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Old 03-16-2014, 10:09 AM #1
OverMyNeck OverMyNeck is offline
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Default CT Results + Pic & MRI Results - Thoughts & Interpretation Appreciated

Hello,
I am a frustrated almost 40 year old male. For around 10 years I have been taking a lot of Advil (600mg - 1800mg) per day for neck discomfort. Over the last 10 years it has been increasingly worse. I got a CT that revealed osteophites 9 years back. I went to a spine doc that told me my "posture was to good" and take these muscle relaxers for 10 days and I will be better, that was 9 years ago. Basically, dismissed me.
Fast forward 18 months ago I got another CT and went to a Neurosurgeon and he showed me scans and my bone spurs. He prescribed 800mg ibuprofen 2x per day. Let's just say he's not someone I would go back to, he looked and smelled like he just got off a bender...
Since then in the last 8 months I have had 4 separate instances where I could not move in certain directions without excruciating pain sending me to floor and my neck being stuck to right for a few days. I looked up slipped disc and my symptoms fit description exactly.
My General Physician ordered a CT of neck & shoulder and referred me to an Ortho. Here's a pic and results of CT (I am no longer "stuck" like this):


* * *Final Report* * *

DATE OF EXAM: Feb 6 2014 2:13PM

AFX 1358 - XR CERVICAL AP/LAT/OBL

PROCEDURE REASON: pain
* * * Physician Interpretation * * *

HISTORY: pain
TECHNIQUE: Cervical spine 4 views. Left shoulder 2 views
COMPARISON: Cervical spine, 8/13/12
RESULT:Counting reference: Craniocervical junction. C6-7 disc space is
diffusely narrowed with small posterior osteophytes bilaterally
encroaching on the neural foramina slightly more prominently on the left.
This is relatively unchanged in comparison with the previous examination
of 8/13/12.
Normal internal and external rotation with normal glenohumeral
alignment and joint space. .
IMPRESSION: SPONDYLOSIS C6-7 WITH SMALL POSTERIOR OSTEOPHYTES, WITHOUT
SIGNIFICANT CHANGE IN COMPARISON WITH THE EXAMINATION OF 18 MONTHS AGO.

THIS is where things get interesting for me. I go to Ortho he gets me off ibuprofen for something easier on the stomach and some muscle relaxers for spasms. Orders physical therapy. By the time I go to my three week follow up with him my thumb is numb from the knuckle area forward and if I move my neck in a certain direction it sends tingling down the back of my arm into the middle finger area. I am still like this, now 8 days in since I noticed. He ordered an MRI, these are the results:

* * *Final Report* * *

DATE OF EXAM: Mar 12 2014 6:17PM

AFM 0482 - MRI CERVICAL SPINE WO CONTRAST

PROCEDURE REASON: Degeneration of cervical intervertebral disc
* * * Physician Interpretation * * *

MRI CERVICAL SPINE WO CONTRAST

HISTORY: Neck pain.

COMPARISON: Comparison examination from 09/09/2005 is not available but
was reported as normal.

EXAMINATION: Routine cervical spine MR protocol without gadolinium.

CERVICAL RESULT:

Counting reference: Craniocervical junction.

Alignment: History of a normal cervical doses. There is mild loss of
disc height at C5-C6 and C6-C7 reflecting degeneration.

Craniocervical junction: Craniocervical junction is normal.

Cord: The visualized cord is within normal limits of signal intensity
and morphology.

Bone marrow signal/fracture: No evidence of pathologic marrow
infiltration. No evidence of prior fracture.

Cervical soft tissues: The paraspinal soft tissues are within normal
limits.

C2-C3: Canal and foramina are patent.

C3-C4: Canal and foramina are patent.

C4-C5: Canal and foramina are patent.

C5-C6: Bulge cause mild narrowing of the spinal canal. Right neural
foramen is patent. Mild left neural foraminal stenosis due to
uncovertebral joint hypertrophy.

C6-C7: Bulge cause mild narrowing of the spinal canal. Right neural
foramen is patent. Moderate left neural foraminal stenosis due to
uncovertebral joint hypertrophy.

C7-T1: Mild left neural foraminal stenosis due to uncovertebral joint
hypertrophy. Canal and right neural foramen are patent.
IMPRESSION:

DEGENERATIVE DISC DISEASE AT C5-C6 AND C6-C7. NO FOCAL PROTRUSION OR
EXTRUSION.

He recommended I go to a pain management doc and likely get injections. I just want to make sure I am going down the right path as I have been so uncomfortable for so long. It has really impacts life as far as mood, patience, and grumpy from discomfort.
I appreciate any insight to scans and your thoughts on best steps. Also, will I inevitably need surgery down the road? Thank you!
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Old 03-16-2014, 10:26 AM #2
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Could not figure out how to edit to add pic of when my neck was stuck this from CT on 2/6/14:
Attached Thumbnails
CT Results + Pic & MRI Results - Thoughts & Interpretation Appreciated-ctscan-jpg  
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Old 03-16-2014, 02:50 PM #3
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I guess if nothing else is surgery inevitable down road at some point? I know this is not the current situation, also know that is the last resort. Thanks!
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Old 03-18-2014, 10:27 PM #4
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Quote:
Originally Posted by OverMyNeck View Post
I guess if nothing else is surgery inevitable down road at some point? I know this is not the current situation, also know that is the last resort. Thanks!
I am not sure anyone can make that determination based off of what you have stated and submitted. The image is only one, and just of an APLC plain film or perhaps a scout from your CT so isn't diagnostic of much of anything and without a tangential view is really not helpful. As far as your report, it is suggestive of degenerative this and that so I think a trip down to your local pain management doc might just be the right idea! Surgery....not so sure from what you have shared.
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Old 03-20-2014, 10:57 AM #5
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Originally Posted by Dubious View Post
I am not sure anyone can make that determination based off of what you have stated and submitted. The image is only one, and just of an APLC plain film or perhaps a scout from your CT so isn't diagnostic of much of anything and without a tangential view is really not helpful. As far as your report, it is suggestive of degenerative this and that so I think a trip down to your local pain management doc might just be the right idea! Surgery....not so sure from what you have shared.
Agree, not needing surgery at this point, just thinking it's imminent years from now. Last resort, would not do unless unbearable, which I believe I am from from at this point once I get injections.

I was referred to a pain doc, appt on 4/9. Meanwhile, my thumb is still numb and tingling down my arm. Really annoying...hopefully an injection(s) will get rid of it
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Old 03-20-2014, 12:56 PM #6
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Have you considered seeking out a very skilled chiropractor?
If not for adjustments , but for an evaluation?
Take copies of your films or reports..for best results..

Any history of past accidents or injuries, sports, vehicle, falls etc?
Any long term desk or repetitive work? (the dreaded forward head posture?)
Body worker, posture expert, skilled PT might be helpful.

I wonder if an inversion table might be beneficial?

If muscle spams are an issue perhaps you have trigger points also..
you can't fully resolve spasms until any TrPs are resolved..
http://www.pressurepointer.com/pain_reference_chart.htm
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Dubious (03-20-2014)
Old 03-28-2014, 10:38 PM #7
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I agree with Jo Mar ....


I have issues with my neck also and I sought out my chiropractor. He did me great until I had my latest MRI of the neck.

My C1 and C2 along with my C6 and C7 are the worst. He did several slow mechanical cervical decompressions. With 6 treatments, 3 each week with a day inbetween to rest. It helped me alot.

But since my C1 (Atlas) and C2 (Axis) can't seem to stay in place, he suggested I see an upper Cervical Chiropractor. They do xrays in an upright position that way they can see what is really being pinched as to the conventional MRI's and xrays where you lay down.

Check out this website ... www.upright-health.com by Dr Michael Flanagan D.C.

He has a book out called "The Downside of Upright Positions".

It is an easy read and understand (pics and everything).

He might even answer your questions if you blog him on the site.

Good Luck and I pray for answers and relief from your pain.
God Bless
Str*
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Old 03-28-2014, 10:53 PM #8
Dubious Dubious is offline
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Quote:
Originally Posted by OverMyNeck View Post
Hello,
I am a frustrated almost 40 year old male. For around 10 years I have been taking a lot of Advil (600mg - 1800mg) per day for neck discomfort. Over the last 10 years it has been increasingly worse. I got a CT that revealed osteophites 9 years back. I went to a spine doc that told me my "posture was to good" and take these muscle relaxers for 10 days and I will be better, that was 9 years ago. Basically, dismissed me.
Fast forward 18 months ago I got another CT and went to a Neurosurgeon and he showed me scans and my bone spurs. He prescribed 800mg ibuprofen 2x per day. Let's just say he's not someone I would go back to, he looked and smelled like he just got off a bender...
Since then in the last 8 months I have had 4 separate instances where I could not move in certain directions without excruciating pain sending me to floor and my neck being stuck to right for a few days. I looked up slipped disc and my symptoms fit description exactly.
My General Physician ordered a CT of neck & shoulder and referred me to an Ortho. Here's a pic and results of CT (I am no longer "stuck" like this):


* * *Final Report* * *

DATE OF EXAM: Feb 6 2014 2:13PM

AFX 1358 - XR CERVICAL AP/LAT/OBL

PROCEDURE REASON: pain
* * * Physician Interpretation * * *

HISTORY: pain
TECHNIQUE: Cervical spine 4 views. Left shoulder 2 views
COMPARISON: Cervical spine, 8/13/12
RESULT:Counting reference: Craniocervical junction. C6-7 disc space is
diffusely narrowed with small posterior osteophytes bilaterally
encroaching on the neural foramina slightly more prominently on the left.
This is relatively unchanged in comparison with the previous examination
of 8/13/12.
Normal internal and external rotation with normal glenohumeral
alignment and joint space. .
IMPRESSION: SPONDYLOSIS C6-7 WITH SMALL POSTERIOR OSTEOPHYTES, WITHOUT
SIGNIFICANT CHANGE IN COMPARISON WITH THE EXAMINATION OF 18 MONTHS AGO.

THIS is where things get interesting for me. I go to Ortho he gets me off ibuprofen for something easier on the stomach and some muscle relaxers for spasms. Orders physical therapy. By the time I go to my three week follow up with him my thumb is numb from the knuckle area forward and if I move my neck in a certain direction it sends tingling down the back of my arm into the middle finger area. I am still like this, now 8 days in since I noticed. He ordered an MRI, these are the results:

* * *Final Report* * *

DATE OF EXAM: Mar 12 2014 6:17PM

AFM 0482 - MRI CERVICAL SPINE WO CONTRAST

PROCEDURE REASON: Degeneration of cervical intervertebral disc
* * * Physician Interpretation * * *

MRI CERVICAL SPINE WO CONTRAST

HISTORY: Neck pain.

COMPARISON: Comparison examination from 09/09/2005 is not available but
was reported as normal.

EXAMINATION: Routine cervical spine MR protocol without gadolinium.

CERVICAL RESULT:

Counting reference: Craniocervical junction.

Alignment: History of a normal cervical doses. There is mild loss of
disc height at C5-C6 and C6-C7 reflecting degeneration.

Craniocervical junction: Craniocervical junction is normal.

Cord: The visualized cord is within normal limits of signal intensity
and morphology.

Bone marrow signal/fracture: No evidence of pathologic marrow
infiltration. No evidence of prior fracture.

Cervical soft tissues: The paraspinal soft tissues are within normal
limits.

C2-C3: Canal and foramina are patent.

C3-C4: Canal and foramina are patent.

C4-C5: Canal and foramina are patent.

C5-C6: Bulge cause mild narrowing of the spinal canal. Right neural
foramen is patent. Mild left neural foraminal stenosis due to
uncovertebral joint hypertrophy.

C6-C7: Bulge cause mild narrowing of the spinal canal. Right neural
foramen is patent. Moderate left neural foraminal stenosis due to
uncovertebral joint hypertrophy.

C7-T1: Mild left neural foraminal stenosis due to uncovertebral joint
hypertrophy. Canal and right neural foramen are patent.
IMPRESSION:

DEGENERATIVE DISC DISEASE AT C5-C6 AND C6-C7. NO FOCAL PROTRUSION OR
EXTRUSION.

He recommended I go to a pain management doc and likely get injections. I just want to make sure I am going down the right path as I have been so uncomfortable for so long. It has really impacts life as far as mood, patience, and grumpy from discomfort.
I appreciate any insight to scans and your thoughts on best steps. Also, will I inevitably need surgery down the road? Thank you!
If your thumb numbness is your primary complaint, then the C5-C6 level with the disc bulging is the most likely culprit. Certain clinical tests (Compression, Distraction, Bakody's) may help correlate your MRI findings and if there seems to be a correlation, then I would shot-gun it. I would aggressively hit the anti-inflammatories (not excluding steroidals like Medrol dose pak), cervical traction 3x per week at PT or chiro and then home traction unit 3x per day progressively increasing resistance and time. If you are seeing a chiro, then adjust above and below the level of involvement, not thru it. This is only a thought based off of what you have shared, not a recommendation/prescription as you need to work thru a licensed provider!
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Old 04-01-2014, 10:35 PM #9
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Quote:
Originally Posted by Dubious View Post
If your thumb numbness is your primary complaint, then the C5-C6 level with the disc bulging is the most likely culprit. Certain clinical tests (Compression, Distraction, Bakody's) may help correlate your MRI findings and if there seems to be a correlation, then I would shot-gun it. I would aggressively hit the anti-inflammatories (not excluding steroidals like Medrol dose pak), cervical traction 3x per week at PT or chiro and then home traction unit 3x per day progressively increasing resistance and time. If you are seeing a chiro, then adjust above and below the level of involvement, not thru it. This is only a thought based off of what you have shared, not a recommendation/prescription as you need to work thru a licensed provider!
Thank you for the long response! I have Sanders pneumatic traction that I have not used religiously as of late. The chiro I have been leery of until my pain doc appt. I like your advice and appreciate your thoughts
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Old 04-02-2014, 11:52 PM #10
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Quote:
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Thank you for the long response! I have Sanders pneumatic traction that I have not used religiously as of late. The chiro I have been leery of until my pain doc appt. I like your advice and appreciate your thoughts
The Sanders unit is tremendous!
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