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Old 08-26-2011, 05:24 PM   #1
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Prominent Degenerative Changes Involving the Cervical Spine?

First off... Hello folks.

Secondly: Could someone please explain the following findings for me, I study Cognitive Psyc., not Neurology.... and I found this board through a search of my "Findings" verbiage.

Thank you all in advance,
Damian

Below is the results of the exam conducted on 8/03/10, verbatim.

Exam: Cervical Spine Complete
CPT Code(s): 72052 - Radiologic Examination, Spine, Cervical; Complete, Including Oblique And Flexion And/Or Extension Studies

FINDINGS: There is reversal of the cervical lordosis. Prominent disc space narrowing is seen at C4-5, C5-6, and C6-7 with prominent spurring and foraminal encroachment. No Fracture is visualized. No evidence of osteolytic or osteoblastic changes.

There is facet joint degenerative arthropathy.

IMPRESSION:
1. Prominent degenerative changes involving the cervical spine.



Again, I do thank you for explanations... my symptoms make it hard to complete my work, to be a functional father of 8 & 10 yr old girls and a 15 yr old son, and a pickle jar opener for my long-time girlfriend/fiance.
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Old 08-26-2011, 06:32 PM   #2
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Re: Prominent Degenerative Changes Involving the Cervical Spine?

Let's take it sentence by sentence.

"Reversal of the cervical "lordodsis". Normally, your neck curves inward at the neck...the lumbar spine goes inward then it bends outward in the main area of the back and then inward again at the neck. This normal inward curve is known as Lordosis. As we age, the neck tends to straighten and we lose the normal curve. But injury and arthritis can cause it to happen as well and you have lost the normal curve so your neck is basically straight. Painful.

"Prominent disc space narrowing is seen at C4-5, C5-6 and C6-7 with prominent spurring and foraminal encroachment". As we age, the discs tend to dry out and shrink in size and in x-rays this appears as thinner discs and a lot of space between the vertebrae. Hence the term disc space narrowing...the discs aren't filling the area between the vertebrae. "Spurring" refers to bone spurs that osteoarthritis makes. In an attempt to fix the deteriorating joint, the bone makes more bone in the wrong areas and you end up with pointy bone spurs building all over the place. You get them all over the bone and even on the disc."Foraminal encroachment" refers to the small hole in the bone where the spinal nerves exit the vertebra and go out to the body. The hole is called the foramina and when the bone spurs are pushing up against it, they are "encroaching" and that can cause a ton of pain if they are hitting the nerve. So bottom line here is that when they look at the areas between the vertebrae, they see a dried out shrunken disc and lots of bone spurs, some of them surrounding the holes where the nerves come through.

"No Fracture"....pretty self explanatory.

"No osteolytic or osteoblastic changes seen"...that means no sign of bone cancer or bone tumors.

Your next step should be an MRI to see if you have the same problem inside the vertebrae that they see outside of the vertebrae...only an MRI will show you what you need to know. And that is if the nerves are being compressed from the inside as well and if the bone spurs are compressing your spinal cord as well and how badly.

Sadly, I welcome you to the bad neck club.

Jenny(fused C3 to T1)

 
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Old 08-26-2011, 06:47 PM   #3
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Re: Prominent Degenerative Changes Involving the Cervical Spine?

DSQ - I'm more concerned about that reversal of cervical lordosis. Just how reversed is it? The normal backward bend of the cervical spine (Jenny calls it "inward") seems to be turning into a forward bend. You're too young for that to occur. You don't want to end up with "kyphosis" - a forward bend - or you'll be looking down at your feet for the rest of your life. Your write-up didn't have the words kyphosis/kyphotic in it, so maybe I'm overly concerned. You can certainly get someone you know to look at you from the side and give you an evaluation.

If you are becoming kyphotic, you want to fight that, starting today.

Jenny explains the disk degeneration and foraminal encroachment well. One actually contributes to the other, not just by increasing wear causing bone spurring, but because degenerating disks cause you to lose the normal amount of separation between vertebrae, which in turn vertically collapses everything else in the spine near that level.

What are your symptoms? I would guess problems in the arms/hands, and maybe pain in the neck? One side or both?

If you had significant symptoms at the the time of the X-Ray (if that's what the "radiologic exam" was), then why didn't your doctor send you for an MRI? I think maybe you need a new doctor. Problems caused by radiculopathy (compressed nerve roots in the foramina) or cord compression may be amenable to treatment for a while, but become less so over time. Fourteen months is too long to wait.

Last edited by WebDozer; 08-26-2011 at 06:49 PM.

 
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