C-4/5/6/7 T-1/2 Nerve & Spinal Cord ??'s

C-4/5/6/7 T-1/2 Nerve & Spinal Cord ??'s

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Joydancer
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Joined: 08/01/2009 - 10:15pm
C-4/5/6/7 T-1/2 Nerve & Spinal Cord ??'s

Would appreciate some input from my C-spine comrades...

re: Current MRI CT Flexion X-Rays done in April, the OS assessed the following:

"bi-lateral nerve root compression at C-6/7 into T-1; compression of nerve root 8 on left side; facet arthropathy more changes at C-4/5/6 osteophytes noted; deformed thecal sac at C-5/6"

MRI & CT Scans done without contrast

Question:
What diagnostics would be able to more clearly define status of nerve root compression & degree of deformed thecal sac of spinal cord?

I have not had MRI CT Scans with contrast nor a myelogram for over 2 years.

Which of these or other diagnostics would be most important to do in trying to determine degree and positional status of severely DDD C-5/6/7 collapsing onto C-T-1/2?

(My wonderful NS who was a master of diagnostic studies and assessment unfortunately retired 2 years ago)

I want to be clear of options - - have an important NS appt out of state in 2 weeks; 2nd opinion and assessment since previous OS backed out from moving ahead with surgery; final decision being "highly unlikely to be successful outcome with doing interventional surgery".

Appreciate your input on the above & any other info you would like to offer to me.

Janelle

Aviatrix36440
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Joined: 09/29/2009 - 10:35pm
MRI

Howdy Janelle!!

As you know our levels on the top side are only 1 off, but the rest sadly, we are twins in many ways.

I can only express what they've done with me that has worked so far. My NS has been more on the physical exam (functionality, strength, pain levels with xx moves), MRI and NVC/EMG thus far. He has been able to nail what's been going on with me until this Neuropathy came into the picture.

As you know, a huge bulge on one person does nothing, yet another with a "small or tiny" they are writhing in pain! Go figure huh? I also opt for the positional MRI's anymore. I feel more of my symptoms standing or sitting (neck or back), and as such prefer though uncomfortable to have my spine under load to let the MRI image "see the real me" if you will. I hope this helps my friend. *HUG*

Brenda

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

BarbF01
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Joined: 06/18/2010 - 12:28am
had the surgery here...

I had a fusion done from C5 through C7 (metal plate and screws). I also had 2 discs that had completely ruptured (per the Doc's comments, after surgery "Wow.. I just kept finding more and more fragments - those discs were demolished!). So, now I have 2 "spacers" (as I call them) in place of those discs, and they help w/ compression and stability issues. Ask me anything, if you'd like to know more about the surgery and my outcome. smiley

Joydancer
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Joined: 08/01/2009 - 10:15pm
Second Assessment Prognosis

Hello and (((hugs))) Spiney Twin!

Well, getting set for the big NS appt. which I know I MUST do with getting another re-schedule date of 10-7!! (oh let it just be that surgery fix on elbow/hand nerve entrapment only - - I'm having delusions of a miracle with the C-spine bypassing those surgeries - - oh gee and why would I want to do that !!

Re: Diagnostics Picture based on always being symptomatic C-Spine on left arm/hand (past 2 yrs episodic) and chronic for past 6 months = advanced nerve damage wrist/fingers

Focusing on Evaluating OS's Prognosis =
"highly unlikely successful outcome" !!

and

Bi-Lateral Nerve Compression C-5/6/7 has taken out my left hand to advanced neuropathy ulnar damage

and no evaluation or definitive opinion re: new changes of "deformed thecal sac" nor degree of how much ???

Trying to determine what would be best diagnostic to have done in order to address where things are right now - - clearly c-spine advanced neuropathy and advanced stage in 3 months arm/hand nerve damage:

Appt with NS second opinion will be to:

1)establish accurate prognosis;
2)address spinal cord compromise; and
3)intervention to reverse more severe compression of 7/8 nerve roots

Janelle

As you know, a huge bulge on one person does nothing, yet another with a "small or tiny" they are writhing in pain! Go figure huh? I also opt for the positional MRI's anymore. I feel more of my symptoms standing or sitting (neck or back), and as such prefer though uncomfortable to have my spine under load to let the MRI image "see the real me" if you will. I hope this helps my friend. *HUG*

Brenda

Aviatrix36440
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Joined: 09/29/2009 - 10:35pm
Well....

Janelle,

Well, as you know, you and I are so similar it is almost scary! My issues for C5-8 per EMG are from lesions in my brain, and as such creating the Neuropathy issues in my arms and legs. I almost think my NS likes that, as he can 'ignore' the failed fusion and crack for now. My hubby is pissed and wants me to go to another surgeon.

There is a renowned one down here - he invented hardware that 'breaks down' (bio-degrade type) over a 1 and a half year period. Pretty cool. Now trying to get in to see him, good luck! I tried when all my crap started, and his staff was such idiots, that was a mess...I went to another NS (Chief of NS at his Hospital), so it worked out.

Just keep after them until you at least have ANSWERS, even if that means that surgery can't fix it, you at least know what the heck is going on.

Off subject...did they just update the software here, the reply set up is different. Might be a fluke... weird.

Don't give up woman!!! *HUGZ*

Brenda

PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

Joydancer
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Joined: 08/01/2009 - 10:15pm
Barb, thanks...have ???'s

BarbF01 wrote:

Hi, Barb,

Appreciate you sharing about your C5 thru C7 severe conditions...and in offering to share more and address any ???'s Thanks...I got several..okay?!

Re: C-5 thru C-7 completely "ruptured" - - was that from trauma or an injury, or from degeneration (or both) ?

Re: surgery done with plates & screws and what you are calling 2 "spacers", was that in addition to the plates, actual hardware spacers?

What approach was surgery done, from front (anterior) or back (posterior)?

What was the level of symptoms you had up to surgery-- best and worst phases?

What was your prognosis / outcome?

Thanks for jumping on here....hope to get more acquainted too c-spiney comrade !

Janelle

Joydancer
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Joined: 08/01/2009 - 10:15pm
Barb, thanks...yes some ??'s

Hi, Barb,

Appreciate you sharing about your C5 thru C7 severe conditions...and in offering to share more and address any ???'s Thanks...I got several..okay?!

Re: C-5 thru C-7 completely "ruptured" - - was that from trauma /injury, from degeneration (both) ?

Re: surgery done with plates & screws and what you are calling 2 "spacers", was that in addition to the plates, actual hardware spacers?

What approach was surgery done, from front (anterior) or back (posterior)?

What was the level of symptoms you had up to surgery-- best and worst phases?

What was your prognosis / outcome?

Thanks for jumping on here....hope to get more acquainted too c-spiney comrade !

Janelle

asignor908
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Joined: 07/03/2010 - 12:39am
Pain Post Op

I had an ACDF C-5 to C-7 on August 3rd 2010 with plate and screws as they said my spinal cord was in danger and of course pain.

How is your post op pain? How are you reating it?

I also have been recomended for low back surgery as well foe severe pain in back, hips, and legs with nueropathy. My pain meds seem ineffective most times.

AL S

Joydancer
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Joined: 08/01/2009 - 10:15pm
Not Post-Op - - But Crucial Assessment Phase !

Al,

Re Your ? reply to my post...

how is your "post-op pain" - - that's not where I am

My post is about getting best diagnostics for crucial assessment phase - - I am needing surgery !

Here's wishing you a very good and successful recovery and full stabilization of your c-spine with no further compromise to your spinal cord !

----------------------------------------------------
My Post was...

Question:

What diagnostics would be able to more clearly define status of nerve root compression & degree of deformed thecal sac of spinal cord?

I have not had MRI CT Scans with contrast nor a myelogram for over 2 years.

Which of these or other diagnostics would be most important to do in trying to determine degree and positional status of severely DDD C-5/6/7 collapsing onto C-T-1/2?

OS backed out from moving ahead with surgery; final decision being "highly unlikely to be susccessful outcome in doing surgery".

-----------------------------------------------

Janelle

Kris-NY
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Joined: 08/05/2009 - 6:23pm
Not sure

Janelle I had the CT first this last time and the surgeon was able to clearly see the bone issues that he felt were the problem. He then wanted MRIs and when he saw those he changed his mind.

My understanding was always that CT show bone best and MRI shows soft tissue and nerves best.

I have no idea why in my case he changed his mind. I am going to another opinion from a surgeon who will hopefully explain what happened since no one else wants to tell me.

You must be getting excited as your appt approaches. Have you contacted the office to see if they think you should get new tests before going? It might be unusual but if everything you have is old it could save time.

tamtam
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Joined: 06/19/2008 - 6:35pm
Best test

The best test to see the cord and the actual nerve roots is going to be a myelogram. Most doctors don't order them unless they suspect something is wrong. The last one I had done was after a MRI that clearly showed the cord was being deformed on the slice images so he went straight for the myelogram to get a complete visual of the cord itself. Also sense he follows them with a Ct scan it gives him more detail on the actual fusions themselves.

But your doctor could also get more detail using a mri with contrast. The fact that you have hardware I would think contrast would be more in order to keep away from the shadows.

But your doctor will need to make the call as to what they are looking at. If it is a stability issue then some good old flexion, extension films will get that. But then a myelogram will as well due to the positioning for the test. Also keep in mind that they orders those test with specifics on the slice depending on what they are looking at.

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