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-   -   C-7.. C-5,6 Aborted nerve block , epidural instead (https://www.healthboards.com/boards/spinal-cord-disorders/881439-c-7-c-5-6-aborted-nerve-block-epidural-instead.html)

Pwalla57 12-11-2011 10:04 PM

C-5,6 stenosis, bonespur hitting nerve,C-7 spine slipped
 
I have C-5,6 foraminal narrowing due to a bone spur hitting a nerve and spondylosis and I also have several millimeters of spine slippage on c-7 anterolisthesis(catalyst was doing the butterfly stroke). I have been in excruciating pain since July 2011. 19 pt appts with no help. On disability and within an hour of waking up, I'm in pain again.
I just had an epidural on C5,6,7 T1,2
This was suppose to be a diagnostic selective nerve block on c-7 ordered by my NS,but could not be done because of pathology in the way(maybe my spine that slipped?). Epidural was Thursday still in pain as expected. Today is Tuesday , no change in pain.
Feeling discouraged because of getting the epidural instead of selective nerve block. I feel like I have a bandaid over my whole problem now. Any comments please?

jennybyc 12-14-2011 10:14 AM

Re: C-7.. C-5,6 Aborted nerve block , epidural instead
 
Epidural injections can be of either type...an anesthetic to numb the area and see if they found the right problem or a shot of cortisone to calm the existing inflammation. Both types can be done through the epidural catheter that is placed in the epidural space and moved from level to level.

I guess for some reason the doc decided to use the steroid instead of the anesthetic but why I don't know. But sometimes, no matter what they do, it doesn't work and that is usually when they start to talk about the need for surgery.

Do you have an MRI report you can post so those of us that understand them can see it and give you more advice and support?

Sorry you hurt so badly but trust me, we understand it here.

Jenny(fused C3 to T1)

WebDozer 12-14-2011 10:56 AM

Re: C-5,6 stenosis, bonespur hitting nerve,C-7 spine slipped
 
I second what Jenny said about posting the radiologist's report. Also, it's important the you describe, in the best detail you can, ALL symptoms, including those you might not classify as painful.

It would seem that you somehow got shunted off into the "anything but surgery" path. Was that just because of the doc you went to, or was that your preference?

Pwalla57 12-14-2011 05:38 PM

Re: C-5,6 stenosis, bonespur hitting nerve,C-7 spine slipped
 
Here's my MRI. Thank you for your comments.
Day 6 after corticosteroid epidural.. No relief from pain.
I will be seeing my NS on Monday (today is Wednesday)and see what he says about the pain doctors not following his directions. Believe it or not this is a very famous institution that I'm going to.
MR SPINE CERVICAL WITHOUT CONTRAST (72141) : 08/05/2011

MRI OF THE CERVICAL SPINE 08/05/2011:

CLINICAL HISTORY: 54-YEAR-OLD FEMALE WITH SEVERE RIGHT-SIDED
RADICULAR PAIN.

COMPARISON STUDY: NONE.

TECHNIQUE: Using a 1.5 Tesla MRI scanner, multiple imaging planes
and sequences are obtained.

FINDINGS: There is 2 mm of anterior spondylolisthesis of C7 on
T1. The remaining cervical alignment is normal. There is loss
of normal cervical lordosis. There is no evidence of an acute
fracture. There are endplate degenerative changes at the C5-6,
C6-7 and T2-T3 levels. The posterior fossa and craniocervical
junction are unremarkable. The prevertebral soft tissues are
unremarkable. The cervical spinal cord is normal in size, shape
and signal intensity.

C2-3: There is no disc bulge or protrusion. There is no spinal
canal or neuroforaminal narrowing.

C3-4: There is no disc bulge or protrusion. There is no spinal
canal narrowing. There is mild right facet and uncovertebral
hypertrophy with mild right neuroforaminal narrowing.

C4-5: There is no disc bulge or protrusion. There is no spinal
canal or neuroforaminal narrowing.

C5-6: There is disc degeneration with loss of disc height,
endplate degenerative changes and marginal spurs. There is a
small posterior disc osteophyte complex. There is mild
ligamentum flavum hypertrophy. There is moderate spinal canal
stenosis measuring 7 mm in AP diameter with near complete
effacement of the cerebrospinal fluid surrounding the cord
without cord compression or edema. There is bilateral facet
hypertrophy. There is a 5 mm perineural cyst in the right
neuroforamen. There is moderate left neuroforaminal narrowing.
There is mild right neuroforaminal narrowing.

C6-7: There is disc degeneration with endplate degenerative
changes and small marginal spurs. There is a small posterior
disc osteophyte complex and bilateral facet hypertrophy. There
is mild spinal canal narrowing measuring 9 mm in AP diameter
without cord compression. There is a bilobed 7 mm perineural
cyst in the right neuroforamen. There is no neuroforaminal
narrowing.

C7-T1: There is no disc bulge or protrusion. There is disc
degeneration with uncovering of the disc. There is an 8 mm
perineural cyst in the right neuroforamen. There is no spinal
canal or neuroforaminal narrowing.

IMPRESSION:

Moderate C5-6 spondylosis and mild ligamentum flavum hypertrophy
causing moderate spinal canal stenosis without cord compression
or edema. Moderate left and mild right C5-6 neuroforaminal
narrowing.

Mild C6-7 spondylosis with mild spinal canal stenosis.


WebDozer 12-14-2011 06:06 PM

Re: C-7.. C-5,6 Aborted nerve block , epidural instead
 
Pwalla - thanks for taking the time to transcribe. There certainly isn't anything in the radiologist's report that explicitly indicates a reason for pain, at least, NOT THE WAY HE DESCRIBES IT. That's the concern I would have, that his description is off. Narrowing of the spinal canal is not good, but it should be asymptomatic as long as the cord itself is not affected. The cysts are a potential problem, but should be asymptomatic if the nerve roots are unaffected.

Still, you have cysts of significant size at three levels on the right side, and you have right side radicular pain. Given the absence of any other apparent causes for the pain, I'd REALLY want to know more about those cysts.

It's interesting that the report specifies "right sided radicular pain", and then doesn't find a cause.

The 2m anterior spondylolisthesis of C7 on T1 means that the C7 vertebra is displaced forward 2mm (1/12 inch) over the T1 vertebra. Seems to go together with the loss of lordosis (backward curve), but doesn't seem like it should cause much trouble, in and of itself. The source of the trouble is likely a little higher up.

I will be interested to see what Jenny has to say about the cysts...

Pwalla57 12-14-2011 09:42 PM

Re: C-7.. C-5,6 Aborted nerve block , epidural instead
 
Yes two Neurosurgeons said the cysts are nothing. They are not concerned about those at all. I am really anxious to see my NS Monday and see what he says. Still in bad pain tonight. Ugh! Taking 800mg of ibuprofen and 600 mg of neurontin... Only takes the edge off.

jennybyc 12-15-2011 12:34 PM

Re: C-7.. C-5,6 Aborted nerve block , epidural instead
 
How did you know, Web? Yup, I've had cysts too but mine have all been lumbar. But I see it a little differently.

The cysts may be causing the pain as they do exert some pressure but to the surgeons, they are insignificant.....not something they would operate for. They tend to form and then grow and then disappear. Doesn't mean they don't cause problems and pain but they will go away by themselves with time.

Just so you know Pwalla, radiologists use the words Minimal, Mild, Moderate and Severe to rate the amount of compression or blockage in the spine. Spine docs rarely operate until you hit the "severe" level as surgery alone carries all sorts of risks. I was telling a friend just yesterday that many docs will not operate because of pain(some will)because a painful nerve is an alive and kicking nerve to them. They wait for symptoms of numbness and dysfunction when a nerve is in danger of dying to finally operate, as simply put, surgery can paralyze you too. So you may be in that stage where pain is maximal but you're just a hair away from needing surgery.

But when you see the neurosurgeon, you might want to look into non-fusion surgery to open the spinal canal at C5-6 where you have the most problems. Web and I have both had a laminoplasty where they go in from the back and remove, re-shape and replace the bone over the back of the spine to double the amount of room for the spinal cord. They can open the holes for the spinal nerves at the same time. No fusion is done and that is good as the problems just begin when you have a fusion. You might be a good candidate for this type of surgery. What do you think Webdozer?

But talk to the neurosurgeon and see what he suggests. And just to let you know, my epidural KILLED! And they never injected anything at all.....just no room for anything including the catheter they put in there. So when it's tight, even a cortisone shot can hurt like heck as there just isn't enough room for anything extra. As if gets absorbed, it will get better.

Jen

WebDozer 12-15-2011 12:59 PM

Re: C-7.. C-5,6 Aborted nerve block , epidural instead
 
The C5-6 level would be a candidate for laminoplasty, because you have two "small" problems, one coming from in front and one from behind. But that's only true for one level. Not saying a laminoplasty wouldn't help, but that a surgeon is unlikely to suggest it.

Of course, a surgeon just possibly might fool me, so why not ask?


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