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  • C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyte

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    Old 10-31-2013, 01:04 AM   #1
    hbhtwa1984
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    C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyte

    I have had a major problem with right neck and right arm bicep and tricep pain after prolonged session on commercial mower on very bumpy ground on Oct 13th.

    After mowing I had tingling sensation in both arms to tips of fingers. Overnight this tingling dissipated and I was left with severe right neck and right arm bicep and tricep pain. This continues right now as I type (with neck brace on).

    I can still only sleep on my back with my head supported by 2/3 pillows to moderate pain. Can't sleep on either side, stomach or flat (normal 1 pillow) without severe pain.

    I have no pain in my right arm, it is all in the left. C6-7 area is tender to touch.

    Went to Physiotheraphist on Oct 15th and subsequently daily treatment and that did very little good for 10 days. My Dr ordered and MRI and the results are posted below and put me on Diclofonac (3x50mg/day) and Endone (2x5mg/night) and Temazepam (2x5mg/night). Endone does little and I sleep very badly, more like I'm in a daze all night, so I'm really exhausted now after 2 weeks. For the next three days I will be trying a short course of Prednisilone to see if it helps.

    Have done some swimming laps with head down and goggles and flippers but it is very painful.

    Even doing MRI I was in agony due to not being able to support my head (raise it to a comfortable level same as I sleep).

    Got MRI results today and wondered what other readers have to say on this.

    I'm booked to see a Neurosurgeon in 10 days and am contemplating surgery.

    Anyone have similar issues and had surgery?

    You can see that there are problems for c3-4 through c6-7 but c5-6 is the worst.

    I'm 58 male 180cm 78kg in reasonable condition, exercise regularly and don't smoke. Drink in moderation.

    FINDINGS FROM MRI

    Findings: Normal craniocervical junction. Acceptable vertebral alignment. No bone pathOlogy.

    Normal cord signal.

    C2-3, normal.

    C3-4, mild central canal stenosis due to a broad disc/osteophyte complex. Minor right anterior cord flattening. Moderate right foramlnal stenosis due to a disc/osteophyte complex. Exiting right C4 nerve root is displaced. Left C4 nerve root exits freely.

    C4-5, mild central canal stenosis due to a broad disc/osteophyte complex. Mild right anterior cord flattening. Mild to moderate bilateral foramlnal narrowing due to uncovertebral osteophytes. This contacts but does not displace nor compress the exiting C5 nerve root.

    C5-6, moderate central canal stenosis due to a right paracentral disc herniation superimposed on a broad disc/osteophyte complex. Right hemicord is compressed. Severe bilateral foraminal narrowing due to disc and uncoverlebral osteophyte. Exiting C6 nerve root is likely compressed bilaterally.

    C6.7, moderate left foraminal narrowing due to disc and uncoverlebral osteophyte. These contacts but does not displace nor compress the exiting left C7 nerve root.

    C7T1, T1-2, normal.

    Conclusion; Multilevel degenerative changes as described, most severe at C5/6 with moderate central canal narrowing, right hemicord Impingement and severe bilateral C5/6 foraminal stenosis and probable bilateral C6 nerve root compression. No myelomalacia.
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    Old 10-31-2013, 10:37 AM   #2
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    Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    C5-6 the worst because you have a herniated disk there. It's lopsided to the right, though, so one might expect your right-side symptoms to be worse.

    Your vertebrae are laying on extra bone due to long-term stress (disk/osteophyte complexes) at multiple levels. It seems a little odd that your cord is slightly flattened by only "mild" canal stenosis. Could be that you start out with a cord that's narrower than normal, a rather common condition called hereditary (or developmental) canal stenosis. This means that otherwise harmless intrusions into the canal are able to reach the cord.

    I wonder why the neck pain came on so suddenly. I suppose it was the herniation. I wonder if they can tell if a herniation is new or old.

    Any symptoms in your thumbs? The C6 nerves go there, as well as triceps and maybe some biceps.

    I would not be surprised if a surgeon suggested a one-level ACDF to remove that herniated disk. I wouldn't be surprised, either, if he suggests waiting a bit or trying non-surgical options first.

    I strongly suggest you get at least two opinions, no matter what.

    Any questions on terminology, let me know...

     
    Old 11-03-2013, 03:44 AM   #3
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    Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    Quote:
    Originally Posted by WebDozer View Post
    C5-6 the worst because you have a herniated disk there. It's lopsided to the right, though, so one might expect your right-side symptoms to be worse.

    Your vertebrae are laying on extra bone due to long-term stress (disk/osteophyte complexes) at multiple levels. It seems a little odd that your cord is slightly flattened by only "mild" canal stenosis. Could be that you start out with a cord that's narrower than normal, a rather common condition called hereditary (or developmental) canal stenosis. This means that otherwise harmless intrusions into the canal are able to reach the cord.

    I wonder why the neck pain came on so suddenly. I suppose it was the herniation. I wonder if they can tell if a herniation is new or old.

    Any symptoms in your thumbs? The C6 nerves go there, as well as triceps and maybe some biceps.

    I would not be surprised if a surgeon suggested a one-level ACDF to remove that herniated disk. I wouldn't be surprised, either, if he suggests waiting a bit or trying non-surgical options first.

    I strongly suggest you get at least two opinions, no matter what.

    Any questions on terminology, let me know...
    Thanks for the feedback. Since my post I have just finished the 3 day Prednisilone oral course which has helped alleviate some of the pain.

    However, now for the first time I am getting tingling sensations in my left thumb and index finger which I never had before.

    Does this mean more of the disk herniation problems are starting to "surface" in the different C levels?

    Pain in the LHS shoulder, neck, triceps and biceps is still relatively constant and only numbed by the medications I am on. Great difficulty sleeping as the pain threshold is just high enough to make sleep very difficult.

     
    Old 11-03-2013, 11:20 AM   #4
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    Wink Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    <<However, now for the first time I am getting tingling sensations in my left thumb and index finger which I never had before.

    Does this mean more of the disk herniation problems are starting to "surface" in the different C levels?>>

    A herniation will not travel to a different level. Too far. Anyway, your thumb (and to a mixed extent, your index finger) are supplied by the C6 nerve, so it's still the C5-6 level.

    I hope it wasn't my asking the question that brought this on. How's your heart been recently? Do you ever get short of breath? Balance OK?

    Last edited by Administrator; 11-03-2013 at 02:36 PM.

     
    Old 11-05-2013, 11:45 PM   #5
    hbhtwa1984
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    Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    "How's your heart been recently? Do you ever get short of breath? Balance OK?"
    Thats all fine thanks and no it wasn't your post.

    Today I have just had a meeting with a Neurosurgeon and the surgeon suggested a one-level ACDF to remove that herniated disk as you thought.

    To be fair, there was no pressure on the surgeon part for surgery. The surgeon looked at the MRI's and pointed out where the problems were for me. It was quite easy to see the problem at c5-6.

    The surgeon said in my case he would not not use a plate with screws to hold the artificial bone graft in as "they have fewer problems". Any feedback on the use of a plate and screws or not?
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    Old 11-11-2013, 05:29 AM   #6
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    Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    Gee... I've heard of not using a plate but don't understand how it would work and why it might be better. When I had an ACDF many years ago, the doc said I didn't have to wear a collar AT ALL, "because the plate is holding it all together". If you don't use a plate, then wouldn't you have to be in a hard collar for months?

     
    Old 11-11-2013, 08:18 PM   #7
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    Re: C5-6 Severe bilateral foraminal narrowing due to disc and uncovertebral osteophyt

    Quote:
    Originally Posted by hbhtwa1984 View Post

    The surgeon said in my case he would not not use a plate with screws to hold the artificial bone graft in as "they have fewer problems". Any feedback on the use of a plate and screws or not?
    How does he plan on keeping it still while it's healing? Unless he plans on making you wear a collar it doesn't make any sense not to put screws and a plate in to stabilize the area while you're healing.

     
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