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iSpine Discuss MRI opinions please in the Main forums forums; Hello everyone, this is my first MRI and dealing with doctors for my pain. Doctor at first visit suspected herniation ...

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Old 02-17-2013, 07:46 PM
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Default MRI opinions please

Hello everyone, this is my first MRI and dealing with doctors for my pain. Doctor at first visit suspected herniation and said would probably resolve with time and PT, after MRI said he was usually against surgery but now wants me to have surgery consult with ortho-surgeon. I am trying to become as informed as I can before the appt. and would appreciate any insight, advice opinions understanding the report from your experiences. Symptoms began 3 months ago with right shoulder and arm pain with tingling/numbish index finger, arm feeling like it's falling asleep in certain positions and occasional shock like feeling down the arm. Thanks for any help.

c4-c5 shows normal disc height with mild right paracentral and lateral disc bulging. There is no facet arthropathy, canal stenosis or foraminal stenosis.

c5-c6 shows mild disc space narrowing with mild diffuse disc osteophyte complex formation although no facet arthopathy, canal stenosis or foraminal stenosis.

c6-c7 shows normal disc height with large right lateral disc herniation measuring 10mm craniocaudal, 12mm transverse and 8mm anterior-posterior. There is moderate compression of the right anterolateral cord. No facet arthopathy or foraminal stenosis is shown.
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Old 02-17-2013, 08:13 PM
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Sounds like C6-7 is the most problematic. My very first surgery in 2007 was cervical fusion and diskectomy or C4-7. I can't remember now which level said severe and which said moderate. I know 2 definitley needed to be dealt with and the third had symptoms and probably would have needed surgery once all the hardwear was in as it weighs a lot . It is pretty common in fusion surgery that the adjacent level has problems shortly after the original fusion. Mine sure did in the rest of my body. That was a pretty easy surgery for me compared to the rest of my spine surgery.
I don't know if you plan on seeing one surgeon and then getting a second opinion., I did and they both said the same thing. I also had the arm tingling and falling asleep . I had looked up which levels effect which fingers . I don't remember now. I did get sent to pt and it didn't do anything. Then i told my surgeon (i had been seeing him for a year with lumbar issues) that my left arm was now weaker in physical therapy and that was when he said no more waiting it was time for surgery.
Ask the doc what his complication rate, infection rate is. See another if you don' t really like the first, it is really always a good idea anyway..
good luck and keep us posted.
judy
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2007 ACDF 4-7
2008 hip , knee scope, hip replacement
2009 thoracic T-5 thru T-11fusion
2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear
2010 lung surgery
2010 T2-L2 kyphosis correction
2010 Kyphoplasty T-3, T-4
2011 Cervical osteotomy ,revision C4-T5
2011 Foot surgery
2011 Revision fusion T7 thru L4/laminectomy
2012 Hammertoe correction left foot
2012 Revision fusion T-12 thru L5
2012 Revision fusion L4-L5
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Old 02-18-2013, 12:13 AM
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Thank you Judy for replying. From the reading I've been doing here my problems are very minor to what so many are dealing with. I am new to this and trying to learn and really appreciate your response. I have seen conflicting information as far as the herniation. Originally thought with time they resolved but the little info from the dr. after MRI he said you will always have this, we can treat and calm it down but from time to time it will flare up and give problems. I am also curious if the disc that is currently only a bulge are likely to also herniate and would that risk increase if surgery is performed on the current herniation. I guess that answer isn't black or white depending on individual factors. I haven't had a recent injury that I can pin this on. My neck has given me problems for years but this is the first time it involved arm pain and finger numbness. Don't want to ramble, thanks again.
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Old 02-18-2013, 02:20 AM
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Default re your report

The C6/C7 does sound like it's problematic and other levels might be too but that's a good size bulge you got going on there so if you're symptomatic and symptoms coincide with area involved it would make sense.

Good luc with a consult that will address your issues. Make sure you get a good explanation of that report that satifies you and what your options might be surgical or non surgical.
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Old 02-18-2013, 04:21 AM
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That is a huge herniation for the c-spine that will likely require intervention. However, I've seen many cases that have resolved without surgery. I think this is a good example:

Cervical Burst Fracture - 1 year - no surgery SUCCESS!

Another story linked below... the thread is about a lumbar case, but I posted some cervical films for another client too:

"Back" into life without surgery!

Good luck... please keep us posted.

Mark
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2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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Old 02-18-2013, 12:35 PM
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looks like the fracture will never heal, and over time will re-surface,,,
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Old 02-18-2013, 02:49 PM
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You'd be shocked. I don't have updated images for this case because you don't do imaging when there are no problems. But, surgeons have shown me pictures of horrible looking fractures, in which the bone has fused in a disfugured kind or configuration. Then, the bone that protudes inappropriately disappears, and the voids that shouldn't be there fill in. Bone grows where it is needed and is resorbed where it is not. I'm not suggesting that anything can heal and get back to normal, but the body does truly amazing things.

Mark
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
Life After Surgery Website
President: Global Patient Network, Inc.
Founder: www.iSpine.org
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