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"Very large right paracentral disc herniation at C6-7"


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Old 09-22-2013, 10:46 PM   #1
seeseven
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"Very large right paracentral disc herniation at C6-7"

About two months ago, having dinner with friends, my arm started to get really sore. The next morning, I woke up and couldn't move it all. I've never felt so much pain in my life. It was as if my arm was on fire, radiating from my shoulder. I went to the ER the next day where they took X-rays, told me I have arthritis in my neck, gave me Norco and sent me on my way.

Fast forward two months. My pain is now fairly manageable, but I have lost feeling in my right index and middle fingers and part of my forearm is also numb. I've done PT and tried several medications which don't seem to work at all. I've been off work for nearly two months since typing (which I do *all* day) causes pain to shoot up my arm. My right triceps are also noticeably weak.

I finally got an MRI last week. Here's what it said:

"Very large right paracentral disc herniation at C6-7 with
inferior and superior migration spanning a distance of 2 cm
effacing the right lateral recess and indenting the right lateral
aspect of the cord at the level of C6-7 and causing severe
right-sided neural foraminal narrowing. Neurosurgical correlation
is strongly advised. Cord indentation is present at C4-5 and
C5-6. Bilateral neural foraminal narrowing is present at C5-6,
right greater than left."

I went to a physiatrist who said definitely surgery. He introduced me to a surgeon who suggested I wait two weeks to see if symptoms improve. So, I'm waiting. I was so scared by the radiologist's comment that "neurosurgical correlation
is strongly advised."

My real question is how to decide whether surgery is the way to go. I'm no longer curled up in a fetal position because of the pain, but my activity is certainly limited and I'm afraid if I don't get the ACDF that I will suffer further and permanent damage.

I would appreciate any stories or comments. Thank you so much.

 
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Old 09-23-2013, 02:40 PM   #2
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Re: "Very large right paracentral disc herniation at C6-7"

Your symptoms are certainly consistent with right C7 radiculopathy caused by a disk herniation pushing on the nerve.

I can't answer the question as to whether non-surgical means will somehow pull that herniation back in. Given that it's not only "very large" (a description, by the way, that I have never before seen a radiologist use) but is going UP 2mm and DOWN 2mm, I'm inclined to doubt it.

Sounds like you really blew out that disk. What did you do? Yoga position, perhaps?

If there's no non-surgical way to fix the disk, then removing it from in front (ACDF) would probably be what most surgeons suggest. If I were you, I'd ask if possibly a foraminotomy (a posterior approach that's less invasive - by a lot - than an ACDF) might clear out that C7 foramen. I kind of doubt it, but I'd ask.

I don't want to be alarmist, but I THINK it's possible for either the inferior or superior migration of that disk "stuff" (the soft filling of the disk that has herniated out) to break off inside your spinal canal. That would complicate matters. Of course, I'm just an amateur, so take that for what it's worth.

As for "how to decide", that's fairly straightforward. You need to see AT LEAST two surgeons. If their opinions are consistent - which would not surprise me - then there you have it.

Last edited by WebDozer; 09-23-2013 at 02:43 PM.

 
Old 09-23-2013, 03:00 PM   #3
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Re: "Very large right paracentral disc herniation at C6-7"

I'd better add that it's kind of odd that you have cord "indentation" at the two levels above the herniation. That sounds serious. The radiologist makes no mention of what's causing the indentation.

I would want to know what's indenting my cord at C4-5 and C5-6. Is it disk bulges, herniations or something else? My GUESS is that you have bulging disks there, but only the bulge at C6-7 herniated open, and the radiologist was so impressed by that herniation that he fell down a little in describing the problems at the next two levels up. I'd really want a good understanding of all that, because I now suspect that a surgeon suggesting an ACDF will want to do multiple levels.

I can't tell from your report, but there's a POSSIBILITY that you have a hereditarily too-narrow spinal canal. I'd ask about that, for sure, and also about the possibility of posterior decompressive surgery.

Last edited by WebDozer; 09-23-2013 at 03:02 PM.

 
Old 09-23-2013, 04:07 PM   #4
seeseven
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Re: "Very large right paracentral disc herniation at C6-7"

WebDozer, thank you so much for the information and suggestions. I'm working on getting at least a second, and possibly a third, opinion.

Now I know better what questions to ask. I was so blindsided by this whole thing and trying to learn about my condition and navigate the health system has been daunting. Is anyone every prepared for something like this?

I also have no idea what caused it. The last activity I had done prior to the searing pain was a three mile walk on a treadmill at a slow, very low impact pace and nothing felt out of place. It was a few hours later that my arm started getting sore and the next day that I thought my arm was going to explode. Given that I sit in front of a computer screen all day every day, that may have had something to do with it. But there was no single moment that I knew I had been injured. PT did say it's purely posture related.

Thanks again for your insight. I truly appreciate it.

 
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