Spinal Cord :: Asymptomatic Severe Compression CSM (cervical Spondylotic Myelopathy)
May 15, 2015
I'm 65 years old, male.
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In Nov 2014 I found by casualty (MRI magnetic resonance imaging) that I have severe spondylotic cervical myelopathy (CSM) at C4-C5. I don't feel or show any neurological symptoms, like gait or radiculopathy. Neither feel any pain. One neurosurgeon strongly recommends surgery, because, he says, I'm in great danger and I will get symptoms soon. Another neurosurgeon strongly recommends not doing surgery, as long as I do not show any symptoms, because, he says, my case is clinical, not surgical, and recommends me to take care, don't walk in slippery floors and don't put my head to much backwards.
Does anyone has a similar condition that may help me to decide for surgery or "wait an see"? Is there any less invasive surgery that in spite not decompressing the spinal cord might at least delay progression, like ozone therapy or foraminotomy?
Have been suffering for 3 months with pain from cervical issues (diagnosed through MRI) - bulging discs, some stenosis, degenerative disk disease that is causing severe pain from neck through shoulder blade, underarm and down left arm. As I've had arthritis in my neck for a long time I know this pain came about from a stress injury to my neck. Have tried much conservative treatment (some physical therapy, chiropractic, and medication - currently 900 mg gabapentin and hydrocodone and ibuprofen and various others that I stopped.) I just had a Epidural Injection last week and thru this week experienced a bit of relief but not what I was hoping for. My question is has anyone gotten better with this type of problem doing these measures and had their problem resolve or at least get about 75% better without having any surgical intervention. My doctor thinks we can resolve this without surgery but also said surgery would be extensive as I have about 4/5 bad levels. I'm thinking of trying acupuncture and would appreciate anyone's input. Very tired of the pain and getting a bit depressed.
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I had back surgery in March 2013 that left me with mechanical instability, acquired spondylolisthesis and lots of pain.
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I have 2 ortho spine surgeons telling me that I need a bi-level spinal fusion surgery to repair the damage, but after the botched first surgery, the thought of another surgery scares me to death. Plus, since surgery is what spine surgeons do, the recommendation seems obvious.
I also started seeing a new pain management doctor (we moved to a new state) and he is suggesting that I consider a spinal cord stimulator trial, with surgical implantation if we find that it helps the pain.
So...I'm left confused. I see the positives and negatives of each, but I'm just not sure if one makes more sense over the other. I think that my spondylolisthesis will worsen over time and could pose a threat of nerve damage, while the spinal cord stimulator is designed to mask pain and does nothing to address the instability.
I'd love to know if anyone else has faced a similar decision...or has thoughts, ideas, comments, suggestions for considering one over the other.
Clinical Notes: Radiculopathy.
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Findings: Reversal of the cervical lordosis associated with a 2mm grade 1 degenerative anterolisthesis at C3/4. Multilevel disc desiccation, loss of disc height and degenerative anterior marginal end plate osteophytic spurring. Multilevel facet joint degenerative arthropathy. No suspicious bone marrow signal abnormality. No paravertebral soft tissue abnormality. The cervicomedullary junction is normally sited with the spinal cord of normal signal and volume down to the most visualised level at D4/5.
C2/3: Moderate left facet joint degenerative arthropathy with mild left foraminal narrowing.
C3/4: Anterolisthesis, a small superiorly pointing central disc extrusion, moderate bilateral uncovertebral and marked left plus mild right facet joint degenerative arthropathy, the latter associated with effusions bilaterally. Moderate canal stenosis with mild cord flattening. Severe left and moderate to severe right foraminal narrowing with impingement at both exciting C4 nerve roots.
C4/5: Broadbased disc bar, moderate right and mild left uncovertebral plus moderate canal stenosis with mild cord flattening on the right. Severe right and mild left foraminal narrowing with impingement of the exiting right C5 nerve root.
C5/6: Small broad based disc bar and moderate left uncovertebral joint degenerative arthropathy. Mild to moderate canal stenosis with mild cord flattening on the left. Severe left foraminal narrowing with impingement of the exiting left C6 nerve root.
C6/7: Small broad based disc bar and moderate bilateral uncovertebral joint degenerative arthropathy. Mild central canal stenosis. Severe bilateral foraminal narrowing with impingement at both exciting C7 nerve roots.
C7/T1 to T2/3: Posterior disc contour is normal.
T3/4 and T4/5: Moderate right facet joint degenerative arthropathy with moderate right foraminal narrowing and impingement of the exiting right T3 and T4 nerve roots.
Conclusion: Multilevel degenerative spondylotic change as described. Spinal canal stenosis associated with mild cord flattening between C4/5 and C6/7. Compressive foraminal narrowing seen bilaterally at C3/4, right at C4/5, left at C5/6, bilaterally at C6/7 and on the right at T3/4 and T4/5.
I had ACDF C6-7C August 2014 and still continued with serious pain around my neck and shoulders. I was told by the surgeon that I have non union C5-7. Can someone suggest my options in correcting the problem?
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I have had chronic back pain for about 9yrs & I finally got an xray to show an old injury. It's not something I can grow back or cure. Of all your opinions what's the best treatment for chronic back pain I've had for 9yrs & only til the 21st this month with an x ray after ER visits & pain management specialists sticking needles in my spine without any diagnosis or x rays at all over this whole time would any of you suggest I perhaps engage? I've suffered the entire time & I feel the negligence of the doctors is something to take into account. I can't grow back my narrowed spine of my L1 from an old injury & there is no cure , I just feel helpless being mother of twin boy toddlers who want to do it all & I can not due to pain. I'm stuck. Any advice? I cry because my sons are the ones to suffer in my prison with me . I can't grow my spine back & I have no babysitter for physical therapy which is I'm sure excruciating, any suggestions considering no doctor wants to help me even though I now have the prove after 9yrs it wasn't all just in my head & them sticking needles in my spine with no diagnosis & no answer for me & no x rays after all this time suffering?
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my Daughter aged 9 year is suffering from cord edema due to road accident. she was hit by a bike three months before, and after all the examination her reports are fine but in MRI report the doctors find that :
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There is a long segment T2W hyperintense extradural collection is seen in dorsal aspect of cord extending from D1 to L1 level. There is rupture of ligamentum flavum at D2/D3 level. T2W hyperintensity is also seen at interspinous at D2/D3 level. On T2W and STIR images paraspinal hyperintensity is seen from D2 to D6-7 level.
Prevertebral hyperintensity is seen from C2 to C5 level s/o edema/bleed.
Impression in MRI:-
1. Long segment Spinal Extra Arachnoid CSF collection in dorsal aspect of cord extending from D1 to L1 level causing cord compression leading to cord edema/contusion D3 to D5-6 level.
2. Rupture of ligamentum flavum and interspinous ligament at D2/D3 level.
after the injury she is on bed due to paralysis and loss of sensation below waist. and also suffering from bed sore due to bedridden.
I have consulted so many neurologist but they said the injury will recover itself after long time.
Is a small disc protrusion on my MRI report saying I have a small Herniation?? I have small central disc protrusion at c5-6 and a focal central bulge at c6-7. So does protrusion mean herniated? I'm so confused. The back pain management doc said "hmm, its nothing" when I asked. Does anyone know the difference?
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Does anyone have sort of fierce electrical pains travelling through spine lasts some short time and returns months later. I am 54 and have had these since my mid forties.
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Neck pain for years, suddenly got very bad 6 months ago. I am an active 61 year old woman, have worked as a checker almost 20 years in very busy supermarket. Lots of repetitive lifting and scanning, the constant lifting hurts, I can feel the stress on my neck and am wondering if continuing this is just aggravating the problem or possibly making it worse. Along with the significant cervical pain I am also experiencing paresthesia in both hands with burning also in right hand. This has been for at least 5 years. No arm pain so don't know if this could be radicular. Left toes also have pins and needles.
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My MRI follows:-
minimal grade 1 spondylolisthesis of C2on C3 and C7 on T1
moderate to severe disk space narrowing from C3-C7, mild at C7-T1 and C2-C3
multilevel DDD and spondylosis. Mild to mod. facet arthropathy also noted.
At C6-7 spondylosis and disk bulging causing cord indentation and bilateral neural foraminal narrowing rt. greater than lft.
Visualized sp. cord normal in caliber and signal
straightening of normal cervical lordosis. DDD causing cord indentation at C34. C45, C56 and C67. Neural foraminal narrowing which is most sig. at C45, C56 and C67. Facet osteoarthritis on the left at C23 with surrounding reactive bone marrow edema.
I am wondering what is difference between cord indentation and cord compression. I see compression often on boards so maybe indentation is not so bad. Is this a normal MRI for a 61 year old? What about the paresthesia and burning hands? I would love to hear from Web Dozer and anyone else who could shed light on this.
I've been dealing with severe sciatica pain that radiates from my lower back down to my calf. It sometimes gets so bad I cannot move. I've been seeing a chiropractor for the past two weeks and we've discovered I have a tilted pelvis and curvature of the spine; aside from my dx, the adjustments don't seem to be helping.
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My question is, should I still be exercising with this pain or is it worsening the pressure and inflammation of the nerve?
**I am a gymnast and athlete so I spend a lot of time at the gym do hardcore lifting and HIIT. My chiro said to focus on stretching but it hurts so bad I can barely manage it.
I was involved in a motorbike accident in June 2013. I had some shoulder pain at the time but all was well shortly after. In December of 2013, I started having shoulder blade pain which was actually C6 C7 radiculopathy . I was going for therapy and was prescribed NSAID and lyrica with no relief. In January on vacation I was riding a motor scooter and immediately noticed shooting pain down my right arm with numbness as well as neck pain. I had some of these symptoms before going on vacation but it definitely got worse while I was away. When i returned back to work, the pain became worse and I ended up going to an emergency department January 28. Up until this time I did not sleep well for over 6 weeks. The emergency room doctor had the same diagnosis, cervical radiculopathy and would not send me for a MRI but told me to go back to my Sports Med Dr to order an MRI. They also prescribed me Percocet, more NSAID, and muscle relaxants. That afternoon my Sports Dr changed to a different narcotic and ordered the MRI which I had 4 days later. The MRI showed a large right sided disc herniation c6 c7 hitting the c7 nerve root with cord compression. I was sent to a neurosurgeon on Mar 5. He reviewed the MRI and did some tests and said I have Myelopathy. He said it is a slowly progressive spinal cord injury and the goal is to stop the progression. He said tingling transitions to muscle weakness to the arms and legs and transitions to loss of function of my arms and legs.
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I signed off to have an ACDF C6 C7.
My question to all is, if the pain is better but my Tricep weakness is still there along with a little bit of numbness, is the surgery still recommended? I want to continue doing all the active things I have always done including working out and riding a motorbike. There still is a little bit of pain in my neck and occasional pain in my arm but nothing like it was. I don't want to lose any strength or risk the chance of having to be in a wheelchair if I fall a certain way.
I am scheduled for surgery May 26 bit I can cancel up until I have it done.
what this means! C5-C6: Posterior central disc osteophyte complex formation results in mild anterior effacement of the thecal sac. Endplate spurring and facet arthropathy results in mild narrowing of the right exit foramen.
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I am new to the board and am now one year out from lumbar fusion. I am a very physical person and a Personal Trainer as well. My low back pain has all but disappeared however neck and shoulder pain,stiffness and numbness are very concerning !!! I am currently treating with acupuncture and muscle relaxers. I also am a chronic migraine sufferer and believe this is partially being caused by cervical issues.
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My brother is on disability. He has a bulging disk in his neck that is making him dizzy. He has fallen several times because of this and frequently has to sit down. His insurance company won't cover the surgery. Is there anything I can do or something he can do to ease the pain? It makes me so sad that he is in such pain and can't afford to get help.
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Hi, I have been reading this forum for a very long time. I have been on Gabapentin since October 2011. I injured my neck January 2011. Lost the use of my left arm. Had C6-C7 acdf September 2012, fell 3 weeks later due to ataxia that came on after the surgery. X-ray showed everything in place, Cervical MRI showed C5 disk herniated minimally. For the last couple of months I've been losing sensation feeling in my hands sometimes up to my elbows. It goes to one side and the other or both at the same time. My doctor thinks it's a side effect of Gabapentin and my gut says it's not it. Has anyone heard of this side effect? I have not found this loss of sensation as a side effect in my research.
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I had five facet joint injections in my neck yesterday and I am in a lot of pain.
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I have a lot of stiffness and can not move my head that well without being in pain. Anyone else experience this?
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Central and Right Paracentral disc Protrusion at C5-C6 level causing thecal sac , Cord indentation, bilateral neural foraminal narrowing (Right >Left) and mild spinal canal narrowing ...
I was diagnosed as having a synovial cyst by a neuropsychiatrist. I had a procedure where he went in and drained the cyst along with that I had a steroid injection. Apparently he did not get much out of the cyst. The pathology report came back negative on what he did manage to get out.
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On day two post procedure the pain starting coming back. Each day the pain level increased to where I am now a level 8 and sometime 9 and can barely stand the pain. My lower right back just above the buttock feels like there is pressure and is very achy. The deep achy pain goes into my right buttock and wraps around the lower groin area. The achy pain goes down my right leg and into my foot. It is a pulsating deep ache and I can hardly stand it. It also feels numb at times and I get pins and needle tingling. When I get up from laying down or sometimes sitting (when I can sit) I get this sharp excruciating pain in my right groin that doubles me over. I have to stay still in the doubled over position to let it subside before I can straighten up and walk. Sometimes the groin pain just hits me out of nowhere when I am standing.
On my follow up visit with my physiatrist he recommended I have a consult with a neuro spine surgeon. My appointment with the surgeon is in a couple of days. I feel very fortunate to get into see this surgeon who is very hard to get in to see. He is rated as "one of the best" in a very large healthcare system where I work.
I am taking 1500mg of gabapentin along with 6 ibuprofen a day. I am also taking hydrocodone. I fight the pain and only take on the average one pain pill a day because I don't like the groggy feeling.
My question is, has anyone else with a synovial cyst had all of these symptoms? Is the groin pain related to the compression on the nerve from the cyst. I appreciate any feedback and would love to hear from someone who has had these symptoms.
can anyone help me understand the medical terminology used in my spine MRI report?
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there is mild reversal of the cervical lordosis. at c 3-4 there is small right paracentral disc bulge mildly indenting the thecal sac. the cervical cord appears normal in caliber with no evidence of compression. normal caliber thoracic cord. conus medullaris terminates at the mid L1 level. there are single small T2 hyperintense foci within T1 and T12 vertebral bodies, which are inconspicuous on T1 weighted imaging, isointense to vertebral marrow, consistent with small hemangioma.
at SI joints, there is minor subchondral sclerosis evident on the sacral side, with low grade subchondral bone marrow edema evident anteriorly.
I went to physical therapy for TMJ 4 days ago, I'm 31 years old. While massaging my jaw the physical therapist went on to my neck, and without me knowing out of nowhere cranked my neck super hard and it popped 3 times on the left side. My neck has been stiff on the left ever since with some pain and when I walk I hear loud clicking crackling/pop rocks sounds in my neck right before it meets the shoulders. Did he injure me? anyone else experience this? will it go away.
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I was so upset he cracked my neck like that he isn't even a chiropractor but said afterwards when I got upset with him that he knows chiropractor movements.
I've never been to a chiropractor so I don't know how it compares but it seems really hard and forceful when he did it. Its weird that when I move my neck I don't hear the sound, only when walking. Someone please advise me on this.
Also what type of doctor should I see for this issue, i'm going to schedule an appointment tomorrow, but don't know the type of doctor who would be best. My GP just gave me ibuprofen and said it should go away on it's own.