Cervical now was a old past lumbar sufferer

[cavalier]

Disc heights are maintainted & No gross signal intensity abnormalities.
Have a MRI that shows Cervical Stenosis -
C3/4 has narrowing of AP canal to 8 MM's slight disc protrusion bilateral facet arthophy Loss of Lordosis to the whole neck is shown & more levels involved -
C4/5 Mild Spondylosis Moderate left facet arthopathy & left neural foraminal narrowing is mild.
C5/6 Moderate L. posterior disc osteophyte Bilaterally with central stenosis mild narrowing of AP canal to approx. 7 MM & bilateral uncovrtebral joint hypertrophy and fect arthropathy with moderate left and mild right neural forminal narrowing.
C6/7 Posterior Disc Ostephyte complex with mild central canal stenosis narrowing AP canal to Approx. 9 MM Mild L.neural forminal narrowing 2ndary to uncovertebral joint hypertrophy.
C7/T1 Probably Root Sleeve Cyst associated with Right C8 Nerve Root.
Have a abnormal Allen's test which is a Ultrasound of my Left hand in April that shows compromised blood flow to both Ulnar & Radial Arteries & a weak pulse,which confirms Thoracic Outlet Syndrome - which we dont know if this is 2ndary to the neck or a separate issue. I would guess tied to the neck, but I am not a doctor just live in this body. The hand started in 06 finally in 07 went to the hand doc - had a EMG nothing showing so just tried to forget about it. I had hand surgery in 01 & just figured it was arthritis & weakneing as the ligament was not a good repair had low blood supply maybe back then ? It came came & went. Came on again in summer of 08 & now does not leave.
I had a VNG test by the ENT doctor which Confirmed the random dizzy spells recently- Evidence of Acute Peripheral Vestibulopathy Left R/O Peripheral Neuritis in April of this year.
Had a EMG nothing noteworthy. Had a EMG in 06 of my lumbar showed mild nerve loss L2 to L5. I just felt the leg numbness was my low back but it has steadily gotten worse if I sit past a 1/2 hour - standing it is fine.
Have started PT for my neck & arm but I really think it is not going to gain me much would love to be wrong, but having been thru back stenosis before... Have been using massage once a week lately to help my shoulder muscles from being so tight with pain.
I have sent my info to Dr Fenk Mayer & am awaiting for the last of the testing to reach there. I am only interested in conferring with a doc who is up on all latest techniques so I know he or she can pick from any tool that may serve me best, including ADR Cervical if they feel that is the best solution for me, who has some experience. I just NEED to know whatever they may suggest is based on complete experience & not due to limitations with good expertise.
I have shoulder issues chest left side by the heart area I feel it is connected to all of this as it comes & goes. Last week the right is now acting up. This has at times since last summer had me worried if I was having a H.A. My blood pressure started being unregulated 3 yr's ago & no meds control it well - sometimes it is normal - so I have always said get to the bottom of this & my BP will normalize. My Mother had the same issue & had neck problems. I feel it is now tied to the neck & found medical articles that support this & other findings I have. Arm pressure & the lack of good blood flow to my Dominant hand as well as huge headaches that med's are not controlling & some intermittent neck nerve feels like it is getting pinched off & on. I always feel as if someone is choking me on the sides of my neck & this does affect what I can eat now. Hands can get clumsy & left foot has given out a couple of times recently after brief sitting. Cant elevate my L arm and use of either hands in extending them exacberate both the hands & the neck. What is interesting is they call the stenosis mild but in my readings on the net, including Dr B's site - a MD had Stenosis of 9 MM's & they called it severe by his Radiologist. I have 7, 8 & 9 but I also went out & found normal canal is 15 to 20 so regardless I know I am less than halfish of normal. If that is mild so be it - I have one respected Spinal doc who has not seen all of the info yet, but they did offer this much on the stenosis - it is considered to be SIGNIFICANT Stenois not mild in their opinion & they felt it was inpinging on the myelin, which I dont need to tell you what that means we all know that aint grand & it explains alot.

There has been no migration of my ADR which is holding the 2 offset spinal ends together at L4 L5. It is positioned still well Although I am having some low back pain down very low below this yesterday & today i think it maybe compensating for the neck - after all we are all connected. Sitting is getting uncomfortable butt & tailbone.
For last 3 yr's eating anything rough or very large it is easy for me to choke - I have known but have been putting off in not wanting to go there til I had no choice. I finally am at that point as now anything that is not small & soft can be hard the pressure on the windpipe & espohagus. My lung also are getting obstructed in air getting thru chest Xray I just had compared to Aug 08 when I broke my 5th rib over my heart shows this conclusively. My thoracic area in the middle below my collarbone is now humped like my Mothers my guess is due to trying to compensate for room.
This neck got 2 whiplashes & then the side hit in 94 that broke my pelvis & hurt my low back at L4 L5 & made my neck weak so it helped move things a bit along. As well as there is bad necks in my Mom now passed, my Aunt & my sister who had more minor neck changes & had Thoracic Outlet Syndrome to her L. hand as well - she had the 1st rib removed but it did return when she tried to go back to her former work - she also did PT for her neck at this time. She had to go into a different line of work so to me I am not convinced the TOS is not in our case connected to the neck & use. As before distance here is a issue, as there are not presently Doc's who do much with Cervical ADR's here I think Foley has done the most - I dunno his count now but it was only under a handful last I checked.
I dont want to see anyone who cant pick from everything so i know their decision was not limited by what they do. I just need to know what is the best option, I have a idea, but I want "them" to tell me. I have refused ESI's knowing they are pointless in helping with Stenosis from my lumbar. I do not want to risk more damage to my osteopenia. I feel I need help sooner than waiting one of the God given gifts we are given is when we know we are progressing & for some reason my neck now is progressing faster I would rather not keep waiting due to the arm & TOS issues. I am in PT now & cant do even more than one lb of traction without making myself really flared up that is not enough to get any benefit. I would rather have a Ortho as my past the NS's usually seemed to want to wait til you had perm nerve damage. I just didnt' want to accept I was needing help - I was just so happy with my relief for my back & didnt' want to acknowledge this could be my neck getting worse but you eventually start to add it up. Sorry this is so long. Jill

[cavalier]

Hubby had been hoping for only one ADR for my neck I had tried to tell him I was not going to be that lucky. I wish I was less complicated. 2 levels maybe 3 Discogram will rule that 3rd in or out.

Dr. Fenk Mayer just sent this - Your MRI shows significant disc degeneration with secondary pathological kyphosis in c56 and c67.

C45 is only initially affected with a median bulge.

So corresponding to your progressive neck pain Dr. Bertagnoli recommends the following surgical plan:

1) Discography into c45 – to identify whether this should be included in the surgery or not. Discography is in our experience the best test in such borderline segments.
(I agree! I would NEVER do a surgery without one!)
2) ADR into c56 and c67 (or plus c45, if discography supports this).

For your arm symptoms: The resulting stenosis of nerve outlets in c56 and c67 is relevant, and it is to be expected, that a relevant share of your numbness and tingling in your fingers is secondary to this narrowing. Which will be taken care for with ADR. The additional vessel symptoms can also have an indirect origin in here – pain causes muscle spasm, muscle spasm and shortening contributes to compressing arm vessels in the thoracical outlets (TOS).

For me getting good circulation back is a must. I so value their opinion. May God continue to watch over them as so many people lives depend on their work. Posting this in case it is of help to anyone. My MRI report is listed in this thread already under Cervie now was a old Lumbar sufferer- Jill

[cavalier]

Update as it is even more complicated -I have TOS & Cervical issues. Been confirmed now by 5 different doc's on the TOS & all say it needs to come out.
I have been having bad circulation issues in my arms & even my legs. It is felt this is due to the TOS & so I have talked to a TOS doc in Colorado this week - he has done over 2,000 TOS surgeries as sadly we dont have anyone who is good in doing this routinely here in town. He asked me about a 1/2 hr of ?'s said I def. have the TOS. I also know from Dr's B & Fenk-Mayer & EVERY doc I have seen besides for my neck I have alot of facet changes & oesteophytes - the facets get this way I was told & it makes perfect sense to me with arthritis etc is due to the loss of disc height she said simply put - this follows the loss of disc height. I am coming to realize I have need for BOTH TOS surgery & for the Neck surgery !
I saw a Arterial doc this week for my circulation as I could see purple blue spots on my arms & across my collar bone. He had me do one simple test & said i DEFINiTELY match the tests i had for arteries being compressed. So I have to do this week one test at the Hosptial a thoracic Aorta Chest CTA & a Carotid CTA & then later this coming week he will do at his office a L Chest & UE & Eval of the subclavical & Axillary artery. So depending on what his tests show will tell me which to put 1st the TOS surgery or the Cervical surgery. IF i have the TOS surgery it will be 2 surgeries one to remove the Extra Cervical rib that less than one percent of the world's population has. It is when someone has one above the 1st rib - have to do only one side at a time so 2 surgeries after you recover from the 1st. Too much risk of clasping a lung a risk with doing just one side at a time. Not a easy surgery to recover from I am told the ADR Cervical surgery would be easier which would make for 3 surgeries. Not a back to back excuse the pun propostion. So hopefully i will know more this week which to put 1st. IF it is the TOS surgery the closest doc who gets people from 5 states around is 7 1/2 hr's away each way. He does 3 to 4 a week & has done hundreds compared to doc's here with one a year done about 3 total. Every one i have told this too of the Nurses who work for the Thoracic Vascular doc's here say the same thing I am thinking go to the one who does the most - they say they would. I smiled & thought yep the same thing as one tries to do with spines if they have a need.
I have relayed all of this to Dr Fenk-Mayer & will update once i get word on the arteries. IT aint fun but there is definitely 2 components to this but it is hard to assign a % to each. I found out one can do a Scalene Block & Percotralis Minor muscle blocks with Xylocaine but what I found out is hardly any one does these. Only one doc here in town who has & he missed twice before getting it right on the 3rd try - my doc says it is so crowded in there you can do significant damage if you miss. The Doc in Knoxville sometimes does them but not routinely. Colorado does them alot & often. I hope i can get some relief soon & things get rolling on which to do 1st. IF the arteries are at risk for a blood clot then I will have to consider the TOS 1st even if i still have a bad neck. But I will lay it in front of the doc's & they should tell me if that thinking is correct. Facet blocks the doc's here say they cant get exact enuf on the neck as opposed to the lumbar. Dr Fenk-Mayer said they could do them but must be a different caliper of expertise.
Meantime I am trying to keep positive even though i am getting impatient & frustrated as tired of not being able to do things with my hands. I have come to find out why the docs here in Memphis just dont know about this stuff for TOS. The Doc in Colorado says no doubt I have TOS. I keep hearing from about 5 doc's now that extra rib needs to come out.
I hate to let the neck go too long but hopefully it will all work out - it has too
Jill

[dshobbies]

Not sure what a TOS is but it doesn't sound good. Another problem to deal with, another puzzle piece that must be put in place.... what a mess. What comes first at this point? What must be corrected before moving on is possible?

Sorry for this complication and hopefully, it will get resolved quickly. My best to you, Dale

[cavalier]

Dale I am sorry TOS means Thoracic Outlet Syndrome - a big name for the fact that everyone has a Thoracic Outlet this is what carries the bloos flow & nerve pathways from the cartod artery down into the arms & chest area. This outlet can get scar tissue or compressed over time - HOWEVER in my case I am one of the rare people who have a EXTRA rib a Cervical rib that only one percent of the worlds population has & this falls in this pathway - so i am MORE crowded than most people & over time - this always tends to cause problems with nerve & compression to the arteries which is what this is doing to me now - I have this on both sides of my spine & it requires this being taken out in 2 different operations. The doc's who do this are typically Thoracic Vascular surgeons but due to the fact that this is not a common surgery - you want a doc who does alot of these under their belt. As alot of complications etc. if you dont have a good one. i have so far alot of pre work ups that show i have the arteries being compressed - i have a couple more tests to do & i want them done ASAP as I have a risk for a clot & anerysm spelling sorry i am tired. So depending on what i find out i will put the one that has the most danger if left untouched 1st - but i am trying to weed thru this & I am talking to doc's around the country on this. Memphis does not have doc's who do much of these.
I have a TOS doc who does alot of these calling me himself this week which is very nice & I had another TOS doc call me last week so far it looks like yes I have this for sure & that this extra rib has to come out - I actually would rather have the ADR Cervical neck surgery as this is a major deal & once recovered have to undergo the other side as both are affected. Once I get all of the final tests & doc's weighed in I will confer with Dr Fenk-Mayer & lay this in front of the doc's & make decisions. I do know when it comes to my neck who i want Dr B. - however with the TOS I am going thru finding who the best are etc. I only want a doc like Dr B & Fenk-Mayer who are willing to address ?'s
Thanks - & all the best to you Jill

[cavalier]

Oh I forgot to mention it causes 4th & 5th digitis numbness & tingling & circulation issues & wrist & hand weakness & neck pain & shoulder pain arm pain so it iis confusing as it can overlap with someone who has neck issues & I have both - so trying to do as much diagnostics to get some guess as to the %'s but not alot of dooc's here know much about it - so thus the need for travel & those who do know the most are the better ones to see.
Jill