Hi.......this is my first post....I see a NS in a week and I am looking for a better understanding of my CT scan so I ask the right questions.
There is a whole page of information from c2 - T2 arthrosis, I am guessing the bottom line is Impessions:
Severe canal stenosis c5-c6
Moderate canal stenosis c6-c7 with central disc herniation
Severe bilateral nueral forminal narrowing c5-c6 and c6-c7; moderate right sided nueral forminal narrowing c6-c7.
In the body of the report it mentions c5-c6 severe disc narrowing...broad based posterior disc ostephyte complex impressing on the spinal cord
and c6-c7 says the same with a central disc protrution extending posterior 0.4 cm impressing on the spinal cord.
Can any one explain this in laymans terms?
c3-c4 & c4 c5 both say
Severe left and mild right sided facet athrosis is seen with severe left nural forminal narrowing
C5-c6 Severe disc space narrowing is seen with broad based posterior disc osteophyte complex which impresses upon the spinal cord. there is moderate to severe canal stenosisand severe bilateral nueral forminal narrowing.
c6-c7 severe disc space narrowing is seen with mild broad based posterior disc osteophyte complex. there appears to be a broad based central disc protrution extending posterior 0.4 cm impressing upon the spinal cord. Severe left and moderate right sided nueral forminal narrowing is present.
Symtoms....Bad neck pain...head feels very heavy, the pain goes into my shoulders and down my arms...worse on the left....burning between shoulder blades and my left hand goes numb and right hand gets very cold and head aches....legs get heavy and sore but that could be an old L1-L2 compression fracture.
I see the NS next tuesday....the symtoms are getting worse and my doc says they will not get any better........leaving me to believe the only option is surgery?
When you have a disk/osteophyte complex, the vertebrae on either side of the disk are growing bone spurs where they interface with the disk. The disk itself may have been pushed backward, too. The disk and the osteophytes are intruding into the spinal canal, creating a narrowing (stenosis) and even going so far as to press on the cord.
The report doesn't mention it, but the severe canal narrowing may be because your canal is too narrow to start out with (congenital canal stenosis). If this is the case, then anything intruding into the canal has a greater and more immediate effect.
At each level, a nerve leaves the spinal cord to the left and the right. (e.g. the C4 nerve leaves from the C3-4 level). As the nerve leaves the cord, it passes through a bony hole called the foramen. A disk/osteophyte complex, or osteophytes growing off the facet joints, can narrow the foraminal opening (stenosis) and impinge upon the nerve. If your stenosis is rated "severe" by the radiologist, then this is probably happening.
Your surgical alternatives could be:
- Have a bi-level ACDF - at C5-6 and C6-7 - where the surgeon comes in from in front, removes the disk (and, I suppose, the osteophytes also), replaces it with a donor bone, and clamps the whole thing together. This is the traditional cervical spinal operation.
- I think this ACDF would most likely have to be followed by "foraminotomies", where the surgeon comes in diagonally from behind and shaves the osteophytes off the facets. This would remove the impingements on the peripheral nerves where they head off into your neck, shoulder and arms. Looks like you might need this all the way from C3 to C7. You have a LOT of osteophytes.
- An alternative might be surgery called a "laminoplasty". If you actually are suffering from congenital canal stenosis, then you can gain a lot more space in your spinal canal by swinging open the lamina (bones on the back of the spine) and putting donor bone and titanium plates to hold them open. This might be a more global solution. It would not fix the disk/osteophytes, but would allow the spinal cord to move backward, away from them. Foraminotomies could be done in the same operation to relieve the foraminal stenosis.
Laminoplasties are not yet common in North America, although they have been done for decades in Japan. They require an experienced and skillful surgeon to deal with the muscles behind the spine. And, of course, you have to be a candidate.
Please keep in mind that this is all from an interested but semi-informed amateur, and only intended to put you in a better position to talk intelligently with the surgeon.
And you REALLY should get at least two opinions.
Let us know what the NS says, please (and on this thread)...
Last edited by WebDozer; 01-23-2012 at 08:33 PM.
The Following User Says Thank You to WebDozer For This Useful Post: okanagan (01-24-2012)
I saw the NS yesterday ....it was a 5 minute appt, I did not get the chance to ask many/any questions. I guess the bottom line is he has ordered a MRI and also reffered me to a doc for my hands as he believes it is a seperate issue being that it is carpal tunnel both hands...I find that strange. He had my CT scan up and quickly showed me the various places of osteophytes/bone spurs and canal narrowing, shortness of space between discs as well as the very obvious spots where the spinal cord is being pushed on....so now I wait for 3 calls, which I guess is a good thing? He said the MRI is to see if surgery would help, however if not surgery then what?. I am getting lidocaine shots every 4 weeks, last time that doc did facet blocks in my neck as opposed to the muscles. I don't find that this helps but will continue, maybe cortizone shots would block some of the pain?