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Amcpamcp
11-09-2016, 12:00 PM
In 1985 I had a severe accident that left me with cervical damage. I have been having chronic pain since then sometimes worse than others. I have continued exercising despite the pain as it helps mobility. I have been undergoing treatment with a chiropractor and massage therapist every month and those treatments alleviate the pain. I recently had another ctscan and the results are worse than before. My questions to you is how much should I worry about it? Could it lead to eventual paralysis?Should I consider surgery? (sorry the following is a bit detailed and long). Thank you for your feedback on this matter!!
FINDINGS: There is a mild anterolisthesis of C3 on C4 secondary to facet degeneration. There is a mild cervical kyphosis from C3-C7. No other significant focal malalignment is seen on this supine study. No fracture or focal bony lesion is identified.
At C2-C3 there is no significant canal or foraminal narrowing
At C3-C4 uncovertebral and facet degenerative changes produce moderate right and severe left foraminal narrowing.
At C4-C5 posterior disc and osteophyte prominence produces moderate canal narrowing. There is a mild right foraminal narrowing.
At C5-C6 posterior disc and osteophyte prominence produces moderate canal narrowing, left worse than right. There is severe bilateral foraminal narrowing.
At C6-C7 posterior disc and osteophyte prominence produces moderate canal narrowing. The previously demonstrated disc protrusion has been resolved. There is a mild right and severe left foraminal narrowing.
At C7-T1 these is no significant canal or foraminal narrowing.
IMPRESSION: Multilevel cervical degenerative changes with moderate canal narrowing at C4-C5, C5-C6, C6-C7. There is severe bilateral C5-C6, severe left C6-C7, and severe left C3-C4 foraminal narrowing.

teteri66
11-11-2016, 04:17 PM
Welcome to the board. As you know, you have issues with a number of segments of the cervical spine...what is sometimes called degenerative disc disease.

The pain we feel is often caused by the compression of a spinal nerve. This happens primarily in two areas: the central canal and in the foramen, which is a small opening located at each pair of vertebrae through which a spinal nerve exits the spine to go out to the part of the body that particular nerve innervates. This is referred to as foraminal stenosis. Stenosis is a narrowing. ( I think of an old iron pipe that gradually gets clogged up by mineral deposits until the water can barely drip on through).

Sometimes a disc will weaken and the wall will bulge out. Especially in the neck where everything is packed into a small space, any part that enlarges in size can cause a problem. As a disc bulges or heriniates there is often a corresponding change in the adjoining facet joint. The disc and facet joint works together as a until and is what gives our backs the ability to bend and twist. When a disc begins to degenerate, the facet joint often enlarges in an attempt to stabilize the
Spinal segment. The body always fights to maintain stability!

As you read through the report, you will see there is a lot of stenosis in the foramina at multiple levels. It is this pinching of the nerves that causes the radiating pain. Also, it helps to know that radiologists use specific words to describe just "how much" or "how bad" a particular issue is....minimal, mild, moderate and severe. Minimal or mild are usually something that a doctor will notice but not worry about. Moderate can go either way and severe almost always requires treatment -- either conservative or surgically. You will note in the Impression section that the stenosis is severe at C5-6 on both the left and right sides, and on the left side at C3-4 and C6-7.

Keep in mind that the Ct scan or MRI are just one piece of the diagnostic puzzle. The spine specialist will correlate these findings to what is found on physical and neurological exams. Then a plan of treatment will be formulated. It will include conservative measures just as a course of physical therapy, oral medications for pain and inflammation, perhaps a series of epidural steroid injections for the same purposes.

I would encourage you to see a spine specialist. This can be a fellowship-trained orthopedic spine or neuro surgeon. This is the best specialist to see for an accurate diagnosis. If surgery is recommended, I suggest getting more than one opinion, preferably from an orthopedic spine surgeon and a neuro surgeon. Their training is similar but sometimes there are differences in approach....

In general, the spinal cord must be damaged in order for there to be paralysis. Stenosis in the foramina can cause nerve damage but usually not complete loss of movement.

Amcpamcp
11-11-2016, 09:32 PM
Welcome to the board. As you know, you have issues with a number of segments of the cervical spine...what is sometimes called degenerative disc disease.

The pain we feel is often caused by the compression of a spinal nerve. This happens primarily in two areas: the central canal and in the foramen, which is a small opening located at each pair of vertebrae through which a spinal nerve exits the spine to go out to the part of the body that particular nerve innervates. This is referred to as foraminal stenosis. Stenosis is a narrowing. ( I think of an old iron pipe that gradually gets clogged up by mineral deposits until the water can barely drip on through).

Sometimes a disc will weaken and the wall will bulge out. Especially in the neck where everything is packed into a small space, any part that enlarges in size can cause a problem. As a disc bulges or heriniates there is often a corresponding change in the adjoining facet joint. The disc and facet joint works together as a until and is what gives our backs the ability to bend and twist. When a disc begins to degenerate, the facet joint often enlarges in an attempt to stabilize the
Spinal segment. The body always fights to maintain stability!

As you read through the report, you will see there is a lot of stenosis in the foramina at multiple levels. It is this pinching of the nerves that causes the radiating pain. Also, it helps to know that radiologists use specific words to describe just "how much" or "how bad" a particular issue is....minimal, mild, moderate and severe. Minimal or mild are usually something that a doctor will notice but not worry about. Moderate can go either way and severe almost always requires treatment -- either conservative or surgically. You will note in the Impression section that the stenosis is severe at C5-6 on both the left and right sides, and on the left side at C3-4 and C6-7.

Keep in mind that the Ct scan or MRI are just one piece of the diagnostic puzzle. The spine specialist will correlate these findings to what is found on physical and neurological exams. Then a plan of treatment will be formulated. It will include conservative measures just as a course of physical therapy, oral medications for pain and inflammation, perhaps a series of epidural steroid injections for the same purposes.

I would encourage you to see a spine specialist. This can be a fellowship-trained orthopedic spine or neuro surgeon. This is the best specialist to see for an accurate diagnosis. If surgery is recommended, I suggest getting more than one opinion, preferably from an orthopedic spine surgeon and a neuro surgeon. Their training is similar but sometimes there are differences in approach....

In general, the spinal cord must be damaged in order for there to be paralysis. Stenosis in the foramina can cause nerve damage but usually not complete loss of movement.

Amcpamcp
11-11-2016, 09:35 PM
Thank you so much for the precise and lengthy explanation of what is happening to my spine. It is so reassuring and not as bad as I feared - I am booked to see a neurologist and then the spine specialist. But because of your answer, I feel that there is hope !
thanks so much, Anne-Marie