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    Old 07-29-2015, 09:03 PM   #1
    Tonyalg
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    help

    Hello All,
    I am new to the site but have been reading several post. I have visited other site trying to find people that have experience the things I am going threw but really have find none but came to this site and see alot of support and caring people that willings to give inputs on their experiences with the issues I am dealing with. Also I know any advice/comments/suggestions are only that, and not of a professional, medical diagnosis. I am really just trying to get input from people that are dealing with the same issues or have dealt with the same issues.
    I am having pain in my neck and lower back well these are the main areas. I am also experiencing numbness, tingling,sharp pain, and burning in my upper and lower extremities. I was seen my a neuro doctor and he tested my nerves and his findings was ankle clonus, hyperreflexia, and positive Hoffman sign. I recently just took my third MRI on my cervical and lower back the result reads as follow:
    Cervical spine reads
    Impression:
    There is marked compression of the cord C3-5 and less prominently at C5-7
    Severe forminal stenosis bilaterally at C3-5
    Subtle intrasubstance cord signal changes at C3-4 but relate to the compression of the cord at this level and minimal myelomalacia.
    Canal is diffusely small in a congenital basis C3-7.
    Lumbar Mri:
    Impression:
    There is a central and right paracentral posterior disc protrusion with annular fissure or tear and what appears to be inferiorly extruded inferior disc material and disc fragment. These findings cause slight encroachment on the anterior thecal sac and right S1 nerve root origins. Correlate with symptoms.

    I forgot to mention I am 43 years old. Is anyone dealing with these issues or have dealt with these issue that can shed some light on what's going on I know your opinion is not of a professional or doctor and I am not expecting a diagnosis just trying to see if other people are going through the same thing have been dealing with this for 3 years but first two Mri did not have serious condition and feel like I am getting worse

     
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    Old 07-30-2015, 10:07 AM   #2
    teteri66
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    Re: help

    Welcome to the board. Yes, you do need some help in the way of an accurate diagnosis and plan of treatment. Do you have an appointment with a fellowship-trained orthopedic spine or neuro surgeon? If not, Iencourage you to make one. Take your test results from the neurologist with you and copies of the MRIs also.

    Your radiology report indicates issues that correlate to the symptoms you write about. The cervical spine appears to have more serious issues than the lumbar spine. Spinal cord compression is evident at multiple levels, and is worse from C3 to C5. Since the spinal cord connects to the brain and carries messages of movement and sensation as well as control of the autonomic system, which controls breathing, blood pressure, etc. it is a serious issue when tissue of some sort is pressing into it and potentially compressing the nerves. When the spinal cord is severed, it results in loss of function below this level. When nerves are compressed, it results in loss or partial loss of the nerve and its function.

    In addition to the compression, you have an additional situation which contributes to the problem. The spinal canal is smaller in diameter than normal from C3 to C7 which would only contribute to the compression.

    In addition to the compression of the central canal, nerves are also being compressed at the foramen at C3-4 and C4-5. The foramen are openings located at each vertebral level that allow the spinal nerves to exit the spine and go out to the limbs or other parts of the body. When compressed, pain and symptoms of tingling, numbness, etc. can be felt at the site of compression or anywhere along the path of the nerve.

     
    Old 07-30-2015, 10:41 AM   #3
    teteri66
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    Re: help

    I'm traveling and I needed to quickly look at a map for my husband! But It was a good stopping point as I was pretty much finished with the cervical report.

    The lumbar report does not indicate which disc is herniated, but I assume it is L5-S1. The disc is herniating in the central area and toward the right and disc material is protruding and is pushing into the S1 spinal nerve on the right side.

    You can look online for a "dermatome map" to see what areas of the body are innervated by the C3-7 and L5-S1 spinal nerves.

    Remember that the MRIis one piece of the diagnostic puzzle. The spine specialist will corelate the findings of the MRIs with what's found on physical exam, basic neurological exam and after listening to your description of your symptoms and what impact it has on your daily life.

    Again, any time there is cord compression, there is the potential for a serious situation, so I urge you to see a spine specialist. The compression may be slight and the doctor will just want to keep an eye on it, but you will not know this until you have a consultation.

     
    Old 07-30-2015, 12:16 PM   #4
    Tonyalg
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    Re: help

    Thanks Teteri66 for replying to my post your advice was well needed. I have an appointment with a neuro surgeon on Monday August 3rd. It's just so hard for me to deal with the whole thing. I have seen several doctors for this issue neurologists and orthro doctors. But at the time the MRI 's I took never had any severe condition just moderate. Most doctors was just focus on my lower back and not my neck. Due to the fact they told me all of my issues was coming from my back and not my neck. The last MRI I took before this one was in Oct 2014. It was on my lower back and neck and I seen an Orthro doctor after that and he gave me an injection in my back which did not help. My dad just had the same thing happen to him he had to get neck surgery due to the fact his neck canal was narrowing and was having the same symptom as me. He had complications from the surgery a couple days after his surgery which almost killed him. But without my dad in the same state as me it's hard to get support from the family I have here my mother think it's a joke when I talk to her about it her response is I will not let them cut on me she also makes fun when I have to go to several different doctors in a one month period and the rest just don't care period I have been dealing with these symptoms for three years plus and people think your not suppose to be in pain. I have been off work for three years because I am in pain if I lift,bend, walk to long or stand to long and my lower body goes numb if I sit to long.
    Thanks again for replying it feels good to have someone listen without giving a negative response like I am crazy.

     
    Old 07-31-2015, 03:31 PM   #5
    ChuckStr
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    Re: help

    The level of cord compression you have, especially with accompanying symptoms such as hyperreflexia and the degradation of your spinal cord at C3/C4 (myelomalacia), indicates a very significant cord syndrome. Your symptoms almost certainly reflect a cervical myelopathy due to the compression which can progress or become permanent. It sounds like you are seeing a neurosurgeon on Aug 3. Make sure that he/she is a spine specialist, that is has received specialized training in spinal disorders including specialized surgical techniques and limits their practice exclusively to spinal issues. You don't want someone who doesn't see this stuff all the time. If the recommendation is surgery, which it may very well be if the radiologist report for the MRI is accurate, I would get a second opinion as well. I would suggest an orthopedic spine specialist. The receive similar specialized training but tend to look at things a little differently than their neurosurgeon counterparts.

    Good luck and let us know how you get on...

     
    Old 07-31-2015, 03:46 PM   #6
    Tonyalg
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    Re: help

    Thank you Chuck for the advice and I will post what the neuro surgeon say after my visit I also have an appointment with the neurologist the same week he's a well known neurologist will ask about the neuro surgeon but the neuro surgeon specialize in the spine and also will get second opinion

     
    Old 08-03-2015, 04:35 PM   #7
    Tonyalg
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    Re: help

    Hello Chuck and Teteri,
    I went to see neurosurgeon today he told me I will need surgery in two levels disc replacement with artificial discs. He said it's the best surgery for me due to my age. He feel most of my symptom is coming from my neck. He said my nerves are very brisk and due to my spine being compressed at these two levels my muscles are spasm up. He also said the surgery will relieve some symptoms but not all. Now I am waiting for the surgery to get approved and then I go do my lab work. I really like this neurosurgeon he explained everything completely
    and compared my recent MRI to my present to show me how my symptoms are gradually worsen over the months. So now the puzzle is complete after three years of going from doctor to doctor to find out the whole time it was mostly my neck and not back. Thanks for your feedback.

     
    Old 08-04-2015, 03:52 PM   #8
    ChuckStr
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    Re: help

    The idea behind the ADR (as opposed to an ACDF) is to preserve motion and limit the likelihood of adjacent segment disease which includes the possibility of future surgery. On the surface I can see why as a younger person this might be beneficial. The problem is that the ADR is pretty new in the US and although not as new in Europe, there is still a lack of research studies that show these benefits over an extended period of time. In addition 2 level ADRs have only been FDA approved very recently and for a limited number of devices. Insurance companies may still balk at multi-level ADRs so you may end up paying for the surgery yourself. Also, if you look on the labels for these devices they almost all list spine instability (listhesis) as a disqualifying condition. I didn't see that you have any instability from your MRI as yet, but it does make me wonder how well a 2-level ADR will hold up as you age. The more levels replaced without fusion the more likely you'll have stability problems down the road it would seem to me.

    I'm definitely not saying you shouldn't go ahead with the surgery, it may be the perfect thing. But, if it were me, I would get another opinion, perhaps from an ortho spine specialist that has knowledge of ADR.

    Either way it sounds like surgery is in your pretty near future so I wish you the best of luck with that. Please drop by and let us know what you decided and how you get on with your recovery when the time comes. We collectively learn a lot from posters' varied experiences.

     
    Old 08-08-2015, 09:22 PM   #9
    Tonyalg
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    Re: help

    Hello all,
    My surgery is schedule for the 13th of August I go do my lab work and stuff Monday. I am not expecting to be completely pain free from the surgery because the surgeon explained to me that the surgery will stop further damage of my spinal cord. I know the nerves in my hands has damage because I had bilateral carpal tunnel surgery and when I took an EMG it stated the carpal tunnel is still there in my right. Also the emg stated motor and sensor nerve damage and the surgeon told me it all depend on how much damage is done to my nerve. But I know one thing I will do is quit smoking. I will post a few days after I come out of surgery to let everyone know how I am doing.

     
    Old 08-09-2015, 09:19 PM   #10
    teteri66
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    Re: help

    Good luck to you. I guess you have decided on the disc replacement without further consideration.

    You may find that the leg pain is coming from irritation or compression of the S1 spinal nerve, which you may want to address in the future.

     
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