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DebraSDDebraS Posts: 12
edited 06/11/2012 - 8:42 AM in Neck Pain: Cervical
first let me start of by saying howdy folks, glad I have found this forum. In 1990 I had 4 extensive surgeries on my throat for thyroid cancer. Those surgeries removed muscles and caused me to have chronic severe muscle spasms since-nothing works for them. I developed shoulder & cervical spine pain about 1993 and have dealt with it since. I found out in 2000 I had 2 bulging cervical discs and congenital fusion on the c5-c6. I was sent to pain management as the nedications my doctors keep prescribing do not work and my pain & symptoms have increased. I had a mri done last week and results given to me yesterday are as follows:

c2-c3 & c3-c4 are normal -YAY
c4-c5 mild circumferential endplate spurring and moderate broad-based disc bulging effacing the ventral thecal sac and narrowing the AP diameter of the spinal canal to 9.5mm, compatible with mild spinal canal stenosis.

c5-c6 decrease of the AP diameter of the vertrebral bodies with narrowing of the intervertebral disc space, compatible with partial congenital fusion.

c6-c7 mild circumferential endplate spurring and moderate broad-based disc bulging effacing the ventral thecal sac and narrowing the AP diameter of the spinal canal to 10mm, compatible with borderline spinal canal stenosis.

c4-c7 mild kyphosis which may be secondary to the muscle spasm or chronic and secondary to congenital partial fusion of c5-c6.

my pain management dr would not discuss this in to much detail as he said he did not want to take the "thunder" away form the orthapedic spine surgeon he referred me to. My pain management dr has been trying to push injections and with this new report I am very nervous about that. I currently take soma 350mg 3x a day and hydrocodone 5/500 2x a day and they dont work,these are the strongest medications Ive taken yet in the last 17 years of this. my pain management dr knows they do not work and even with the new report refuses to prescribe anything other than nucynta which is not covered on my insurance and beyond my affordabillity.

what does my mri look like to you? am I in need of surgery? Given the congenital fusion, kyphosis & stenosis is it fixable? I am trying to decide if I need to find a new dr that isnt pushing me into surgery or injections. With his refusal to prescribe medications that could potentially help my pain & spasms I feel that is what he is doing. Of note this is a multi physician practice and just so happens the orthapedic spine surgeon he has me seeing next week is in his medical practice.


  • Hi Debra,

    First let me say welcome to spine-health. Have a look around and you will find many whom have or are going through the same as yourself. As far as interpreting MRI's that is something we really frown on. There are so many radiologist interpreting the MRI's differently that we don't want to lead you down the wrong path. In my experience I prefer that I see a surgeon who is looking at the films and not at the reports. They seem to really know what they are looking for and often times just at a glance so to speak. But here are some things you can do to prepare for the appointment. At the top of the page you will find the FAQ section. In that list is a "list of 38 questions to ask a spine surgeon'. Go through the list and see if any of those questions you can answer and make notes so you are prepared. Additionally you may come up with some more questions to ask. Also keep in mind many things are going to show up on a MRI as we age, and some of those issues may not be symptomatic.

    Also at the top of the page is the search function. You might want to look up cervical stenosis and get acquainted with that. The kyphosis means the the normal curve in the cervical spine is straightening.

    You speak of pain, of what type of pain are you having? Where is it located? As far as doing the injections or surgery I always think it is best to get a multiple opinions. I have seen many come and do very well with injections, and move on to a normal busy life. Sometimes injections are used for diagnostic purposes to.

    As far as the issues with getting different medicine from your pain management doctor that is a difficult one. One thing I have done is journal my pain and go over that journaling with my pm doctor. That way he can see clearly areas I am having issues with. We always caution members of not asking for any specific med, just doesn't look so good for the patient.

    Anyway just thought I would stop by and welcome you to spine-health. If I can be of any assistance don't hesitate to pm me. Keep us post on the appointment with the surgeon. Take care.
  • "You speak of pain, of what type of pain are you having? Where is it located? "

    I have constant pain-it is unrelentless. Of note, I also have a shoulder deformity it is mild, my scapula and shoulder are rotated up & forward so that adds to the equation, and the muscles taken from my cancer surgeries left the remaining ones to work overtime causing constant spasms. so...

    I have constant pain from the base of my skull down my neck, to about the end of my shoulder blades, across to my left shoulder now its going into my right shoulder. At times down my arm and my back to my hips. I occasionally get sciatic pain when my hips are hurting. Always cramping, aching at times burning, shooting like electric shocks. I have daily headaches from the time I wake until I go to bed sometimes the headaches get so bad it feels like im being stabbed in my skull. My shoulder & fingers get numb if it sit in the same position for long. When i look down i get shooting electric like throbbing pains down my spins to just below my shoulder blades. I have had pain for the last 17 years but some of these developments are new as of the last 6 months.

    My kyphosis isnt just straight, i have a backwards c in progress. Its a wide c but its the only way I can describe it as how the films looked at pain management.

    On a good day my pain is an 8 on bad days 13. I seem to have more bad days than good the last 6 months or so. I have dealt with this for 17 years but now that its alot worse and the mri's have the stenosis & kyphosis I am truly scared.

    I did ask my pain management doc where he would inject me he said we could try c7, how will it help injecting me below the damage? I see the prthapedic spine surgeon tuesday his study of interest is spinal deformities so I guess he is in the right direction given the kyphosis & congenital fusion?

    of note I am 38yrs old have been dealing with this since I was 19. Its documented in many of the reports from the neurologist, orthapedist & primary care doc I used to see that I declined medication unless I was in severe pain and only used the bare minimum of medication until the severe phases were over maybe 2 weeks, than I would just deal with the pain on my own. For me to ask or want medication is not me-it has come to the point of being unbearable that I need something to ease it enough I can do dishes, laundry and sit without wanting to cry.
  • Debra,

    Some of what you are describing sounds like radiculopathy. Look at the cervical radiuculopathy video and see if the pain follows those patterns. Also you might want to look at a dermatone map and see the patterns. Another thought is how long have you been on Soma, I use that medicine as well and just moved up to the max of 4 a day. With the muscle loss you had from the cancer surgery it is no wonder you have so many spasms. Have you tried getting medical messages to help with them or a ten's unit? I do understand that you are under medicated, and how frustrating it can be to make someone understand the approach they are using is not working. Do you know what type of injection they will be doing? For example I have had selective nerve root blocks that were diagnostic in purpose. I do hope when you see this surgeon he has some answers for you, and can help find at least something in the short term to get you some relief.
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