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Old 04-04-2013, 10:34 PM   #1
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Question Lumbar and cervical MRI severe pain-Bad Fall

Hi new to this board. Would appreciate any feed back. Going to Neurosurgeon next week. Hoping I don't need surgery again. A little Hx. Nov 2010 I had a bad fall and hit the back of my head resulting in a shattered C6-C7 disk that required emergency ACDF. I have been Dx. with DDD of the cervical and lumbar spine, don't know about the thoracic, but that hurts as well. This all started at age 47. The fall also resulted in Post concussion syndrome and a closed head injury and I developed a seizure disorder also as a result of the fall and injury to my neck.
I was Dx. with Cervical spondolytic myelopathy. Had Gait and balance problems. All resolved but was left with 25% residual myelopathy in my right leg, Still a little weak. Have had continuous low back pain all along but the emphasis was always on the cervical issue. The past 6 months or so I have developed mod to severe right leg cramping in the thigh, calf, and foot pain when walking, the foot pain never goes away. Also have mod to severe right hip pain and can't sit still very long about 20-30 before my hip or low back starts hurting. Also have for about 2 years shoulder pain both sides and upper arm pain and weakness that goes down to my forearms and includes my hands at times. My arms feel week and kinda hollow or numb especially in the morning when waking or after using the or lifting them. Has been getting worse. So I'm not sure if my problems are stemming from my cervical spine again or if the lumbar back is the problem or both. Just had MRI of lumbar back, and gonna ask Neurosurgeon for a new cervical MRI. I only have one that is over a year old and my original one. I am getting severe occipital headaches weekly, it feels like a dagger going thru my right oor left eye. All CT scans of brain are normal. Any insight would be greatly appreciated. I am so tired of pain. I lost my ins for awhile and was previously told it was in my head. Believe me this pain is VERY REAL.Very frustrated and hope my Dr. can help. I do have insurance now. Here is my MRI results.

MRI Lumbar spine without contrast, 03/30/13

Normal lumbar lordosis
Degenerative changes of the lumbar spine with loss of disc height at L1-L2, L2-L3, L3-L4, L4-L5, and L5-S1.
L5-S1 Disc bulging with facet degenerative changes, with mild left foraminal encroachment.
L4-L5 Broad based disc bulging with facet degenerative changes and biforaminal encroachment, greater on the right side.
L3-L4 Broad based disc bulging lateralizing to the right.
L2-L3 Broad based disc herniation with degree of inferior migration of disc material in the central/left paracentral distribution, without overt central spinal canal stenosis. Biformaninal encroachment is present however.
L1-L2 No compressive central disc herniation, no overt central spinal canal stenosis.
T12-L1 No compressive central disc herniation, no overt central spinal canal stenosis.

The conus medullaris is normal in position. he visualized portion of the sacrum is grossly intact.
Bulky uterus, possible uterine leiomyomatous disease.

Impression:
1. Disc herniation L2-L3.
2. Multilevel disc bulging in the lumbar spine.
3. Mild levo-curvature of the lumbar spine.
4. Bulky uterus, possible uterine leiomyomatous disease.

Old Cervical MRI without contrast 03/11/2012

Craniocervical area: Normal foramaen magnum with no chiarri malformation.
Paraspinal area: Normal with no visible mass.
Bones: Minimal dextroconvex scoliosis which appears to be compensatory to a slightly larger levoconvex scoliotic curvature of the upper thoracic spine. There has been prior fusion of the C6-C7 vertebral segments. Bone marrow signal is within normal limits. Mild disc height loss at C5-C6.
Cord: Normal contour and signal intensity.

Cervical disc levels:

C2-C3: No significant disc/facet abnormality, spinal stenosis, or foraminal narrowing.
C3-C4: Mild left facet and un covertebral joint hypertrophy, with minimal left foraminal narrowing.
C4-C5 Mild circumferential disc osteophyte complex. No cord compression. Uncovertebral and facet joint hypertrophy on the right, with mild right foraminal narrowing.
C5-C6 Circumferential disc ostephyte comple which minimally flattens the anterior cord. No abnormal cord signal. Facet and uncovertebral joint hypertrophy, with mild/moderate bilateral foraminal narrowing.
C6-C7 Disc contour is within normal limits. No cord compression or significant foraminal narrowing. Limited evaluation at this level due to artifact from the fixation hardware.
C7-T1 No significant disc/facet abnormality, spinal stenosis, or foraminal narrowing.

Conclusion:
1. No acute processes identified.
2. No abnormal cord signal at any level.
3. Multilevel degenerative changes and postoperative findings as described above.

Any insight would be greatly appreciated. This pain is VERY REAL!!! What can I expect at my appiontment next week. Thank you!!

 
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Old 04-05-2013, 12:37 PM   #2
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Re: Lumbar and cervical MRI severe pain-Bad Fall

What a terrible litany of troubles, and all from one fall!

Cervical MRI looks fine, lumbar not so fine. Several lumbar levels you could be having trouble at, and they could cause foot/leg/hip problems, of course.

Is it possible that the foot pain is due to altered gait? If it hurts when you've been off the foot all night, that may not be the case, but you could ask a podiatrist or even a physical therapist.

I don't know what's meant by "25% residual myelopathy". What does it mean, who said it, and how did they determine it to be so?

 
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Old 04-05-2013, 08:38 PM   #3
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Re: Lumbar and cervical MRI severe pain-Bad Fall

I developed gait disturbance, loss of balance, and significant leg weakness especially in the right leg. After my C6-C7 fusion my right leg improved dramatically but there was still some weakness in the thigh at which Dr. rated the weakness of the right leg at 25% weakness remaining.

With my cervical symptoms recurring, (occipital headaches, mod/severe, shoulder pain and arm pain and weakness again recurring, I would like to ask for a new cervical MRI just to be sure if its not something further going wron in my neck. Or is it truely my lumbar causing the pain and weakness in my back and legs. Right now at this point I am very frustrated and tired of the pain. My whole spine just hurts including thoracic. Yes it was a very hard fall hitting the back of my head, when I fell the left side of my head was hit by a door as well and I lost consciousness. The toll and loss has been great!!! I had a very good Spine surgeon in Ga. fortunately or the loss would of been greater. But I do fear that with so much DDD throughout my spine, I am again facing some painful spine issues. I used to be a runner (1000 miles per month club when younger, karate, tennis, swimming and etc., remodeled homes and worked as a surgical tech and med assistant which is hard on the spine. So my lifestyle was not very kind to my spine and now I'm paying the price. Thanks so much for your reply

 
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Old 04-06-2013, 06:38 AM   #4
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Re: Lumbar and cervical MRI severe pain-Bad Fall

OK, I understand the weakness thing. You likely have a bit of myelomalacia in your cervical spine. Not a darn thing you can do about it, I'm afraid. I have the same problem, but it doesn't really affect my life. I'll never again be a great dancer, though.

Oh, wait... I could never dance to start out with.

That hip pain you mention sounds like a classic lumbar symptom. Have you seen a physiatrist/orthopedist about it? He'd likely recommend PT. As for the headaches, I don't see how they have a cervical connection, especially considering your fairly benign cervical MRI.

 
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Old 04-06-2013, 06:31 PM   #5
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Re: Lumbar and cervical MRI severe pain-Bad Fall

The headaches are occipital is what I was told. They start when my neck stiffens and my neck and shoulders hurt. Hopefully you are right and the neck is fine. Just wanting to make sure due to the fact that the cervical MRI is little over a year old. My main concern is my lumbar spine. I see the Neurosurgeon on 4/8/13. And If I need to I will definately seek another opinion, actually I will seek one no matter what. I am hoping for PT, and perhaps adjustments through a Chiropractor. Just scared because the leg pain is getting worse very quickly and it hurts to walk, sit, stand, lye down. Perhaps I should just go out and dance...LOL I'm not that good either but it's fun. I have until the last 2.5 years been very active in sports and have worked in healthcare as a med asssitant and surgical assitant, remodeled homes as a side hobby, none of which is kind to the back. Thanks for your feedback, appreciate it.

 
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Old 04-12-2013, 11:22 AM   #6
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Re: Lumbar and cervical MRI severe pain-Bad Fall

What was the result of your meeting with the neurosurgeon?

Please be careful visiting a chiropractor for adjustments. With the extensive degenerative disc disease that you have, I don't think it will help a lot and just might make things worse.

 
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