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  • surgery recommended

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    Old 07-25-2014, 05:05 PM   #1
    Ihaveneckpain
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    surgery recommended

    Does this sound like surgery is the only way to relief? There is no pain only numbness in some extremities.

    C2-C3: Disc osteophytic bulge and uncovertebral hypertrophy contribute to
    moderate central canal stenosis with flattening of the thecal sac/cord contour
    and moderate to severe bilateral neural foraminal stenosis.

    C3-C4: Disc osteophytic bulge and uncovertebral hypertrophy contribute to severe
    central canal stenosis with effacement of CSF and flattening of the cord, as
    well as severe bilateral neural foraminal stenosis. No definite intrasubstance
    cord signal abnormality appreciated.

    C4-C5: Disc osteophytic bulge, uncovertebral hypertrophy contribute to severe
    central canal stenosis with effacement of CSF and marked compression of the
    cord, as well as moderate right and severe left neural foraminal stenosis.
    Possible small focus of intrasubstance T2 signal abnormality in the cord.

     
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    Old 08-05-2014, 05:08 PM   #2
    ChuckStr
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    Re: surgery recommended

    If it were me (and it almost is, although my MRI is a little better than yours), I would consult at least a couple of qualified spine specialist surgeons. I would do it soon. The compression of your spinal cord is the most worrisome problem especially since there is some indication of spinal cord damage (possible small focus... T2 signal abnormality). Marked compression of the cord can cause a condition known as myelopathy (you can search for that). If you have numbness in your legs or feet in addition to your upper extremities you may already be suffering from early stages of that. Other symptoms include bowel/bladder issues, gait abnormality, incoordination etc.

    Surgery, in such cases, may be recommended urgently to relieve the compression on the cord and prevent further damage. Symptom relief is only a secondary goal in these cases although between 50-70% (in some studies) experience it. Occasionally, less aggressive therapies can be used (such as PT, traction etc) and can provide relief (as they have in my case), along with a "wait and see" approach looking for progression of myelopathic symptoms.

    In the end, the bony spurs that are causing impingement on your spinal cord and nerve roots aren't going to go away on their own. I'm not a Dr but given what I was told about my own condition (which is not as advanced as yours) it is quite possible spinal surgery may be required at some point.

    I would definitely follow up with some qualified spine surgeons. They can help you figure the best course of action now and later on as well. Let us know how it goes and Good Luck...

     
    Old 08-05-2014, 05:18 PM   #3
    Moonstar22
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    Re: surgery recommended

    Quote:
    Originally Posted by ChuckStr View Post
    If it were me (and it almost is, although my MRI is a little better than yours), I would consult at least a couple of qualified spine specialist surgeons. I would do it soon. The compression of your spinal cord is the most worrisome problem especially since there is some indication of spinal cord damage (possible small focus... T2 signal abnormality). Marked compression of the cord can cause a condition known as myelopathy (you can search for that). If you have numbness in your legs or feet in addition to your upper extremities you may already be suffering from early stages of that. Other symptoms include bowel/bladder issues, gait abnormality, incoordination etc.

    Surgery, in such cases, may be recommended urgently to relieve the compression on the cord and prevent further damage. Symptom relief is only a secondary goal in these cases although between 50-70% (in some studies) experience it. Occasionally, less aggressive therapies can be used (such as PT, traction etc) and can provide relief (as they have in my case), along with a "wait and see" approach looking for progression of myelopathic symptoms.

    In the end, the bony spurs that are causing impingement on your spinal cord and nerve roots aren't going to go away on their own. I'm not a Dr but given what I was told about my own condition (which is not as advanced as yours) it is quite possible spinal surgery may be required at some point.

    I would definitely follow up with some qualified spine surgeons. They can help you figure the best course of action now and later on as well. Let us know how it goes and Good Luck...

    ChuckStr, what does CSF mean in the results? I see that on mine and I don't know what that stands for???
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    Old 08-05-2014, 09:56 PM   #4
    littlebitlarisa
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    Re: surgery recommended

    Moonstar22 it is Cerebrospinal fluid. I actually have been dealing with a CSF leak the last couple days as a result of a spinal cord detethering I had about 2 weeks ago. Not sure what your MRI says about CSF but I have learned they do not want it to leak.

     
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    Old 08-05-2014, 10:58 PM   #5
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    Re: surgery recommended

    Yes, Cerebrospinal fluid. The way the radiologist wrote the finding is strange. There is a covering around the spinal cord called the thecal sac. The innermost layer of this contains the spinal cord with CSF surrounding it. Effacement of the CSF then means that something is pushing on the thecal sac enough to just touch the CSF. This is normally not a serious finding. In the next bit, the radiologist mentions "and marked compression of the cord". That can be a serious finding. Most radiologists use minimal, mild, moderate, severe but some replace severe by marked. So there is basically a finding of severe cord compression. That sounds bad, but it does depend on what marked means in this case. I've read that the cord needs to be compressed between 30 and 50% in order for myelopathy symptoms to show. This is why you need to get opinions of qualified surgeons as they can assess your symptoms in relation to the amount of compression on the MRI and then help plan an appropriate course of treatment. All of the surgeons I went to ignored the radiologist report (unless I brought it up), and did their own assessment.

     
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    Old 08-06-2014, 06:53 AM   #6
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    Re: surgery recommended

    Welcome to the board.

    In addition to the other comments, keep in mind that, in general, numbness is "worse" than pain because it indicates nerve compression that is more severe than if it is just causing irritation or pain.

     
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