Spinal Surgery :: MRI - Mild Reversal Of The Cervical Lordosis
Oct 8, 2014
can anyone help me understand the medical terminology used in my spine MRI report?
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.
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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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RECENT HISTORY
First, I am diabetic and have had a fairly normal healthy life except in the last two years where I gained 40 pounds, did not control my blood sugars well, and went off the rails. I have had a lot of issues this year, but to focus on my most recent issues, I had a A1c of 10.5 two month ago and went to 9.1 a month ago finally to 7.6 right before my single incision laparoscopic with robotic-assisted single-incision surgery to remove my infected gallbladder (Hida Scan 11% no gallstones). 6 month ago i started experiencing a lot of bloating, indigestion and took charcocaps that helped a lot after meals.
Two weeks ago I went out for a cup of iced coffee (huge coffee drinker 3-4 cups a day for a long time no problems for years), and something hit me, it felt like a sharp pain and instant feeling of bleh no appetite and sick feeling the rest of the day. This continued for a week before I knew something was wrong, I could not have anything acidic or felt like I could eat anything. I had just seen my doctor for a bike accident a month prior to get a referral to a PT and osteopathic doctor. I had a l3/l4 compressed nerve with a twisted sacral (this is much better now with some minor spasms in my right leg from time to time). With all of that pain (took hydrocodone and muscle relaxants to sleep, sleep was poor) and school, I figured I must have given myself an Ulcer. My doctor game me a ppi-omeprazole (i've never had reflux and didn't then) since I had symptoms of some burning sensations and this chronic dyspepsia so this would treat the possible Ulcer for two weeks while I was sent for an ultrasound to check out my gallbladder (family history - Mom, aunt, and uncle had their's out with gallstones). The ppi sort of helped but I just was fatigued, could not eat anything but a bland diet, I had chronic dyspepsia and general nausea that I could never shake. My daily caloric intake decreased with each new day and food just made me generally feel sick, however if I skipped meals it would still be bad, worse with food.
TEST RESULTS
After the Hida scan came back positive with an ejection rate of 11%, I scheduled my new a1c test, ekg (family history of heart disease), I was cleared and scheduled for surgery. I stopped taking the ppi as I believed this to be the cause of all my problems. btw, I was 254 the end of june and lost 25 pounds by the time of surgery (average daily caloric intake ~900-1200 prior to surgery
POST SURGERY
After the surgery 7/21-one week ago, I had my two days of pain and adjustment, and recovered decently with a soft food and liquid diet. I noticed the general sickness was gone! Hazzah!, except on Saturday I was feeling bloated, cramping, and I could not eat a solid one bite without feeling sick. I knew I was constipated. I stopped the pain meds the day before and I knew I had not eaten too much but it was over a week since i went. I took magnesium citrate and nothing after 7 hours, I drank another 1/2--then BOOM it was insane. I was sooo wiped out and tried to replace lost liquids but I believe I was dehydrated. I was sick that night and stomach was not happy.
Sunday was much better but I was wiped out still and felt generally just depleted of all my energy. I ate, walked a bit and then came back home. That night I started feeling very uncomfortable and the symptoms were somewhat similar to prior to surgery of the general dyspepsia and nausea chronically. I could not sleep because of my back problems (had to sleep upright on my back all week). I woke up in the middle of the night turned to my side and then all of a sudden I felt a warm rush of something just above my stomach and the constant burn in my stomach no reflux. I could not sleep until the morning.
NOW,
I have had really bad gas (low fat diet) for the past few days. I was getting and feeling better on day four but now this!
I felt extreme discomfort all day, felt like a low grade fever 98.6 (no fever) incision site is also slightly red, but the doctor said to call if I had a fever. I was worried about an SSI. The pain was like I threw up (I never have even starting out back in at the coffee shop) and that ache afterwards. The burning sensation let up later in the day after I took some antacids and saltines (I must have some acid issues, but I have read a lot of people suspecting many people may actually have low acid).
The thing is a lot of people have episodes after food, but mine is chronic with mild discomfort, burning sensations, upper abdomen and stomach discomfort (with some nausea), and food helps it initially and then it comes back. I feel week, slight low grade fever even though I don't have one. I keep thinking I have an infection of H. Pylori or something. Food takes a while to do much, I walk after I eat everything. I feel like I could eat but I get so much bloating and indigestion that it is uncomfortable. I drink plenty of water, but I wonder if I am low on essential things for the long ongoing low calorie daily diet. I can't eat more then 800 calories even with smaller meals-since Thursday.
Why was my gall bladder inflamed in the first place? I had no stones, and the surgeon said I had a very long a big gallbladder (ready to rupture!) that was really inflamed including a little on the liver. Pathology reports came back negative. I theorize my rapid change in weight and blood sugar levels inflamed the organ or an infection.
Possibilities:
diabetic Gastroparesis
H. Pylori
Peptic Ulcer (was never officially tested)
Gastritis
Anxiety
Low/High Stomach Acid
Low bile leak?
Sphincter of oddi dysfunction
What I feel could help:
HCL Betaine
Digestive Enzyme (Garden of life chewable vegetarian)
ppi (I would hate to take them unless I had to)
something to coat my stomach if I do have an ulcer to heal
ability to eat more so I can have more assimilated minerals, ect.
Anxiety med (first year i've had a lot of anxiety-mainly school related and upcoming wedding planning for next year
more tests!
My burning anxiety questions:
When will I get my appetite back?
(i really suspected my odds were decently good that I would get better after surgery, I had a great surgeon)
Did anyone have any of these chronic symptoms? Is it due to an infection or some issue with surgery?
Have some people eventually been able to eat what they wanted after a period of time?
How many had these excessive bloating, indigestion, nausea and general malaise through the day, worse a little while after food or between meals?
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I had back surgery in March 2013 that left me with mechanical instability, acquired spondylolisthesis and lots of pain.
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.
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CT c-spine Findings: There is postoperative change related to previous c5 c6 interiors fusion spacer with anterior retention hardware placement. There is no evidence of hardware fracture or loosening, alignment of the cervical spine is maintained. There is no findings of acute fracture or subluxation. Craniocervical junction is intact. C1-C2, C2-C3,C3-C4 no disc bulge or disc protrusion. No central canal stenosis or neural forAmina narrowing, within limitations of ct. C4-C5 small posterior disc osteophyte complex partially effaces the thecal sac without significant central canal or neural foraminal. C5-C6,C6-C7,C7-T1 no disc bulge or protrusion.
Impression, postoperative change at c5,c6 fusion. No evidence of hardware failure or acute fracture or subluxation of the cervical spine.
MRI findings: There is susceptibility artifact at C5-C6 related to intermediate fusion and cervical retention hardware placement.
C2-C3, C3-C4 , No disc bulge or disc protrusion. No canal stenosis or neural foraminal narrowing.
C4-C5 there is a 3 mm central disc protrusion with superimposed posterior endpapers osteophyte which partially enfaces the thecal sac. AP diameter the central canal measures 1.0cm. There is no significant central canal or neural foraminal narrowing.
C5-C6,C6-C7,C7-T1 no disc bulge or disc protrusion. No central stenosis or neural foraminal.
Impression: mild discogenic degenerative change at c4-c5. No significant central canal or neural foraminal seen at any level. Postoperative change c5-c6 anterior fusion.
I thought I was doing better from the first surgery. Pain, tingling, and numbness subsided, as well as migraines. Few months thst ago I get excruciating pain in my neck and shoulder with headaches again. I've seen my neurologist, but he says to go back to ortho. I go next thursday. I was hoping to get English what this means. My first mri and ct before surgery was quite obvious, and my pcp gave me the basics. The pain meds now im on aren't helping, in fact not even touching tje pain. Oxycodone 10/325 every 4-6 hours for breakthrough pain.
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I'm 65 years old, male.
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?
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I had TLIF spinal surgery in 2010. Went as well as could be expected, but I have a very weak back and live with constant pain. I body won't accept strong painkillers, so was prescribed Amitriptyline. Came off them due to nose bleeds and feeling like a complete zombie. Although it was good to get a good night sleep!!! Doc then put me on Gabapentin 300 mg 3 times a day. Had no pain relief and so doc has now upped me to 600 mg 3 times a day, plus zapain in between.
I worry about taking so much, but I need something to take the edge off my pain. I've read a lot of negative reviews about Gabapentin. Will have to see how I get on.
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I am 40 and have grade 1 l5 s1 spondylolisthesis. When I read forums, all I see is people having to be on painkillers, fusion surgeries that don't work, people who can not work, have children (pregnancy) and so on because of this condition. I am so terrified I will end up in a wheelchair or without a social life. There is so little information about the condition online. Please, please, can someone give me some hope that you can live with this condition, perhaps by doing exercises, yoga, pilates etc? Please tell me I can avoid surgery, have a pregnancy to term without complications from spondy. I feel so alone. I hope all of you are having a good day.
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I had two RFA procedures done in 2014. This was after 3 sets of epidural spinal injections done over a year's time throughout 2013. The first RFA worked so well I was nearly pain free for 9 months. I was overjoyed to feel normal again. I have bulging discs at L4-L5 and L5-S1, causing radiculopathy and sciatica. Having had such amazing relief from the 1st RFA, when the pain started to return, I had the 2nd RFA. During the procedure, the doc had a problem at the bottom two burning sites and the pain was so bad I screamed for him to stop. He did... briefly.. but asked me to "hang on" for the 90 seconds and it would be done.
I never got relief from this second procedure...not even for one day. Fast forward to Dec 2015 and the pain is worse than ever. And I just read today that a complication of RFA is "permanent nerve pain", I was never told about this complication! I'm permanently disabled now, on SSDI and walk with a cane. Even after researching for 2 yrs. online, I just found out about this complication TODAY. Very upset. Anyone else have complications from RFA? I feel very alone in this.
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8 months after my L1 compression fracture, another doctor (fired the first one) found out that one of the T12 facet joints is fractured (broken off in 2 pieces). I should have been operated on after the fall, but it's too late now.
Could someone tell me what this could cause (what kind of pain)? I have local pain, and severe pain in the iliac area, after being active for a while, or after sitting for a while.
I can sleep at night, but after 5-6hrs, I wake up because of the pain, can't continue to lay down. Very painful.
also, I still can't lay down on my back on a hard surface.
I'm scheduled for a nerve ablation T12-L1, both sides this Friday and Monday. I'm scared because of all what I read...
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After a L5-S1 in October, I am left with residual left foot and partial leg nerve pain. In addition to numbness, my leg aches. My MRI looks clean, but neurosurgeon referred me to neurologist for possible nerve root injections. He also suspects the it may be radial sympathetic nerve issue. If nothing else, he's willing to take hardware out to see if that helps. I keep falling with my left foot so "numb," so I am frustrated. Is the device that scrambles pain. (can't think of it now) good for nerve pain? (Pain extends to my left lower back.) Has anyone had nerve blocks for nerve pain? I wouldn't have had surgery if I had known my mobility would have been compromised so much.
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Lisa here...Before my S1-L5 fusion, I had some foot pain caused by waiting two weeks to have a laminectomy/discectomy in my L 4 and 5 discs after a herniation (5 years ago). After my fusion - about 7 weeks ago - I have had terrible burning pain, sensations that feel like I am being bitten on a toe or have tape in between my toes. At night the pain is worse. Walking intensifies the pain and weakens my ankle and leg. I can't wear any of my shoes. Does anyone have any experience with this? I've called my neurosurgeon and he wants an x-ray. Suggestions? Comments?
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I am a 50 year old female who had lumbar laminectomy at L3/4 eight weeks ago for lumbar stenosis and spondylolisthesis. The surgeon also performed a dynamic stabilisation at this level. As I understand it, this involves the insertion of a flexible and rod and screws, similar to fusion but allowing more flexion at this level while at the same time preventing the vertebra from slipping. Prior to surgery, I was unable to walk or stand for more than 5 - 10 minutes without becoming uncomfortable because of weakness in my legs and a tight cramping sensation in my buttocks. Surgery has relieved me of these symptoms, but I now have aching in my lower back, groins and hips when standing or walking for more than 5 - 10 minutes. I wasn't given any physio follow-up after discharge from hospital, but have had a couple of sessions with a private physiotherapist. She seems to think that these pains are due to the ligaments and muscles having to stretch as my spine as been realigned and my pelvis is now tilted forwards instead of backwards as it was before. Has anyone else experienced similar pains and if so, how long did it take for them to resolve? I am also very stiff first thing in the morning and when getting up from a sitting position. I do not have any pain when sitting or lying down.
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After a long two years trying to get a Consultant to help me. Yes I found the right one. Mr Fox a vascular surgeon. I saw him on 22nd May 2015. He diagnosed me with two extra ribs "one each side" . And Said he would operate on my left side first, has this was the worst side "pulse was very weak when arm was raised. Had my op on Thursday 4th June 2015. Mr Fox removed my first rib and some muscle. Op started at 10,30 and in recovery room by 2.o'clock. Rib was removed from the front just above collarbone and had draining tube, I was really surprised The pain was on scale 1-10 only a 3. stayed in overnight, drain removed next morning and allowed home late afternoon. Seeing Mr Fox again in six weeks. The only symptoms I have at the moment is tingling down my arm into my fingers, I am hoping this is due to swelling in side. And I find it hard to sleep on my back. I am into my 4th day after op. and to be honest getting bored, I am moving my arm and shoulder ok, but not lifting or doing anything so that things can heal. But I am really pleased at long last one side's done, and when swelling goes down inside, hoping that pins and needles go. time will tell in the next few weeks. Keep you updated weekly on progress. It shows find a great surgeon and you are halfway there. do your research in your area. and don't be frightened to ask for the surgeon you want. it.s your body.
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Does nerve pain on the feet and calves go away after spinal surgery? I've been suffering from burning nerve pain since my back surgery. I had a laminectomy and fusion at t22 l1.
What can I do to help. Other imaging?
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In 2009, I was diagnosed with Thoracic Osteoarthritis, Degenerative Disc Disease, and Fibromyalgia - and in November 2015 diagnosed with Cervical Radiculopathy. As you see, I have dealt with chronic pain for a long time, and I am tired of it – it’s exhausting and limits my day to day activities.
Anyway based on my MRI results and my physical symptoms - the surgeon diagnosed me with Cervical Radiculopathy and *suggested* a Posterior Cervical Decompression (PCDF) as well as an Anterior Cervical Discectomy with Fusion, ( ACDF). No pressure … he told me to just think it over and referred me to Physical Therapy.
Since the diagnosis, I am doing a ton of research and educating myself about my condition and the surgery.
Last week I asked my physical therapist what she thought of the surgery and she said, “I had time to have the surgery later”. (I’m 63 and not clear about what “later” even means This week my primary care doctor said outright, that I do not want this surgery because it may not relieve the numbness and pain, and does nothing for the arthritis in my neck, and there will be issues with scar tissue and that my condition is not that bad – yet. He suggested I get a second opinion. I agreed to get a second opinion.
Cervical Radiculopathy Timeline
January 2015 I developed a pinch nerve in the left side of my neck along with the slow progression of excruciating numbness and/or pain in my arm, fingers and thigh. In June 2015, my primary care doctor diagnosed me with pinch nerve and referred me to PT along with the suggestion that I get a back massage. I had tried PT before for my osteoarthritis and hated it. So, I decided to try yoga instead.
Through yoga, I relieved most of the thigh and neck pain and increased my range of motion. However, the numbness and pain in my fingers and in my arm became worse - along with the loss of grip strength. I informed my primary care Dr. in Oct of 2015, he referred me to an orthopedic surgeon, who of course ordered an MRI.
As I said, based on the test results, the surgeon suggested surgery but wanted me to first try physical therapy, this time I went. I started twice weekly therapy sessions in November 2015 and so far it’s effective. After 6 weeks of passive exercises, my arm pain had diminished significantly and the numbness decreased to a ‘low buzz’.
Because I was progressing so well - the week of Christmas 2015 the therapist changed to more aggressive exercises (10 mins on the treadmill, resistance bands, etc) I felt ok while there. However, by the time I returned home after the session the pain in my neck and back was out of control. I had learned many PT pain intervention techniques and I tried them all but the pain escalated. Numbness increased significantly in my thumb. In addition to that I now not only have pain on the left side of my neck but also the right - along with a considerable decrease in my range of motion on both sides of my neck. My grip strength decreased almost immediately and I am dropping things again. Thought it best to cancel my next appointment, ha-ha! Although I feel better, today I am still in pain - most movements makes it worse. At this point, I’m confused and not sure what to do next. My next PT appointment is on Jan 5th and I see the surgeon on Jan 19 to inform him of my decision.
My questions.
1. Without ongoing physical therapy –(i.e. the rest of my life) will the symptoms of Cervical Radiculopathy return? (Anyone have experience with this?)
2. With degenerative disc disease, overtime, will my disc continue to lose height and stack on top of one another causing even more pain? (So far because of this I’ve lost 2” in height.)
3. From the point of being diagnosed with Cervical Radiculopathy what is the longest time anyone has waited in deciding to have the surgery or not to have surgery?
4. Why would waiting for the symptoms to get worse be beneficial to obtaining a positive outcome or to justify the surgery?
5. Finally, why are some medical professionals against having this surgery? Has anyone experienced being discouraged from having the procedure and how did it influence your decision to have or not have the surgery?
I thoroughly understand this is a major surgery with a very rough and long recovery period. To be honest at age 63 – I am more worried about recovering from the anesthesia and if my body can withstand the actual length of the surgery, and those factors are certainly not going to get better as I age.
I also understand that I need to rely on the medical professionals’ opinions however, I have been ‘burnt’ in the past with so-called medical opinions. That is why I am seeking experiences related to this from ‘normal’ folks ---I need a different perspective from people who have dealt with this process.
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I would like to hear from someone who has had one solid rod from top of spine and pelvis where it is attached to pelvic bone...I would like to know how it affects them and what their quality of life is like...I'm not sure if I should have this second surgery or just stay on my crutches for rest of my life...
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I had dynesys done from S1 to L4 back in 2011. A year or so later a screw removal was done to the right side. The original problem was because L5 disc had collapsed. New MRI has shown the L5 and L4 both degenerated and L5 disc is bulging to the right side which is causing alot of pain around to the right hip. In the last 4 weeks u have had a couple of scares and immense pain I am due to see consultant on 23Rd May I think I am gonna possibly just gonna be fobbed off with a nerve root injection I am worried it's not gonna work any advice please does anyone think that this would be the right course of action for me to take??
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I had this unit put in in Dem. 2013 but because of the lead trying to push through the back of my neck it had to be revised in August 2014. Was doing great until January 19, 2016 when the lead again pushed entirely through the skin on back of my neck. Now my insurance company will not approve for me to have another unit put back in. I was free 90% of the time with my unit in and now I am back to having so much pain in this area. It makes it very hard to have any quality of life except to wait around for another horrible burning pain that takes 3 mores days to overcome each time. Has anyone else had their insurance refuse this especially when it worked great?
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Has anyone had the Neuro 10 implanted ?. It's really difficult to try and figure out because there are so many different types of stimulators. I had fusions that were not successful and the Neurosurgeon at Mayo thought this might be the answer. It is fairly new on the market (2015) so it's difficult finding any reviews.
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Two years ago I broke my ankle and had pins and plates put in. On Monday I am having them taken out because they are irritating my tendon. I am also having a 'bone spur' basically shaved off and they are going to 'explore' the damage done to the tendon.
When I had them put in I had a general anaesthetic, but I wasn't asked what I'd prefer. This time, at a different hospital I have been.
I don't know what to do for the best. Obviously I can talk about this when I arrive on Monday I'd just like people opinions on which they prefer and why. Or even which they think would be suitable for my surgery.
I was fine after my anaesthetic last time, no side effects etc I just think I feel more comfortable not being 'put to sleep'... just in case. I'm a bit of a worrier!
I am leaning towards opting for the spinal anaesthetic combined with a bit of sedation as I do think I may get anxious. The only thing that is putting me off is what I will hear. Obviously they will be using screwdrivers etc and the thought of hearing them and knowing what they are doing makes me feel a little queasy!
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