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    Old 06-27-2007, 07:16 PM   #1
    beach117
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    C3, C5 & C6 problems .....

    I'm new on Healthboards and have questions on my MRI's of my cervical spine. This is a little long, Sorry! But I'd appreciate any thoughts or feedback anyone could give me! ......

    3 weeks ago, I obtained a copy of an MRI that was done in 2005 (that I never saw) of my cervical spine/shoulder and learned that there were "findings" on this MRI . I had a followup MRI last week , that compared the two(see below)

    • Incedentail finding of a Hemangioma on C3 (2005 & 2007)
    • C5 & C6 : paracentral left lateral (what's this ?) protruding discs. (2005 MRI indicates a High signal , 2007 indicates a low signal) That's good right ? Also noted in both MRI's I have moderate to severe neural forminal narrowing (this appears to have progressed since the 05 MRI)
    • Cervical Spine alignment was "normal" in 2005 ..... 2007 it states that there is a 'reversal of the normal cervical lordosis at the C5 & C6 level (Also Ligamentous injury cannot be excluded) What does this mean, is it fixable without surgical intervention ?
    • Spinal Cord maintains normal signal (2005 & 2007)

    Now ...... for the last 10 years of my life, I have been told my *ailments* are in my head (Fibromyalgia - anyone that's 'got it' would fully understand how maddening & upsetting these words are !!!) Ironically , I was diagnosed with a small meningioma in my temporal lobe in 2006, so now I can say "it's all in my head" (sick humor, couldn't resist!) .

    Anyway, with all *this* stuff going on , along with the Meningioma, I decided to send my films/reports to a "top Notch" medical center, along with my symptons to see if there was any connection to all these things.

    Well, I am distraught! They are saying my pain , weakness, severe & frequent headaches & leg / foot cramping (amongst many other things) is not related to anything they see in the films. Only mentioned that perhaps I may have "arthritis". Great , let's throw more BS diagnoses on the list that's a new one!!!!!

    This just doesn't make any sense to me! I was praying against all praying that *now* I had a *real* situation going on, it would explan everything and they would fix me, Finally !!! I'm just disgusted. I don't know if this is a DR covering another DR's backside ... or it is the medical insurance situation (I am on medicare/disability) but I feel like I am being cast to the wayside , and left to think this must be in my head!

    I am throwing the towel in. I give up on Dr's ..... if I never see the insides of a hospital or office again , it will be too soon!

    anyway quick couple of questions:
    What is the difference between neural forminal narrowing vs. Stenosis of the Spine ? Is the narrowing a pre-cursor to the stenosis ? Is it something that requires treatment ? How do I fix this ???

    Also , how does a DR determine if there is nerve compression or damage with the above situation that could be triggering other things, like vision problems, facial/ear pain , etc...... ???? Can they see that in the MRI ?????

    Any thoughts , comments or feedback I would really appreciate it !

    Thanks!

     
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    Old 06-28-2007, 04:26 AM   #2
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    Re: C3, C5 & C6 problems .....

    Hi
    I have been having ear pain and facial spasms for the last two years and seen 2 tmj dentist. My neuro had done lots of brain scans to check for my blood vessels in my head and so on. I do have MS but she and I don't feel this is the true reason for the head ear and facial spasms.

    Now they think I should have facet block injections in my neck to see if it helps the facial and head pain. I have a couple bulges and an large osteocyte complex at c 6-7 . They can say if the neck is causing this, the facet block injections might help to rule out the neck. I haven't decided what to do yet.

    I can see where you wish you could get a real dx of what the prob. is- I sure understand.

     
    Old 07-08-2007, 08:19 AM   #3
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    Re: C3, C5 & C6 problems .....

    Hi. I am new here also. Oh your situation sounds a bit like mine in some aspects. I am in the process of changing neurologists actually which is no easy task.

    My neuro told me I only had arthritis in my neck at c5-6. Hogwash. I have battled with him for years on this issue to the point of simply staying on muscle relaxers for the spasms and mind over matter to deal with the pain and associated increasing frequency of related symptoms. Last MRI of mine showed the reversal lordosis thing which I am given to understand is comparable to a straightening of the cervical spine (often the result of muscle spasms) which is normally curved. I was given a diagnosis of spinal stenosis which my neuro states is nothing more than arthritis. MRI in my case showed mild effacement of the cord at C5-6 as well as formation of osterophytes at that level.

    It was related to another issue that I went to see an orthopaedic surgeon who included x-rays of my neck with others. I was informed that I had a very serious condition in my neck that, had I reported <key word there is reported> more pain, I would be on my way to surgery. I further discovered that C5 is as vulnerable to paralysis as C4. So I remain in the process of transferring everything to another neurologist who I hope will accept me as a transfer patient.

    Injury history: survivor of multi-trauma near fatal head-on MVA. Neck not diagnosed until three years later to be the cause of persistent muscle spasms - 1986. Second trauma to neck was a handful of years after that when a chair flipped over on me pinning me under a desk. My neck has never been the same since. Third trauma: also at work. Crutch went out from under me, jamming under the arm on one end and under the fridge at the other end. I went instantly numb from the neck down to the tips of my toes. No contrast was used in the MRI in 2003. I suspect that I may have sustained a hairline fracture in one of the vertebra at that level.

    Symptoms: constant muscle spasms even though on muscle relaxers for a numebrb of years. Increasing in frequency and torque. Persistent numbness on left side of meck and throat to left finger tips. Increasing episodes of uncontrollable tremors in both hands. Development of facial tics. Muscle spasms in toes (I think you reported the same there) to the degree that my toes literally freeze in the most painful position I ever thought would be possible until the spasm passes. Sleep apnea is worsening. Periodic episodes of extreme pain radiating from neck to left side fingertips - lasting up to a week. Migraines are increasing. increasing difficulty swallowing.

    I regret that I didn't get a second opinion sooner. If anyone has suggestions for my situation as well as the OP's - I would welcome any input as this is getting a bit scary actually.

    Thanks!

     
    Old 07-08-2007, 09:14 PM   #4
    john449
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    Re: C3, C5 & C6 problems .....

    I apologize in advance but I see a lot of confusion about the anatomy of the spine and how it effects the nerves, etc.. Maybe what I say here will help a little in interpreting MRIs and symptoms.
    The spinal column forms a tube that runs its full length from skull to tailbone. The spinal cord runs down this tube and the cerebral spinal fluid (CSF) circulates in there. When the tube is narrowed (at any level) it is called spinal stenosis. This can be caused by arthritis - usually the degenerative or "wear and tear" type seen to some extent in most of us as we age but also earlier in people who have had some neck trauma. Usually it is accompanied by some degeneration of the discs (cushions between the vertebrae) which allows the vertebrae to form osteophytes - extra bone growth due to irritation because of the loss of that cushion. These osteophytes often encroach into the spinal canal, causing narrowing or stenosis. When this encroachment extends to the spinal cord it produces a small impression referred to as effacement (Amanda). Fortunately the cord is flexible so damage is rare but it is always something to be aware of and follow up on.
    The foramina are small passageways formed by the bony arch of the vertebrae. The individual spinal nerves leave the cord at each level and go thru the foramina to their respective areas (arms, legs, stomach, skin, etc.). Narrowing of the foramina gives the nerve less room. Here is where the nerve can sometimes be "pinched". Severe foraminal narrowing (Beach) can certainly produce symptoms, most usually in the distribution of the nerve that is being "pinched".
    Finally the straightening which you all mention is, as you guessed, usually due to tension or spasm in the neck muscles. If you can get a handle on this often things markedly improve. Know from your posts you've tried - I've had these problems and so far have kept away from the knife. Hope you can do the same - Good luck to you all.

     
    Old 07-08-2007, 11:04 PM   #5
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    Re: C3, C5 & C6 problems .....

    Hi welcome to the board. Sorry for your problems.

    There is a test called EMG (electromyogram) that can test for radiculopathies (nerve root compression). It isn't pleasant, a little painful at times, but can give more information to the story.

    The EMG helps to distinguish between muscle conditions in which the problem begins in the muscle and muscle weakness due to nerve problems like a "pinched nerve" in the C-spine.

     
    Old 07-09-2007, 03:12 AM   #6
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    Re: C3, C5 & C6 problems .....

    Morning all.....My last MRI of cervical area shows bulging from the C3 through the C6. Large bone spur on the C5-C6 area and a possible pinched nerve at the C7, and stenosis. I say possible because I had the EMG done 3 weeks post injury and neuro said it was really too soon. Also suffered a shoulder injury at the same time. 14 months later, my neck was doing great just through PT and massage but my shoulder was getting worse. Had shoulder surgery 10 weeks ago. Part of the acromium bone was removed along with 10 bone spurs and a 2 inch rotator cuff repaired. Left side neck pain gone. Doing great until PT started to manipulate my arm to the point of tears. Pulling, pressing, crushing until I wanted to scream and run. Have an anxiety attack before I go to PT now. Saw the shoulder surgeon who said my shoulder froze up ( any wonder) gave me two injections and so far since last week 90% of the arm pain has gone. Also saw the Spine Specialist since after PT i aquired a large lump above my collar bone, collar bone pain is horrible, and the left side of my neck into my pec muscle is in agony again. He ordered an MRI of the Brachial Plexus as he feels I also have a problem in that area. Point behing all this typing is as you can see I have 3 problems on my left upper side. What is causing what? They don't know yet BUT the pain is not just from my cervical spine problems.


    ICC

     
    Old 07-09-2007, 03:12 AM   #7
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    Re: C3, C5 & C6 problems .....

    Thanks John. That helps to clarify the different terms anyway.

     
    Old 07-09-2007, 03:28 AM   #8
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    Re: C3, C5 & C6 problems .....

    Quote:
    Originally Posted by neckpatient View Post
    Hi welcome to the board. Sorry for your problems.

    There is a test called EMG (electromyogram) that can test for radiculopathies (nerve root compression). It isn't pleasant, a little painful at times, but can give more information to the story.
    I've had the EMG test back on 2002 which my neuro said was normal. He refuses to re-test and order an updated MRI, stating that I only have arthritis in my neck that everyone gets. I have other issues with my neuro who also treats me for TBI, ADD, Migraine and post-concusive syndrome. Aside from the neck issue, I recently discovered through the TBI rehab work eval that he should have recommended treatment with a neuropsych which he failed to do. Orthopaedist put me in PT for a month with my neck and I couldn't tolerate the exercises as they kicked up my pain for days. Traction was wonderful, but ortho doesn't want to order home traction - wants to have neuro evaluate neck. So...I wait.

     
    Old 07-09-2007, 03:53 AM   #9
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    Re: C3, C5 & C6 problems .....

    Quote:
    Originally Posted by ICC View Post
    . They don't know yet BUT the pain is not just from my cervical spine problems.ICC
    You make a good point, ICC, and it is possible that is the situation in my case. I am also being followed by ENT for a small mass in the parotid gland on the same side as my pain, as well as slight enlargement of multiple lymph nodes in the posterior cervical triangle. I even had one lymph on the upper part of the back of my neck removed as it's location was right close to a nerve in that area. No improvement, btw, on my neck pain.

    I am very receptive to the possibility that other issues may be contributing. However, when I spend a day driving my car and am laid up for days thereafter with extreme pain radiating from my neck on down, from a patient perspective, I associate the pain with whatever is going on in my neck. In my case, my situation is further complicated 22 years post-trauma from the MVA and TBI - in that the frontal lobe injury I survived negatively impacts on effective communication plus my neuro, who has also experienced head trauma, assesses me through the eyes of his personal experience rather than professional knowledge and experience.

    I only found out that the nerve conduction tests performed back in 2002 revealed mild carpul tunnel bilaterally, although my neuro told me all tests were normal. I further discovered upon examination of my records that my neuro has falsely reported neurological findings in my records. The man has not conducted a neurological exam on me in the past few years, yet reports in my records that he has. Other issues along those lines as well. It is possible that the CPS has progressed which could be contributing to the nerve pain. Either way, I clearly need a neuro that will "hear" that something has changed as well as worsened and someone needs to investigate it more thoroughly. This has progressed to the point that I cannot sustain gainful employment which infuriates me actually.

    I never had collar bone pain, but I can imagine it is off the scale painful - as is a fractured rib (did do that!)

    Amanda

    Last edited by Amanda55; 07-09-2007 at 03:54 AM.

     
    Old 07-17-2007, 08:52 PM   #10
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    Re: C3, C5 & C6 problems .....

    Hello Everyone ,
    I wasn't aware that there were posts/replies to my original post , technical glitch I suppose !

    Thank you all for sharing your experiences. I was able to compile enough data to send to MGH in Boston for review. The Tumor Board addressed the Meningioma only , which leaves all the spine related 'stuff' and symptons with no definitive answers, as this was outside their scope of expertise. I'm not sure what I need to do at this point. Would this be a spine specialist or a nuerologist that would address my questions or concerns ?

    Thank you again !

     
    Old 07-17-2007, 09:08 PM   #11
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    Re: C3, C5 & C6 problems .....

    Neck or C-spine falls under neurology. The rest of the spine I believe is orthopaedics but spine specialist should suffice.

    Actually if anyone knows of a good neuro surgeon in Central FL - please kick me a name. Looks like I now have moderate degeneration at C3-5 with severe degeneration at C5-6 - per x-ray. Hate to even wonder what MRI would show now. ( I am "firing" my neurologist - he should have listened)



    Quote:
    Originally Posted by beach117 View Post
    Hello Everyone ,
    I wasn't aware that there were posts/replies to my original post , technical glitch I suppose !

    Thank you all for sharing your experiences. I was able to compile enough data to send to MGH in Boston for review. The Tumor Board addressed the Meningioma only , which leaves all the spine related 'stuff' and symptons with no definitive answers, as this was outside their scope of expertise. I'm not sure what I need to do at this point. Would this be a spine specialist or a nuerologist that would address my questions or concerns ?

    Thank you again !

     
    Old 07-18-2007, 08:48 AM   #12
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    Re: C3, C5 & C6 problems .....

    I had neck surgery (ACDF c5-c7) in Jan. I used a orthopedic spinal surgeon. They DO do necks. I am real happy with the job he did. I am fully fused now.

     
    Old 07-18-2007, 12:51 PM   #13
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    Re: C3, C5 & C6 problems .....

    Keep in mind there is a big difference between Neurology and Neurosurgeon. Neurologists can diagnose and treat a variety of conditions but are not surgeons. I saw a Neurologist first who referred me on to a Neurosurgeon. I actually ended up later being referred to an Orthopedic Spine Surgeon who was amazing. So keep all your options open.
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    Old 07-18-2007, 09:15 PM   #14
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    Re: C3, C5 & C6 problems .....

    At what point do you know it's time for a nuerosurgeon (or spine/ortho surgeon) ?????? Is nerve damage (due to narrowing) reversable without surgical intervention ?

    Just curious ..... I would prefer to fix my neck (if possible) anyway I can avoiding surgery. I'm beginning to wonder if things have progressed to far for this to be an option

     
    Old 07-19-2007, 02:39 PM   #15
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    Re: C3, C5 & C6 problems .....

    The way I knew it was time for surgery was that I was seeing a PHYSIATRIST and he worked with me for about 6 months and told me I was at the end of the line and I needed to see a surgeon. I thought I would faint. Its weird, I had been in terrible pain for 5 years, saw every type of Dr. imaginable, had every procedure imagineable, but still it didnt occur to me that I would need surgery. I was very grateful that the physiatrist did refer me because the surgery did help me alot. Too bad I have another screwed up level that was not great before the surgery and is bothering me alot since I went on a trip and did the luggage thing.

     
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