictly neuro for me.

your biggest issue right now is that you don't actually know just where your pain and other symptoms are really stemming from since the areas you mentioned can also be symptoms from your c spine issues alone.i do think,really,that your best bet here would be to actually at least consult with a good neurosurgeon FIRST,and then see what he or she has to say,THEN move onto the ortho.you just need to find out what the neuro thinks about your symptoms first.if this were me,this really would be what i would do first.but this is entirely up to you.you just need a really good eval with that NS first.they will want to also see your films so they can make there own determinations.any rad report is only as good as the rad who is reading it.the final word should come from a very real neurosurgeon who actually sees things that an uniformed non experienced rad just cannot interpret.

i wish you lots of luck with this.i would really seek out a good NS before actually having anything done with that shoulder.tho you DO indeed have some level of shoulder damage,you just need to identify what symptoms are actually stemming from what issue first before actually "doing' anything else.please keep me posted on what you find out.Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 01-18-2007, 12:17 PM   #3
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Re: MRI results from neck and shoulder....freaked out !!!

Quote:
Originally Posted by feelbad View Post
I cannot believe either that your doc stated your c spine was 'fine'.i would honestly consider seeing a different primary.geez,thats pretty in depth to say everything is just ducky there ya know?what else does this doc think is actually 'fine" with you that you have never been informed of????my primary would not have stated fine,when looking at that c spine report.

you really do need to see an ortho about the shoulder but you should also seek out a neurosurgeon for an eval on that c spine.i just personally wouldn't trust anyoone other than a good neurosurgeon to do anything on my c spine.it is alot different from the rest of the spine mostly because of the very high innervation this specific area has and the fact that you have some cranials coming down from the head and brain that you just dont have further down.i personally have one of the best orthos in our area who has done extensive work on my knee,and i would let him do something with anywhere from the T spine on down,but anything in my c spine,as much as i really love this guy,that would be strictly neuro for me.

your biggest issue right now is that you don't actually know just where your pain and other symptoms are really stemming from since the areas you mentioned can also be symptoms from your c spine issues alone.i do think,really,that your best bet here would be to actually at least consult with a good neurosurgeon FIRST,and then see what he or she has to say,THEN move onto the ortho.you just need to find out what the neuro thinks about your symptoms first.if this were me,this really would be what i would do first.but this is entirely up to you.you just need a really good eval with that NS first.they will want to also see your films so they can make there own determinations.any rad report is only as good as the rad who is reading it.the final word should come from a very real neurosurgeon who actually sees things that an uniformed non experienced rad just cannot interpret.

i wish you lots of luck with this.i would really seek out a good NS before actually having anything done with that shoulder.tho you DO indeed have some level of shoulder damage,you just need to identify what symptoms are actually stemming from what issue first before actually "doing' anything else.please keep me posted on what you find out.Marcia
Hi Marcia and thanks for responding....
Unfornunatly, the doc that said my neck was fine...was a neurosurgeon...the very same one that did the ACDF back in june...on the very same area of my c-spine! I just wonder if he actually read the report, or just went off what he thought he saw on the films....I took the films to him immediatly after having the mri...the report came to him later on....so I would have expected at least a phone call to say that just maybe things weren't "fine"...but, I havent' heard another word from him. I admit, my c-spine was in much worse shape than before the ACDF, but from what I'm seeing on this lastest mri, it's far from okay! Especially with the symptoms. I am actually more symptomatic than before the surgery! oh well, maybe i should seek out another opinion from another NS? Again, thanks sooooo much for your response....I just needed to hear from someone that it didn't look fine to them either...lol. Thanks, Robin

 
Old 01-18-2007, 07:37 PM   #4
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Re: MRI results from neck and shoulder....freaked out !!!

While some changes in the spine are normal as we age the findings you relayed seem like they are beyond "normal degeneration due to aging". I would seek out an opinion from a Neurosurgeon or Orthopedic Spine Surgeon (I consulted with both but used an OSS for my fusion).
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Old 01-18-2007, 09:39 PM   #5
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Re: MRI results from neck and shoulder....freaked out !!!

Quote:
Originally Posted by kross426 View Post
While some changes in the spine are normal as we age the findings you relayed seem like they are beyond "normal degeneration due to aging". I would seek out an opinion from a Neurosurgeon or Orthopedic Spine Surgeon (I consulted with both but used an OSS for my fusion).
Hi Kross and thanks for the reply and advise. I was wondering.....If the NS, fused the c4-5 and c5-6 with hardware, and removed large bone spurs and cleaned out the foraminal stenosis......what at this point could be causing more spinal cord compression and how in the heck did "prominent osteophytes" form so soon after the ACDF? Any ideas? And BTW, I was 44 at the time of the surgery. I have arthritis in virtually every joint, am awaiting news from insurance on a partial knee replacement for a large osteochondral tear in the trochlear groove, and as mentioned in the post before, have 2 possible tears in my rotator cuff as well as diabetes, hypothyroidism, osteoprosis in the severe range ( no fractures) and have already had menical shaving and a partial synovectomy of the same knee twice. It seems to me that all of these problems should lead to some kind of sydrome. I have tested negative for RA and lupus.....I dunno, I just sometimes have too many pity parties....but I suppose I'm entitled to those occasionally! Thanks for allowing me to vent! Robin

 
Old 01-19-2007, 04:49 AM   #6
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Re: MRI results from neck and shoulder....freaked out !!!

the BIG thing here is that you currently have actual spinal cord compression.thats not a good thing to have for alot of reasons,some of which are just plain common sense,but others can cause a host of really nasty symptoms and actually result in permanent damage to your cord,the surrounding nerves and most importantly,the actual spinal tracts themselves

i unfortuently suffered damage at three spinal tracts within my cord when my NS had to open up my cord,go in and dig out a glob of blood vessels that were intermittantly oozing blood.i never knew that spinal tracts actually existed in your cord until my damage was actually done and over.these tracts govern just about every body system function by carrying signals to and from the brain.when there is something impeding those signals,well,all hell can break loose within certain areas of your body.the ride never stops for me.every day is somehow a bit different than the day before neuro wise.this DOES need attention,much sooner than any shoulder or knee issue.you most definitely need a second opinion,definitely,i wouldn't even see this idiot doc anymore at all.any neurosurgeon who could look at actual spinal cord compression and say evrything is 'fine",well i would be out that door in a heartbeat,honestly.thats just appalling to me.i actually sought out three seperate opinions from three totally unrelated NSs before i would actually let anyone even go near my spinal cord with a scalpel.you just HAVE TO fully inform yourself as to what you are realistically looking at here and the best possible treatment options.at some point,that compression will just have to be relieved somehow since it will only get worse with time,not better.then you will be facing some pretty big decisions along with possible deeping neuro damage and pain.

getting that second and even possibly a third if needed(i had to do this to get that 'tie breaker' opinion since both others were extremely opposite of each other)is very very crucial for your particular situation right now.you just need to know the risks and what you are really looking at and you will never ever get that from this current NS.just having that compression going on really puts you at a bit higher risk for further damage to the actual cord,even if you were to be involved in a fairly minor fender bender type of low speed accident at some pint.the thing is right now,your spinal cord is very vulnerable and not as well protected as it wuld be without that compression going on,you know what i mean?you just cannot afford to take any chances here.this just needs a full eval with a good,brand new,neutral NS.

you really have to see just an actual neurosurgeon for this type if an issue.i personally wouldn't trust an ortho at all for this area.unless you can find an actual spinal specialist,an NS would definitely be your best option.if this was just deterioration or even just a herniation that was not actually touching your cord,it wouldn't be quite as vital,but in your particular situation,this is really what you need here.but you DO need to leave your current,'alledged" NS in the dust right now and move on.

i hope this helped some and didn't actually confuse you even more(i have that affect sometimes).i wish you lots of luck with this and hope you can find a good experienced NS soon.if you happen to live near a university teahing type of hospital,this is where i would look into first.i ended up seeing the head of neurosurgery at the U of MN for my thrid opinion and was extremely happy that i did since he really was the only one out of the three who really understood cavernomas and all of my inherent risks.he was the one who did my surgery.you just need knowledge and most important,experience when dealing with spinal cord issues.most teaching hospitals have alot of experience in certain areas since these types of hospitals just seem to really draw the "worst of the worst' types of neuro conditons.they arejust usually many peoples last resort or last hope.this wa also the case with me.please let us know how things are going,K?Marcia
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3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 01-19-2007, 09:55 AM   #7
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Re: MRI results from neck and shoulder....freaked out !!!

As stated, a second look by a NS may be a big help.

The discs are a different issue from the cervical arthritis (spondylosis & osteophytes). The report doesn't indicate the significance of the posterior osteophytes, which are not addressed during an ACDF procedure.

You may want to obtain a copy of the O.R. report. What it indicates (or doesn't indicate) may shed some light on your current situation. For example, my report stated that at one level "decompression was achieved." It didn't state the same for the other level.

I don't even know if it's possible for a NS to remove anterior osteophytes that are not growing off the actual discs. I would think that other bone growths would be largely left intact, unless they were present in the foraminal canals.

The purpose of the fusion, in part, is to arrest the progression of the process causing the anterior osteophyte growths. If your neck is no longer moving in such a manner as to reallocate stress and cause the bone growths, I believe the current anterior osteophytes may even dissipate on their own over time, although it may be a very long time.

I hope you get some good answers from an NS soon.
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Last edited by ThoreauFan; 01-19-2007 at 09:56 AM.

 
Old 01-19-2007, 10:23 AM   #8
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Re: MRI results from neck and shoulder....freaked out !!!

Hi , couple things.

First, I am a person that had a fast degeration of another level after a 2-level acdf on C4-6. I had minor osteophytes on C7 and they thought it might go bad eventually, but predicted like 5-10 years. Not the 9 months that it did. It went so bad quickly that 9 months after my first surgery I had such bad pain and issues that I had another ACDF adding C6-7 to the fusion and replacement of a new plate within 12 months of surgery 1.

It can happen. What I learned is the doctors like to think their "work is perfect". Mine told me when I first went back. "well your fusion is textbook" it looks perfect, etc. I felt on that first visit he wanted to make sure I didn't think it was his work. I don't blame him, so many people are SUE happy that I am sure they are always wondering. Well after I asked him to sit down and talk, we really got to the point of my symptoms etc, and he realized that yes, I was really going bad. We got the new MRI and yes, it confirmed. SO, there was something he said. You don't treat the MRI you treat the person. However in your case, your MRI does show some problems and you are having symptoms. Either go back and make this doc listen or find another that will.

P.S. - I still have problems after surgery number 2. I have come to accept that my spine is degenerating and I may improve a little, but surgeries are not going to fix the inevitble - my spine is older than me (48) but it feels like an 80 year old spine. I have central canal congential stenosis from short pedicles and ostephytes that keep growing.

Hang in there.

 
Old 01-19-2007, 09:30 PM   #9
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Re: MRI results from neck and shoulder....freaked out !!!

.i just personally wouldn't trust anyoone other than a good neurosurgeon to do anything on my c spine.it is alot different from the rest of the spine mostly because of the very high innervation this specific area has and the fact that you have some cranials coming down from the head and brain that you just dont have further down.i personally have one of the best orthos in our area who has done extensive work on my knee,and i would let him do something with anywhere from the T spine on down,but anything in my c spine,as much as i really love this guy,that would be strictly neuro for me.>>

Like it has been said in another post, orthopedic surgeons that are Spinal Specialist are just as well qualified to assess someones cervical spine just as a neurosurgeon is. If both are Spine Specialists.

I wouldn't chose a Orthopedic surgeon that just operates on knees for a spinal problem nor would I choose a Neurosurgeon that just does brain surgeries. Neither is qualified to work on the cervical spine or any part of the spine.
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Old 01-19-2007, 09:44 PM   #10
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Re: MRI results from neck and shoulder....freaked out !!!

I have tested negative for RA >>

Robin,

FYI, you can test negative for RA and still have the disease. You might want to see a Rheumatologist if you think you might have lupus or RA. They don't base their diagnoses on just a blood test.

Even though I did test positive, my PCP at the time said I didn't have RA. I was in severe pain (hands). I could see the changes happening in my hands and couldn't stand the pain any more and I insisted on a referral to an RA doc after about 6 months. The RA doc did say I had RA and started treatment right away.
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Old 01-20-2007, 12:37 PM   #11
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Re: MRI results from neck and shoulder....freaked out !!!

Hey folks,
I talked to my NS, he says that Radiologist tend to "over-read" these MRI's and that my cspine is in much better shape than before the ACDF. He told me to do the PT for my shoulder and come back to see him in 2 weeks and he would show me the pre and post op mri's side by side. The spinal cord compressions or deformities could possibly be from long standing cspine compressions before diagnosis and treatment.....so, I suppose in a way, that makes a little sense.....but as I type this reply, my left arm is killing me....so I will post more as it comes.... Thanks for being here, Robin

 
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