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  • Help Understanding Extent of Cervical Stenosis

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    Old 01-25-2015, 11:59 AM   #1
    vedic134
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    Help Understanding Extent of Cervical Stenosis

    I have yet to meet with a neurosurgeon in regards to my cervical stenosis. This appointment is soon.

    I am a 38 year old male. No injury, accident caused this. I believe it is because I have been sitting at a desk for the last 14 years as a software engineer. My pain level continues to rise. My symptoms now include odd feelings such as my hand involuntarily grasping things or not being able to type efficiently (fingers weren't where I thought them to be). Weakness in upper body, less so below the waist but do have off-balance moments.

    A year ago it was discovered (due to pain in my right arm and hand) that I had mild to moderate cervical stenosis. A year later it is now moderate and severe.

    My doctor has put me on pain medication and I have since lost the ability to work. Now, after a few weeks, I am almost bedridden as the only comfortable position is on my back. I have had some in my family tell me that this is nonsense and that I should not be in as much pain as I'm in. I am also not sure if disc bulging means herniated. I'm quite new to all this. What I'm asking is, in general, is the findings below serious?

    Here is the results of the latest:

    Powerscribe Read
    CLINICAL HISTORY: RADICULOPATHY. Neck pain as well as right shoulder and arm pain.

    COMPARISON: None

    FINDINGS: The posterior fossa unremarkable with no Chiari malformation. Cervical and upper thoracic cord normal in size with normal signal throughout. No syrinx. The vertebral bodies are normal in height. There is edematous degenerative endplate change abutting the the C5-6 disk interspace and to a lesser extent C6-7 disk interspace to the right of midline. Signal intensity within the visualized skeletal structures otherwise normal.

    C5-6: Broad-based disk bulge and asymmetric uncovertebral osteophytes worse on right than the left. Minimal effacement of the thecal sac anteriorly. Moderate to severe narrowing right-sided neural foramina. Only mild mass effect right lateral recess. This could potentially affect the right C6 nerve root.

    C6-7: Less severe disk bulge and uncovertebral osteophytes are present, but there still appears to be severe narrowing of the right-sided neural foramina which could affect the right C7 nerve root. The remaining disk interspace levels unremarkable with no impingement.

    IMPRESSION: Asymmetric uncovertebral osteophytes and disc bulging on the right at C5-6 and C6-7 with moderate to severe narrowing right-sided neural foramina C5-6 and severe narrowing right-sided neural foramina at C6-7. This could potentially affect the right C6 and C7 nerve roots. Severe degenerative endplate change at C5-6 and minimally at C6-7. Exam otherwise negative.

    Last edited by vedic134; 01-25-2015 at 12:26 PM. Reason: Addt'l info

     
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    Old 01-25-2015, 12:56 PM   #2
    Titchou
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    Re: Help Understanding Extent of Cervical Stenosis

    You should definitely be seeing a neurosurgeon. My sister had a herniated/bulging disc and stenosis. She finally had a laminectomy a little over a year ago. She said if she had known it would be so easy, she would have had it done sooner. Am sure you can find some relief.

     
    Old 01-25-2015, 12:59 PM   #3
    vedic134
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    Re: Help Understanding Extent of Cervical Stenosis

    My issue is made worse in that i have lost everything. insurance, home. Staying with what was supposed to be a friend who now obviously wants me out.

     
    Old 01-25-2015, 01:03 PM   #4
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    Re: Help Understanding Extent of Cervical Stenosis

    So sorry you weren;t sent to a neuro sooner. The stenosis could be congenital as well...and the sitting - probably with bad posture - could have caused the remainder.

     
    Old 01-25-2015, 10:48 PM   #5
    ChuckStr
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    Re: Help Understanding Extent of Cervical Stenosis

    I don't know if there have been studies on this but I have also been a software engineer for the past 25 years and have significant spine issues. Posture is a huge issue for us.

    In general, DDD - degenerative disk disease is where the discs start to lose water and shrink which can cause them to herniate (move from between the vertebrae), and can also cause various of the vertebral structures to rub on each other causing bone spurs or osteophytes. The discs or the osteophytes can move/grow into either the space behind the vertebrae where the spinal cord resides, or into one or both of the exit holes for the nerve roots (foramen) at each spinal level. Both of these situations are called stenosis, when crowding the spinal cord it's called central canal stenosis and when crowding the nerve root exits it's called neuroforaminal stenosis. The distinction is important as the symptoms, clinical course and prognosis can vary significantly between the two conditions.

    The good news is that you have pretty minimal central canal stenosis according to the report. The only mention is minimal effacement of the thecal sac at C5/C6. The thecal sac contains spinal fluid and the spinal cord. This is unlikely to cause any of your current symptoms as there is no sign of compression on the cord.

    You do have quite significant neuroforaminal stenosis at C5/C6 and C6/C7. The disk bulges and bone spurs at c5/c6 and c6/c7 are severely narrowing the space for the right nerve root at both levels resulting in likely compression on the nerves. This could cause severe pain, numbness/tingling and potentially weakness along your right shoulder, arm and hand. Weakness indicates a more severe, possibly longer term compression that is more likely to result in longer term issues. These type of radiating issues are known as radiculopathy.

    Symptoms of radiculopathy will usually subside over a period of months with conservative treatment such as PT, traction, and steroids. Even if that is the case, the underlying pathology of bone-spurs won't go away so it is possible that your symptoms will recur. If at all possible, it would be good to get under the care of a spine specialist, that is either a neurosurgeon or orthopedic surgeon with specialized spine training that limits their practice to spine issues only. They will be able to monitor your progress and recommend appropriate treatment. If you can't do that, getting under the care of a good PT will probably be helpful.

    Good luck and let us know how you get on...

     
    Old 01-26-2015, 06:56 AM   #6
    anna10018
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    Re: Help Understanding Extent of Cervical Stenosis

    I just had my second surgery form the syrinx I also have chiari malformation im now 4mo po and now having the spasms in my legs, arms face under cheek bones and the mid back area having a syrinx is very pain especially if it is an active syrinx! I understand what you are going through I hope that things settle down but with this there is always a possibility that there also can be a reoccurrence as well which after surgery so I knw I must be careful of not falling it scares me.

     
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    Old 01-26-2015, 11:08 AM   #7
    ChuckStr
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    Re: Help Understanding Extent of Cervical Stenosis

    The op vedic134 doesn't have a syrinx according to the MRI report.

     
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    back pain, cervical stenosis, pain, radiculopathy



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