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Posted By : JakenGess - 7/27/2017 6:05 PM
Ok everyone, I went to my Neurosurgery appointment and got his recommendations. I was visited by a resident who first said 'it's not bad at all' comment which made me nervous they would not listen to the rest of my symptoms. The neurosurgeon was great and explained that at this point we look at how it affects my every day life first and to not go to the appointment for spinal injections.

He recommended physical therapy and a CT scan to look at bony anatomy. The results showed a mild disc bulge at c3-4 with minimal posterior spurs, no narrowing. C4-5 has mild disc bulge with slight right foraminal stenosis. C5-6 has a disc protrusion with posterior osteophyte with mild central spinal stenosis. C6-7 has a mild disc osteophyte complex with small disc protrusion and mild spinal stenosis.

I am curious what the neurosurgeon will say next. I feel a bit perturbed that the resident thought this was mild compared to the pain i am having. I did not feel very validated especially with all the worrying I have done since the MRI a month ago showing a disc herniation. They didn't even call it a herniation when speaking with me?!?

Does anyone know how to interpret these results?

Posted By : straydog - 7/27/2017 9:48 PM
J&G, interesting a CT was done. Sorry I can not remember what your MRI showed. What I am reading you have mild bulging disc, mild stenosis which means narrowing & two spurs. I would not worry about the resident. The main thing is the neurosurgeon sat & listened & talked. It is worth giving PT a good effort to see how you respond. By the way, the mild bulging disc are ok, people have bulging disc & do not even know it until they have diagnostics done. Bulges & herniations can heal on their own. When do you see the dr again? Please keep us posted.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : JakenGess - 7/28/2017 12:05 AM
I see the neurosurgeon on the 15th of August. He wanted to do the CT scan and then see how physical therapy was working and then go from there. He did not seem too worried about my pain and fatigue to my arms. My MRI showed a disc herniation at c5-6, bulge at c4-5 and bone spur at c6-7.

Posted By : (Seashell) - 7/28/2017 1:09 AM
Jaken:
It is wise to adopt a course of conservative treatment and symptom management as a first - line approach.

Any surgery has the risk of unexpected consequences and a less than ideal outcome.

I hear you and acknowledge your troubling upper extremity pain and motor weakness. That the resident failed to acknowledge your symptoms is obviously upsetting to you. That alone leaves you subjectively feeling that the appointment was inadequate and impersonal.

Almost everyone has disc bulges - that is, small extrusions of diac material. Thoracic and lumbar protrusions are a common incidental finding when individuals have imaging studies. A bulging or protruding disc is not addressed with surgery as a first line treatment option.

The truth is that most disc protrusions will retract on their own with time and patience. The disc material receeds on its own. Disc material is a thick and viscous consistency and morphs easily.

Physical therapy will likely include manual traction that applies long-axis traction, to ease protective and reactive muscle co-contraction. The long-axis traction provides a posterior directing moment, enabling the disc material to recede. Physical therapy will also provide postural alignment - again, with an intent to provide an energy to direct the disc material to flow posteriorly back into the body of the disc space.

Posture is key. The human head weighs about 10-12 pounds. It is analogous to a bowling ball suspended on a thin pole (which is the next). A forward oriented posture - shoulders rounded forward and head forward ) is typical in upright humans. This places an inherent stress on the cervical vertebrae, translating top down. A frequent root cause of recurrent headaches and disc protrusions is owing to the forward posture of the head and shoulder girdle.

Find a physical therapist that is a good "fit" for you. A congruence of personality and work style. A good relationship is a collaborative relationship where you, the client, are involved in the plan of care. A good therapist will constantly evaluate and treat during the physical therapy session - modifying and tweaking exercises, modalities, postural re-education as the session is in progress. Use your voice to communicate to the therapist with regards to pain, stiffness and range of motion, what is working/aiding you, and what is not working/hinderence to you.

The body has amazing abilities to heal itself. I would give your body ample time to resolve and heal your cervical disc protrusions.

Best wishes for healing,
Karen
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Post Edited ((Seashell)) : 7/28/2017 1:17:15 AM (GMT-6)


Posted By : Mercy&Grace - 7/28/2017 2:14 PM
It is important to remember this is a teaching hospital. Residents are still learning and training. If this happens again, you might want to talk to the neurologist about your concerns with the residents conduct. This is the time for medical students, interns and residents to learn pain is important to the patient. Chances are the resident meant the problems were not severe. That does not mean the pain is not severe and a great concern to the patient.

Posted By : JakenGess - 7/28/2017 2:59 PM
Yes absolutely, was pleased with the overall appointment. Just the choice of words. We all have to learn and would not have any problems seeing either of them again. Both very professional. It just strike me funny, my thought was, wait a minute I have been miserable with all this pain and it's nothing?!? That was my only concern.

Posted By : tiredredhead - 7/30/2017 7:10 PM
Sometimes medical professionals need experience to learn to understand how much impact their words can really have on a patient or a loved one. Most learn. Some never do.

I have dealt with your type of disc issues for a long time. The first round I did traction and PT. Worked great. The disc material migrated mostly back where it belonged and symptoms decreased by 75%. That was 8-10 years ago. Now it's all out again, causing some issues for me. Neurosurgeon here I come.

I can relate to your frustration. My neurologist looked at my MRI results and knowing I have hand pain, loss of sensation, and loss of function, said he "wasn't concerned". He's an example of those that never learned.

Hope all goes well for you!
Sarah

Posted By : JakenGess - 7/30/2017 8:26 PM
Thank you Sarah for your response. I have not gone back to my neurosurgeon yet. I have PT this week and then two weeks later I go back to him. Hoping he doesn't say anything bad but worried that maybe my problem isn't just my disc but the bone spurs. What do they normally do for bone spurs? Anyone know???

Posted By : tiredredhead - 7/30/2017 9:39 PM
I did some quick research, while doing that I discovered bone spurs are what the disc osteophytic complex finding on my MRI report means. Sheesh, my neuro didn't explain much.

What I learned was that they like to treat conservatively first. With things like shots to lessen inflammation. But it really depends on how severely your nerves are compromised by it. Seems like strictly pain symptoms they treat the pain until it becomes a major quality of life problem. If the nerves are in danger of damage, then they look to surgery.

Not sure if that's helpful or not, hopefully someone with personal experience will swing by and reply.

Sarah

Posted By : straydog - 7/31/2017 7:55 AM
Sarah, gave you a very good explanation about the bone spurs. The spurs can irritate things causing a lot of inflammation, this is where steroids can help get the inflammation down. Conservative care is the first line of treatment for this condition. Surgery is also a last resort, any reputable dr will recommend conservative care before going the surgery route. You certainly do not want some knife happy cat taking care of you. Here is another thought too, the dr may consider a short course of oral steroids for five days or so, something like a Medrol Dosepak. If I remember correctly my son did that prior to having an ESI.

If it comes down to you having injections you do want a dr that is trained to do them & the injections should be done by guided imaging to insure the correct area is being injected. I recently had a Ct of my neck, I have implanted metal & cannot have MRI's. I have had neck problems for years but as I have gotten older & have a lot of narrowing at multiple levels, spurring & disc issues, lots of nasty things going on. My PM dr started me on Gabapentin because of the nerve pain. I have a lot of burning pain in my shoulder & upper arm. Narcotics will not touch nerve pain, this is why he rx'd the Gabapentin.

If you want to read about your neck problems, go to SpineUniverse.com., its an excellent site to read about spine issues. The more informed you are about your condition the better for you. Drs. tend to not always go into a lot of detail with us patients.

Hang in there.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Posted By : JakenGess - 8/21/2017 5:17 AM
Just wanted to update everyone on my follow up appointment with my neurosurgeon.

After having my CT scan, my doctor said he spent some time looking back at my CT and MRI's. He diagnosed me with new onset myelopathy that has not turned into permanent spinal cord injury. He stated that he would not have surgery emergently by that I would need a surgery on my neck, a two level acdf. I have moderate stenosis of my C5-C7 vertebrae. I have two bone spurs, one at each level that are pushing into my spinal cord. I have little cerebrospinal fluid protecting my spinal cord at these levels which is causing spinal cord irritation. He also found that I am hyperreflexia emperor and hypersensitive on the left side of my body.

That was on Tuesday. This past weekend I started having tingling in my left arm with little pain?!? It has gotten better but it makes me worried that maybe I have some worsening symptoms for the spinal cord irritation.

At what point should I call the doctor and ask for an evaluation? I am scheduled to go back in 3 months to determine surgery or not, but what if that is not soon enough? Those of you that have had this surgery, do you think. After 4 weeks of post op I will be able to return to online school?

Thank you for all your kind responses!

Posted By : straydog - 8/21/2017 2:11 PM
JakenGess, please look at your thread on the front page called cervical myelopathy I believe is the title. I have addressed some surgical issues there.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Post Edited (straydog) : 8/22/2017 7:16:36 AM (GMT-6)


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