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Old 07-20-2012, 05:11 PM   #1
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Just Starting lots of questions!!!

Hi everybody, I'm new to this board and have been reading a little of everything trying to gather some information. But I have some questions I am hoping to find answers to. So any information would be VERY welcome.

4 years ago I fell down 14 steps onto a concrete floor. After that i started having pain, numbness, and tingling in my left arm and hand. I went to the doctor he said don't worry about it you just pinched a nerve it will go away.

Well 4 years later the tingling has finally stopped but the pain is in my neck shoulder arm and hand. I am losing my fine motor skills with my left hand. It cramps or draws up when I try to write or paint or do any kind of small detailed work. Also my left arm is getting weak to the point that when I empty the dishwasher and pick up a plate there are times when i drop it, it's like there is not control over holding it.

The pain has gotten worse and I got worried enough about it that I went to another doctor who gave me a MRI and it says that I have bulging disc in my C4-5 C5-6 and C6-7 with moderate to severe narrowing of the left C6-7 neural foramen.

My doctor made an appointment for me at a spine specialist for this Monday. And of course I am reading everything I can find on the internet but its all very confusing.

I was wondering if anyone else has had or has this problem and what type of treatment am I looking at?

Thank you for any information you can give.
Jeana

 
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Old 07-20-2012, 07:52 PM   #2
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Re: Just Starting lots of questions!!!

C7 radiculopathy will have most/all of the symptoms you mentioned. Since you're reading up on it, I suppose you know that already.

The severity of your symptoms would - to me - argue for surgery. The most common surgery for disk impingement on the foramen would be an ACDF, where the C6-7 disk is removed and the C6 vertebra fused to the C7. If this is the only level done, it "should" be quite straightforward, and should result in only a small loss of range-of-motion.

There may be other surgical options, as there has been quite a push in recent years to develop less invasive alternatives to ACDF's. One alternative might be a foraminotomy, which is a microsurgery coming in from behind and specifically aiming to clear out whatever's obstructing the foramen and impinging on the nerve. I don't know, though, how effective a foraminotomy would be when targeting a herniated disk, as they're move often used for bone spurs.

At any rate, I really think you should see AT LEAST TWO surgeons, better three. The reason is that some/many? just want to do ACDF's, and you'd probably feel better if you explored the alternatives, even if you ended up with an ACDF.

Of course, there are alternatives to surgery, too. All the more reason to see 2+ docs.

If you want a more detailed - albeit amateur - take on your MRI, post the radiologist's report here....

 
Old 07-20-2012, 08:12 PM   #3
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Re: Just Starting lots of questions!!!

Thank you for your reply I am posting the report I look forward to knowing what it means.

Findings: Cervical Vertebrae are normal in height alignment and signal intensity There is no bone destruction or fracture. The disk spaces are preserved.

C2-3 Normal
C3-4 Normal
C4-5 Mild diffuse posterior bulging of the disk is seen. The neural foramina are normal
C5-6 Mild diffuse posterior bulging of the disk is seen with mild narrowing of the left C5-6 neural foramen The right neural foramen is unremarkable
C6-7 Mild diffuse posterior bulging of disk seen Bulging or protruding disk material is seen in the left neural foramen associated with moderate to severe narrowing of the neural foramen with compromise of the left C7 nerve root the right neural foramen is unremarkable
C7-T1 Normal

No other extradural abnormality is seen. No intradural abnormality is identified. The cervical cord is normal. C1-2 articulation is normal. The portion of the brainstem that is seen on this study is normal.

Impression:
1. Mild diffuse posterior bulging of the C4-5, C5-6 and C6-7 disks.
2. Small left posterior lateral focal bulging or protrusion of the C6-7 disk associated with moderate to severe narrowing of the left C6-7 neural foramen.


Ok so what does all that mean???????????

 
Old 07-21-2012, 04:34 AM   #4
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Re: Just Starting lots of questions!!!

Radiologists often use the adjectives minimal/mild/moderate/severe to describe the severity of things bulging/growing that shouldn't be bulging/growing, or things getting narrowed that should remain open. So you can see that "moderate" is only one step below "severe". It is the kind of thing that's open to interpretation, and can vary from radiologist to radiologist.

Interestingly, you apparently only have one level that's problematic at all. The C6-7 disk is bulging out, or the soft inner material has broken through the tough outer ring. The radiologist considers this condition to be "mild", which is a bit odd because the EFFECT it is having is more serious. It's possible that this is the case because your spine is congenitally structured so that the foraminal opening is narrower than is optimal. This might be because your "pedicles" are too short. Your research may show you that pedicles are kind of "spacer" bones. Short pedicles mean narrow foramina. (BTW, I have this condition)

Anyway, this apparently "mild" disk bulge is causing a worse-than-mild narrowing of your left C6-7 foramen. Sometimes, something like this will affect the C7 nerve, and sometimes not. The radiologist goes so far as to say that the nerve IS affected. This results in radiculopathy.

So you seem to have a straightforward and quite localized problem. I'm optimistic that you can deal with this without an ACDF, either via foraminotomy or some other relatively new procedure.

Please keep in mind that I'm just an under-educated and over-experienced amateur. The docs - in particular, the spinal surgeons - will know best. That is, SOME of them will know best. That's why I repeat my strong recommendation that you get multiple opinions.

Last edited by WebDozer; 07-21-2012 at 04:35 AM.

 
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Old 07-24-2012, 11:38 AM   #5
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Re: Just Starting lots of questions!!!

Hi again, So I went to my doctor appointment Monday they gave me pain meds then told me I needed to do 2 weeks of PT 3x a week. They also set an appointment for early this morning for a shot in my neck. I got the shot and am supposed to wait a week go for PT then see them in 3 weeks. They say since it has been going on for 4 years that they will know fairly quickly if this course is going to work or not. He did warn me that the numbness in my arm and hand is more then likely permanent since the nerve has been damaged for so long. He says he can help me get the strength back and take care of the pain. If PT and Shot doesn't work he says we will have to start talking about surgery. My question is if PT makes me hurt more do I keep doing it or stop?

 
Old 07-24-2012, 03:15 PM   #6
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Re: Just Starting lots of questions!!!

Apparently the doc wants to "try everything" before recommending surgery. It's not unreasonable to think - or hope - that PT will get that protruding disk back out of your left C6-7 foramen.

As for pain and PT, I guess I'd leave that up to the therapist.

 
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