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How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?


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Old 03-25-2017, 08:08 PM   #1
Alaura921
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How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

I just had a cervical MRI for numbness/pain in shoulder, head, neck and arms with headaches being a more common thing these days. Sometimes it feels like i have sunglasses on my head or a hat and i dont. I also have some weakness in my arms and hands.

After getting my results, I have read that some issues with upper cervical spine C2 - C3 can effect your hearing. I was surprised reading that because my hearing has been getting bad for a while now but the past 6 months it seems to have really sped up with the loss - i was even researching ENTs in the area for testing the week prior. I also have an occasional "clicking/ticking" sound that happens makes me think of Morse code. This is on right side only. Also on right my eye tears and right nostril drips....strange. I never put all these issues together over the last 5 to 6 months.

My MRI results are below. My Pain Mgmt sent me for the MRI. He wants me to have cervical epidural but im just not 100% trusting in it. I currently only seeing PM and Chiro. Shouldn't I have been referred to neurosurgeon at this point?

I also read that a C2/C3 disc herniation is extremely rare..... is this true? I can't seem to find much on it so it seems to be.

Thank all who take the time to read this ☺


MRI FINDINGS:

Examination demonstrates slight reversal of the normal cervical lordosis. No evidence of fracture, dislocation, or bone destruction. The facet joints demonstrate normal alignment.

C 2-3 level, a central subligamentous disc herniation is noted with thecal sac compression

C 3-4 level, annular bulging is noted with thecal sac compression

C 4-5 level, and disc osteophyte complex is noted superimposed upon annular bulging with thecal sac compression

C 5-6 level, and disc osteophyte complex is noted superimposed upon annular bulging with thecal sac compression and right foraminal stenosis

C 6-7 level, and central subligamentous disc herniation is noted with thecal sac compression

Last edited by Alaura921; 03-26-2017 at 08:15 AM.

 
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Old 03-26-2017, 08:07 AM   #2
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Also, when I say "shouldn't I have been referred to a neurosurgeon at this point?" I meant more to just for an opinion of what is going on. I am certainly not about rushing into any surgery.

I am just puzzled that my follow up after MRI with pain mgmt was so......assembly line feeling. Sure he mentioned epidural injections before MRI but wanted to see what MRI would say first. Then he really didn't explain any of it to me, despite me asking and becoming tongue tied.

Also, my MRI is lack of details compared to others I have seen on here. No measurements, etc. Maybe that means all minimal? Or that I need another radiologist to read it?

Just scared, frustrated, numb and on pins and needles - litterally! 😓

Last edited by Alaura921; 03-26-2017 at 08:10 AM.

 
Old 03-26-2017, 08:49 AM   #3
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Welcome to the board. I would suggest making an appointment with a fellowship-trained orthopedic spine or neurosurgeon. Check with your insurance carrier, but you often don't need a referral to make an appointment. Just be sure the practice is limited to neck and back! These are the two specialties with the most education, training and experience with the spinal cord, neck and back. Also, personally I would stop seeing the chiro until you learn the extent of any nerve involvement.

Yes you are correct in that your MRI report offers no measurements...so it makes it hard to assess how concerned you should be...but the spine specialist will not read the report. He/she will look at the images and then should perform a basic physical exam and neurological exam to correlate the findings from the images.

The report suggest degenerative disc disease, which is really just an umbrella term used to describe deterioration that is causing pain, often from wear and tear/aging. While painful, this really only causes issues when it begins to come in contact with the spinal cord, pushing into it and causing cord compression and disease(myelomacia).

Unfortunately all the discs from C2 through C7 are bulging sufficiently that the material is pushing into the thecal sac...the tough membrane-like sac that contains the spinal cord fluid and contains the spinal cord. As you suggest, we don't know the extent of this compression. Since you don't mention anything in your legs, it probably isn't too bad. (The thecal sac can be compressed without it affecting the spinal cord. I would assume/hope the pm doc would have mentioned cord compression if it existed!)

Why he suggested ESIs ....basically speaking, in a great generality that shows my bias, this specialty doesn't have much to offer...drugs and injections. It is common protocol to give an epidural steroid injection before basic diagnosis is done. Crazy. I hate to think snide thoughts, but it is a money maker for them, and usually does no harm. However, they are not without risk. Just ask anyone who has developed arachnoiditis after this "safe" procedure....

For you it is not effective because you have issues at five levels. Was he going to inject all five levels?

 
Old 03-26-2017, 09:08 AM   #4
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

C2-3 disc herniation isn't all that uncommon...particularly when the rest of the discs are also degenerating.

C2 vertebra is known as the Atlas. It, along with the C1 vertebrae hold up the head. Because the nerves that supply the top of the head run through this area, misalignment of or issues with these vertebrae can result in headaches, dizziness, etc.

 
Old 03-26-2017, 12:57 PM   #5
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

I have lived normally with a C2, C3 and C4 disc hernation for over a decade now. I do occasionally get numbness and neck pain when I wake up in the morning, but otherwise it has not stopped me from doing anything.
Since I refuse surgery unless it is critical, I do see a neurologist, neurosurgeon and ortho spine specialist once a year to see what changes are taking place...all 3 of them tell me to 'carry on" and not look into surgery as it is not compromising my quality of life.

2 people in my family have similar nerve compression due to herniation in this area, its not uncommon at all to get hernations in this area as they can result from whip lash (car accidents), trauma and even from doing sit ups and yanking on your neck...

Hope this helps.
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Old 03-26-2017, 01:27 PM   #6
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Thank you teteri66 and MSNik for reading my post and for the info. It's a relief hearing C2-3 herniation isn't uncommon! The few things I've read and the lack of information had me belive otherwise.

I am definitely going to make an appointment with a neuro-spine specialist tomorrow.

Teteri66 - I did read that arcticle on the Superior Cervical Ganglion Syndrome and I do have 90% of those symptoms. I wouldn't be surprised if this is what is going on with me as a result of all these multi-level disc bulges/herniations.

Thanks again ☺

 
Old 04-18-2017, 05:20 PM   #7
Alaura921
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Hi again....

I went to an ortho-spine surgeon on Monday for a 2nd opinion on my MRI that I first wrote about in this thread.

He only looked at the films (not written report) and went over what he saw.

I have 3 level herniation c4-5, c5-6, c6-7. C5/6 being the worse with the matter extremely close to touching the actual cord. He believes in am getting most of my arm, hand, finger numbness and pain from this level.

So I asked him "what about c2-3?" He said it's fine...completely flat. This is when I pulled out the actual report and showed him how it said I was herniated 2/3 & 6/7. He was shaking his head in disbelief.

I told him that pain management didn't go over films, just looked at report and wanted to do ESI and I wanted 2nd opinion before moving forward.

He agreed that I should start with ESI as my strength isnt very bad. He said it is possible that epidural can help eliminate numbness and pain.

He wrote me a script for an anethstesia group which says

DX- HNP'S Cervical
C4-5, C5-6, C6-7
Please evaluate for cervical epidural

I did see my Rheumatologist last week and he told me do not let anyone put needles in my neck without them doing an EMG to know what level my symptoms are coming from.

So.....because I have totally 2 differing opinions on my MRI, is a 3rd opinion warrented??

I'm just at a loss.....and I have to make appt with ENT for my ear and tinnitus as he said my herniations would not cause that.

Any advise, comments, wishes of good luck are welcome ☺

Last edited by Administrator; 04-18-2017 at 05:31 PM.

 
Old 04-19-2017, 04:06 AM   #8
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Most good doctors do not read reports. They prefer to read the flims themselves and interpret them themselves. Remember that reports are just Radiologists who report what they see, but are not necessarily medical opinions.

An epidural is simply to block pain. It works for some people, not for others, and is not permanent nor does it help heal anything.

If your doctor is only suggesting an edpidural, it is only to relieve some of your pain.

You can get another opinion if you really want one, or you can get the epidural if you are in so much pain that you want relief....its not a big deal and its not surgical. It is over in less than 3 minutes!

I hope you get relief as being in pain is never fun! Feel better soon!
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Old 04-19-2017, 12:11 PM   #9
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Quote:
Originally Posted by Alaura921 View Post
Thank you teteri66 and MSNik for reading my post and for the info. It's a relief hearing C2-3 herniation isn't uncommon! The few things I've read and the lack of information had me belive otherwise.

I am definitely going to make an appointment with a neuro-spine specialist tomorrow.

Teteri66 - I did read that arcticle on the Superior Cervical Ganglion Syndrome and I do have 90% of those symptoms. I wouldn't be surprised if this is what is going on with me as a result of all these multi-level disc bulges/herniations.

Thanks again ☺
I myself have 4 herniated discs. C4-t1. I seen neuro and they said you must see pain mamagement and try injections unless emergency trauma to the neck. Ive been Going thru injections and has helped sum. But wearing off. Seeinv surgeon next week to see what else. Tried physical therapy as well. See neuro to ease your mind. Very common.

 
Old 04-19-2017, 04:29 PM   #10
Alaura921
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Quote:
Originally Posted by MSNik View Post
Most good doctors do not read reports. They prefer to read the flims themselves and interpret them themselves. Remember that reports are just Radiologists who report what they see, but are not necessarily medical opinions.

An epidural is simply to block pain. It works for some people, not for others, and is not permanent nor does it help heal anything.

If your doctor is only suggesting an edpidural, it is only to relieve some of your pain.

You can get another opinion if you really want one, or you can get the epidural if you are in so much pain that you want relief....its not a big deal and its not surgical. It is over in less than 3 minutes!

I hope you get relief as being in pain is never fun! Feel better soon!
Thanks for your reply MSNIK. I feel much better now that I saw a recommended spine surgeon who went over my MRI films with me. It was amazing to me how different the views were but I'm now hearing/reading that commonly happens with these things.

Yes, he said my 5-6 is worst answer while all are compressing thecal sac, that one is near kissing my cordad but no quite. He thinks this is the level most of my pain and numbness comes from and hoping that these ESI will give some relief.

Thanks again for writing.

 
Old 04-19-2017, 04:38 PM   #11
Alaura921
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Quote:
Originally Posted by mmtodd View Post
I myself have 4 herniated discs. C4-t1. I seen neuro and they said you must see pain mamagement and try injections unless emergency trauma to the neck. Ive been Going thru injections and has helped sum. But wearing off. Seeinv surgeon next week to see what else. Tried physical therapy as well. See neuro to ease your mind. Very common.

Hi mmtodd....thanks for your response. Yes, not only do I want to see a neurologist, my Rheumatologist really wants me to as well.

So how long have you been doing your injections and how long did they help? I'm hoping that they work for me but most things I read say it doesn't last; a bandaid.

I'm not thrilled about having corticosteroids injected as I take low dose prednisone daily for lupus.

When you went to pain management didn't they do EMG before the injections to know what what level was causing your pain?

I hope you get relief too.....this stuff is no joke.

Thanks again for chiming in.

 
Old 04-19-2017, 09:33 PM   #12
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Re: How rare is a C2/C3 disc herniation? Should I be seeing a neurosurgeon?

Keep in mind that you will be limited to the number of epidural steroid injections you can have in one year. Many spine surgeons limit them to three per year. Unfortunately they have become something that is almost required by insurance carriers before surgery will be considered. Thus, doctors tend to automatically start with this and a course of physical therapy.

The steroid helps by reducing inflammation in addition to helping with pain. Sometimes it is enough to allow the person to begin physical therapy. Occasionally, it is very effective!

My first MRI was ordered by my internist, who then sent me to a PM doctor for the ESI. I never saw a neurologist until after I had my first surgery, which was a PLIF at L4-5.

The only reason I can think of for seeing a neurologist is to have an EMG/ nerve conduction study...which will not definitively show which level is the pain generator.

 
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