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  • C4-5 protrusion abuts cord, C5-6 herniation L5-S1

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    Old 03-11-2014, 03:26 PM   #1
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    reingrua HB User
    Unhappy C4-5 protrusion abuts cord, C5-6 herniation L5-S1

    I have been through PT, chiropractic, acupuncture, homeopathy, and three Epidural Steroid Injections (in L5S1 only). I've been focussed on L5-S1 with neuro because that's the major pain generator right now. They are talking PLIF. Sent MRI report to Hospital of the University of Pennsylvania for a second opinion and I see them Thursday. They are concerned with the cervical issues. Chiropractor read MRI and thought "C4-C5 broad-based central disc protrusion which abuts the ventral surface of the cord" equates to necessary ACDF. Is this always the case? Are there any non-surgical solutions to this problem? I have pain through shoulder down arm, with some tingling. Hands tingle when I raise them over head to wash hair. Sometimes have numbness in the butt. Cannot sit for more than a few minutes. Any thoughts?

    40 year old Mom of three
    L5-S1 diffuse disc bulge with broad-based central disc protusion
    C4-5 broad-based central disc protrusion which abuts the ventral surface of the cord
    C5-6 central disc herniation with subarachnoid effacement only

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    Old 03-12-2014, 08:06 AM   #2
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    Re: C4-5 protrusion abuts cord, C5-6 herniation L5-S1

    Chiropractors know the spine - I'll give them that - but I wouldn't trust them to give me advice on surgical intervention. From the MRI quote it seems that the protrusion abuts the front of the spinal cord. Ventral is also used in terms of the root that exits the cord, a protrusion, or stenosis there, can be operated on with endoscopic foraminal surgery. You may want to clarify that with a surgeon. A ortho or neruo that specializes in the spine.

    Sometimes radiologists use terms interchangeably or in terms of severity. So abuts, seems to be a milder contact then compression but it might not be. If its the protrusion pressing against your cord, and it's been so over an extended period of time, and it's just that one level of concern - then an ACDF would be likely if surgery was performed. But the only two people can make that call are you and the surgeon. Good luck on your appointment. I recommend you get at least two opinions. I live outside of Philly and have been to numerous surgeons who were recommeded to me.

    Ive been told time and again that surgery is not a practice to relieve pain, it's not really to reverse nerve damage, and its to prevent future damage. Surgeons will discuss the risks involved, some to do with any surgery, some to do with damage, more pain, future surgeries from added pressure of the fusion etc

    I cannot speak to the Lumbar issues. But I know what you're talking about with arm/shoulder pain with numbness in the fingers. My doctor refers to certain positions as a double crush. In that there is already pressure on the nerve, so any additional pressure, no matter how slight, along the nerve path can cause this temporary numb/tingly sensation.

    Surgery can be great, it can be bad...but everyone will tell you it's a risk. Don't be surprised if surgeons want to wait and see how things progress before making any decisions. It will depend on myopathy, pain level, quality of life, ease of operation, potential future damage and lots of other things that you can discuss with a surgeon (not chiropractor).

    As a side note - be weary of chiropractors with cervical spine problems. They say and may well help the situation - but they may just as easily make things much worse. I have been to several of them - relief was short lived and I was told the risk is too high - but everyone is different. Just like all of this stuff we deal with proceed at your own risk.

    A disclaimer I have yet to have any spine surgery Im the common, gray area, wait and see patient

    Old 03-12-2014, 09:28 AM   #3
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    reingrua HB User
    Re: C4-5 protrusion abuts cord, C5-6 herniation L5-S1

    Thank you for your input. I am no longer seeking chiropractic care after reading about possible risks with cervical issue and certainly don't see him as an expert on this issue. I am hopeful to get some answers tomorrow.

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    acdf, plif

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