[BetsyAnn]

I was here briefly back in January, but I haven't been very active in this forum at all. However, I am now facing the fact that my neck isn't going to magically improve if I just wait it out, so I'm looking for the best route to go now.

I had a fusion of C5-C6 back in 2005 for a herniation and bone spur causing symptoms on my right arm. Now it's the left side causing me problems haha.

C2-3: No significant bulge, yada yada.

C3-4: Mild annular fissuring with a minimal paracentral bulge. There is some additional uncovertebral osteoarthritic changes. These, however, are only associated with minimal neural foraminal narrowing and canal effacement.

C4-5: There is an annular tear with a broad-based bulge projecting greater toward the left neural foramen. This is associated with a moderate-to-severe left foraminal narrowing, mild on the right. The central canal is effaced.

C5-6: This level is fused. There is residual disc osteophyte complex. This, however, is only associated with minimal neural foraminal narrowing and canal effacement.

C6-7: There is an annual fissuring with a paracentral bulge. This effaces the thecal sac. Additional disc osteophyte complex formation and uncovertebral osteoarthritic changes are noted. These contribute to a moderate right and moderate left neural foraminal narrowing but with only a mild canal effacement.

C7-T1- No significant bulge, narrowing, etc.

also, there is reversal of the normal cervical lordosis BUT I am pretty sure that's a long standing thing, noticed even before I had issues at C5-C6. This report suggests it could be due to muscle spasm, hard to say, my neck always has some spasm going it seems

I am being referred back to my original neurosurgeon, hoping for a non-surgical approach. I do have pain, but more of issue to me is the heavy aching I get in my arm, the feeling of fatigue and the 'hesitation' I get with fine motor tasks such as typing (lots of typos now) and taking the lid off my razor, etc. Will injections, PT, etc help to relieve the pressure on the nerves caused by the herniations?

Btw, I am a 41 y/o female I do have some other neuropathy type issues.

[Leesa]

Let's see if I can help ~

C3-4 Mild annular fissure with small paracentral bulge. Osteoarthritis changes. Minimal foraminal narrowing & canal effacement. The annular has a slit in it - the annula is a fluid filled sac that the disc sits in, and it's filled with fluid. When that fluid seeps out onto the nerves it's PAINFUL. The foramen are the holes that the nerves pass thru to get to the spinal cord -- yours are mildly narrowing.

C4-5 Annular tear (same as fissure, basically) with broad based disc bulge projecting toward left neural foramen. This is associated with moderate to SEVERE left foraminal narrowing, mild on the right. (see above) The central canal is effaced. By "effaced" they mean the central canal could not be seen due to above.

C5-6 Fused area. There are residual bone spurs. Minimal foraminal narrowing & canal effacement. (see above)

C6-7 Annular fissure with paracentral bulge. This effaces the thecal sac. The thecal sac is a membrane of dura matter that surrounds the spinal cord and cauda equina. The sac is filled with cerebral spinal fluid. Additional bone spur formation and osteoarthritic changes noted. These contribute to moderate right & left neural foraminal narrowing (see above) & mild canal effacement. (see above)

As to the Lordosis, you may be correct in that it could be due to muscle spasm.

I'm no doctor, but I really do NOT see this as being a surgical event at this time. I AM glad you're being sent to a Neurosurgeon. The only thing I'm a bit concerned about is at C4-5 and that is the moderate to SEVERE foraminal foraminal narrowing on the left. But this may not have to be corrected at this time. Your Neuro will be able to tell you. PLEASE let us know what he says, will you? PLEASE???

Do you have an appointment yet? If so, when is it? Let us know when you go, okay? God bless and please take care BetsyAnn! Hope to hear from you soon! Hugs, Lee

[BetsyAnn]

Thanks so much for your time to reply I was having a difficult time figuring out what effacement meant.

I will certainly keep you posted, I just saw my PCP and got the results yesterday. She had suggested calling the NS when the results first came in but I sort of freaked out and said I wanted to wait until I could talk to her (PCP) and see them myself.

Back when I had my first surgery I was a bit younger, 33, and more irritated by the way the symptoms of my right hand were constantly interfering with my life. The NS did the traction trial but overall it seemed he was preparing to do surgery from the get go. I was excited to be magically 'fixed' and it did work out well for the most part.

I'm just older and more leery now :lol Even though (can't remember for sure) my symptoms and neck seem worse now, I really don't want to jump into an OR. But I've never really spent much time looking at other options. I'm more concerned about the weakness and lack of 'control' I'm getting in my left arm.

I'll definitely let you know when I have my appt. scheduled. I'm supposed to get a disc of the MRI images to take to the NS, so maybe I'll even get a chance to copy them to my comp mwahaha.

[Leesa]

Betsy, don't take just ONE Neuro's opinion, okay? You've GOT to have at least 3 opinions before you opt for surgery! As you know, this is a life changing event!

And you may have just been lucky the first time around, because surgery is NOT for pain. Surgery is only for mechanical problems. usually you're left with the same pain or worse! And not only that, but you have to figure on the "Domino Effect" where the levels above/below the surgery site fail. This happens all the time.

So make sure you get more than one opinion, okay? Hugs, Lee

[ginnie]

Lessa is spot on about your spine. I have an additional observation. Your origional fusion is C5-6, now the one above and below are having some trouble. Make sure you go to a neuro surgeon, not assiciated with the doctor who did your first fusion. This is a good thing to do, when getting that second opinion. Also the verterbre that said Severe, would be the first thing I brought up to the doctor. Bring someone with you, and keep your pain journal. This helps the doctor, and backs up what you are saying concerning your pain.
I don't know if this is something surgery could correct. Make it your last option when all other conservative measures fail. The domino effect can get to be a big issue with repeat fusions. That is where the ones above and below the fusion site, do not hold up due to the hardware, or condition of the verterbre. I sure wish you all the best as you go forward in this. None of it is fun. I hope you find that second opinion, and a doctor who has some compassion. ginnie

[BetsyAnn]

Thank-you both I was pretty sure my left side was problematic, going by symptoms. I am definitely going to be cautious, more-so this time around. I faintly remember hearing that the discs above and below the surgical site would have more strain on them, but back then I tossed that thought aside. Now I know from experience. I did NOT think it would go bad this quickly, it's not like I do a lot of jarring physical activity. I definitely don't want to repeat this scenario, so surgery is MY last choice, for sure.


I also have a neurologist now, as I have some sort of neuropathy/abnormal EMG/NCVs/etc. So I'll be getting the report to him as well to see if he has any input.

[ginnie]

How long was it between your first fusion, and the trouble you are having now.? I waited 5 years between my surgeries, though I was having trouble before that time. ginnie

[BetsyAnn]

Originally Posted by ginnie

How long was it between your first fusion, and the trouble you are having now.? I waited 5 years between my surgeries, though I was having trouble before that time. ginnie

Hmmm, I'm not really sure. It's been 8 years since my surgery, but this area has been giving me problems for a while. It's hard to say b/c it flares up for a few weeks/months, and then dies down, and I can't always tell if it it's neuropathy or neck issues. The worst ever was this January-March, though. I got hit by a car while riding my bike back in Sept, not sure if that impacted it or not. I felt fine after the accident, just some stiffness in my neck, my xrays were clear taken that day.

[Dubious]

Originally Posted by BetsyAnn

I was here briefly back in January, but I haven't been very active in this forum at all. However, I am now facing the fact that my neck isn't going to magically improve if I just wait it out, so I'm looking for the best route to go now.

I had a fusion of C5-C6 back in 2005 for a herniation and bone spur causing symptoms on my right arm. Now it's the left side causing me problems haha.

C2-3: No significant bulge, yada yada.

C3-4: Mild annular fissuring with a minimal paracentral bulge. There is some additional uncovertebral osteoarthritic changes. These, however, are only associated with minimal neural foraminal narrowing and canal effacement.

C4-5: There is an annular tear with a broad-based bulge projecting greater toward the left neural foramen. This is associated with a moderate-to-severe left foraminal narrowing, mild on the right. The central canal is effaced.

C5-6: This level is fused. There is residual disc osteophyte complex. This, however, is only associated with minimal neural foraminal narrowing and canal effacement.

C6-7: There is an annual fissuring with a paracentral bulge. This effaces the thecal sac. Additional disc osteophyte complex formation and uncovertebral osteoarthritic changes are noted. These contribute to a moderate right and moderate left neural foraminal narrowing but with only a mild canal effacement.

C7-T1- No significant bulge, narrowing, etc.

also, there is reversal of the normal cervical lordosis BUT I am pretty sure that's a long standing thing, noticed even before I had issues at C5-C6. This report suggests it could be due to muscle spasm, hard to say, my neck always has some spasm going it seems

I am being referred back to my original neurosurgeon, hoping for a non-surgical approach. I do have pain, but more of issue to me is the heavy aching I get in my arm, the feeling of fatigue and the 'hesitation' I get with fine motor tasks such as typing (lots of typos now) and taking the lid off my razor, etc. Will injections, PT, etc help to relieve the pressure on the nerves caused by the herniations?

Btw, I am a 41 y/o female I do have some other neuropathy type issues.

Hi Betsy,

Sorry to hear of your issues. At least you seemingly had almost 8 years of right-sided relief, right? Anyway, your C4-5 problems are significantly more problematic on the left than anything going on at C6-7 on diagnostic imaging (MRI). But....

Fortunately, MRI's make more sense when they are ordered to verify exact clinical ortho/neuro findings and historical information, for which there is almost none provided in your post (it puts the cart before the horse). So the answer to your left upper extremity issues is it is either coming from the C4-5 level (probably), the C6-7 level (maybe), both (possibly) or neither (doubtful) depending upon your clinical exam and history (you need to talk to the doc that ordered the MRI!). The MRI needs to be correlated to your subjective complaints and exam findings, not the other way around. Good luck!

[BetsyAnn]

Originally Posted by Dubious

Hi Betsy,

Sorry to hear of your issues. At least you seemingly had almost 8 years of right-sided relief, right? Anyway, your C4-5 problems are significantly more problematic on the left than anything going on at C6-7 on diagnostic imaging (MRI). But....

Fortunately, MRI's make more sense when they are ordered to verify exact clinical ortho/neuro findings and historical information, for which there is almost none provided in your post (it puts the cart before the horse). So the answer to your left upper extremity issues is it is either coming from the C4-5 level (probably), the C6-7 level (maybe), both (possibly) or neither (doubtful) depending upon your clinical exam and history (you need to talk to the doc that ordered the MRI!). The MRI needs to be correlated to your subjective complaints and exam findings, not the other way around. Good luck!

sorry, I'm quite a rambler, and I also tend to think people can see inside my head so I often leave tidbits out.

As for my right side, I was mostly having what could be 'carpal tunnel' type symptoms, had CT surgery (after NCV showed slow conduction), still had issues but a lot of it was in my forearm, just strange jumping around nerve pains and I guess pressure palsy type symptoms. MRI done then, showed osteocyte and pressure on right nerve root at C5-6, so I jumped into surgery. A lot of the symptoms were relieved, but I still have problems with that arm, mostly still in the CT region ie. can't use a mouse, nerves are easily irritated with chopping veggies, vacuum, etc.

I began having issues in my left arm/hand quite a while back, thought it was b/c I was compensating for my right arm (I am right handed) doing most computer navigating w/my left hand. Began having similar issues such as CT like symptoms, nerve pains, iciness, tingles, etc. when arm is lying on armrest, typing, etc. I am NOT on the computer all day, I am a SAHM, not an office worker. IMO I should not have issues like this. If anything I feel like I baby my arms too much, trying to avoid known irritating movements, positions, etc.

I do also have neck pain almost all the time, but it isn't in a constant place, sometimes left (mostly) sometimes right, usually upper scapula region, but a lot more in the front/scalene area (SUPER sore) on the left side. Jan-March of this year I dealt with a constant feeling of my neck being squeezed, but that has eased up. I have a very sore spot at the front of my left shoulder, my left lateral chest is sore and sometimes burns. I have a very tender strip of nerve/muscle going down my lateral bicep and I get twitches in my elbow (forget what the nerve tunnel is, but in there). The muscle as it comes down my forearm, just past the origin from the elbow is quite sore and for a while in March it would make me yelp to touch it. But I worked on it to slowly relieve some of the tightness and it's not so bad now.

I am having some lack of 'control' in my left hand, I don't know how else to describe it. I can do things, but I have think harder about them and move more slowly. I do feel like it's weaker, the whole arm feels fatigued a lot.

I feel as if the worst of my arm/shoulder symptoms occur when I am relying on my shoulder to support the weight/stability of my arm such as when typing (as I do this I am getting tingles in my elbow, chest, my shoulder is aching). So yes, I do feel that the C4-5 correlates. I try to rest my arm on an armrest to take pressure off the shoulder/neck muscles, but then I get pressure palsy type symptoms, or the armrest isn't EXACTLY the right height and on and on. It's a constant balancing act of avoiding pain and getting stuff done.

My question was whether or not injections/PT can help relieve pressure on the nerve. I have really only the experience of surgery. I do not want surgery again. I thought injections would relieve pain, but I am more concerned about the fatigue and motor skills. My doc said injections could reduce swelling, which I assume COULD help on all symptoms. I want to do my best to prevent further/permanent nerve damage. I'm also not really keen on sticking needles in my neck, especially b/c some days I have rather mild symptoms. It's only on the bad days that I want to rip my neck off

I guess I was just surprised at the MRI b/c I have had so many different nerve symptoms bouncing around all over my body, I didn't really expect my neck to be much worse off than the MRI I had 2 years ago (some bulging, no major issues, even in C4-5)