My c-spine acting up again... (discography results)

[mmglobal]

Here is a tip, boys and girls.... with a 10 month-old around the house, you cannot walk around in the dark. Last Thursday, I tripped over some baby stuff and had a great fall. Good thing I didn't drop the laptop... but I did break the cable-end for the AC adapter. Got some good bruises, but I thought that I was just OK. Just a few hours later, I was beginning the 20 hour travel ordeal, LAX to Munich. The flight to Atlanta was OK, but by the time we boarded for the ATL-MUC flight, I started to notice that all of my c-spine symptoms were flared... not too bad yet... but definitely there.

In all the trips I've taken with clients for their surgery (now more than 20), this is the first one where I've had a worse time flying than my client. Interscapular pain constant with great increase if I turn head in either direction or put my chin to my chest. Extension is OK. Hand numbness was worse, but that has gotten better. Neck/upper back pain is a little better, now 4 days later, but it's still way significant compared to before.

Those who have followed me on the forums for years know that I've been talking about getting discography on my neck for the last 2 years. I've always been too busy and my pathology puts me into the 'quality of life' decision category instead of needing to do surgery because of more significant symptoms or fear of permanent damage. This has me motivated... I'm always an accident waiting to happen. I know this isn't getting better on it's own. I should have time on this trip to do the disco... if the results are conclusive... I may be good to go. The problem is that I have 2 obvious bad levels, plus a third level that may be causing some unusual symptoms that are difficult to correlate. We'll see what the disco shows... hopefully Friday or Saturday... I'll know more.

All the best.

Mark

[dshobbies]

Mark,

I wish I had the words to express how sorry I am for your pain and plight. I believe your own sufferings have turned you into an angel of mercy for so many of us... you have walked a mile in our shoes... but it ultimately makes it no easier to bear.

You also need to know that in a marriage, it is usually agreed upon that only one of you can go crazy at any given time so you'd better discuss this flair up with Diane and decide which of you needs to take care of the other! Maybe you can delegate that responsibillity to the 10 month old.

Please take care - and I hope this doesn't affect dinner

All my best, Dale

[ellecincos1]

Mark,

When my children were little I constantly looked down to the floor to make sure I wouldn't fall and break my neck. The large amount of toys all over the floor kept me in a constant alert. Luckly I mastered the technique to jump over them. I hope with some antinflamatories and rest it will calm down and feel better. I agree with dshobbies you have walked in our shoes we don't want you to have to also deal with more pain issues. I hope all goes well.
Take care

[KL Aguilar]

Mark, I am so sorry to read this, but thank you for the new word (for me) to describe my almost constant companion: interscapular. Flexeril helps for me and I have gotten trigger point injections in the last month that have made a big difference.

[fuzzy]

I hear you Mark, I am still watching very carefully where I step even though the few minor mishaps I have (already) had clearly show that my spine is a lot better then it was before, but I really dont want to chance any more trouble down the road (no more motorbikes, traded those for some more camera gear!). Dr. Z. told me to "live life, don't worry about spine .. but at the same time to always use the hand rail." When ever I "forget" to use the handrail and my wife reminds me of Zs words it becomes very obvious how we become complacent so easy in light of lower painlevels. I tripped over one of the cats a couple of days ago, o boy!

[fortitudine]

Mark,
I hope your pain disappears, and I hope you don't show up as needing surgery ASAP. Keep us posted.

[Maria]

Hey Mark,
Yeah that can be so limiting as well as incredibly painful when the cspine flares up. My acute incident took me a few weeks (3) plus toradol shots every week and being very careful to get over and then a few months to be rid of the weird sort of guarding pain.

Acutely I couldn't even look downwards w/o severe spasm/pain in neck and rotating head left to right wasn't even possible. That was so weird and actually worse than my lumbar spine in terms of limitations.

Good luck with your disco results and whatever you might do. Hope you get yourself taken care of pain and spasm wise and your trip back is easier on you.

[mmglobal]

Thanks for all the kind words... all the acute stuff is almost gone (6 days after fall)... not too bad now. Focusing on this kind of brings it home... how limiting the daily stuff is. It's strange not having acute pain, but by the end of the day, what seems like a minor, dull ache; pretty much has you exhausted. Trying to sit and get some work done when something is gnawing at you is really difficult.

We'll see what the discogram says. It'll be wierd being on the table.

"Ow, ow, ow.... that's a ten!" said Mark.

"I haven't even touched you yet" said the doctor.

Take care all... I'll keep you posted.

Mark

[Maria]

Perhaps you could get some Marcaine or an ESI done after the disco if it's going to be leave you in the type of pain the lumbar ones left me in (or would have if not for the Marcaine injected after '03 one and ESI/transforaminal after '05 one).

Or a Cadillac Margarita drip

[ans]

Hey Mark,

Sorry to hear of this. Wishing you my best. - Allan

[Sonata]

Hi Mark

I am so sorry to hear about your c-spine. It's good to hear you are doing better. I hope the discogram goes all well. It's wonderful that you are already with the best doctors out there.

Best wishes
Sonata

[mmglobal]

Well, I got the answers I needed, but they are not the answers I wanted. Maybe they were.. maybe not. I've been trying to get this discogram done for a couple of years now... but I'm always too busy or Bertagnoli's out of town towards the end of the trip, or I can't consider having a discogram done the day before I have to fly home. It's done now.

C5-6-7 both look severely collapsed w/big osteophytes. C3-4 clearly has a significant bulge, but it's unclear how it it's involved in my symptoms. Remember that this is not about discovering about bad discs as we already know that... it's about discovering if there is a very positive relationship between the discs that seem bad and my symptoms. The symptoms we are not sure about are the neuro symptoms on the side of my face. There is no dermatome from my bad discs and that area. Some doctors pooh-pooh the idea that a symptom pattern that doesn't match a dermatome could be in play. Others have seen too many unexplainable situations to simply write it off as impossible. (Note that before I told Baumbach about C3-4, he told me that my known bad C5-6-7 are mostly not involved in this symptoms... probably higher up.)

Bertagnoli did C3-4 first. As soon as he attempted to pressuize the disc, he noted that he was unable to generate significant pressure as the dye immediately extravasated into the canal area. "Just like on Tuesday" (Some of you will have read my post in another thread about the surgery a few days ago.) With higher volume injection, he generated 7/10 pain in my shoulder. More importantly, it also generated a warm tingly feeling over the entire left side of my face in the same pattern that I usually experience. The rest of the day, that has been more active than usual.

He then moved to C5-6. He was better able to generate pressure, but the disc is pretty severely broken down... there was no question about it needing ADR.... only if it is involved in my symptoms. He clearly generated 8/10 without too much pressure, but the pain was only similar to my pain. I could not really call in concordant.

I suggested that we already knew that C6-7 was completely compromised... No need to test it. Bertagnoli agreed. Upon further consideration, while I did not want another needle in my neck, I was not comfortable with the non-concordant response at C5-6, so I asked him to continue. 9/10 concordant pain at C6-7.

Bertagnoli had to leave, so we did not get to debrief the results. I don't expect any surprises, but I look forward to the lengthy discussion we'll have tomorrow. What I know for sure is that if I'm considering cervical ADR, I'm clearly a 3-level procedure. These three discs have looked like this for some time and will not get undegenerated with time. I'm glad to get confirmation that my neuro symptoms in the L side of my face are related to C3-4. My interscapular pain is likely related to C6-7. However, I am still very high functioning to consider 3-level ADR. I cannot consider surgery before the GPN conference in May, in Miami. So, now I know. I'll let this cook for the next few months and if things don't improve substantially, I'll probably have 3-level Cervical to go with my 2-level Lumbar ADR.

While cervical discography without any sedation was quite painful, I've been functioning pretty well since then. It's 9:30pm and the procedure ended about 3pm. I've been to the hospital to visit my client (she's doing quite well.) I had dinner in my room, but went out later for coffee and dessert with a friend and have been working for the last few hours back in my room. I'm still a little sore and a little nauseous, but I've only had some Tylenol and ibuprofen. (I don't even carry a vicoden any longer.... probably should.)

I hope that the blow by blow report helps someone to understand the process better.

All the best,

Mark

[dshobbies]

Mark,

That which doesn't kill us only makes us stronger and in your case, you only continue to get better at what you do. I'm so sorry that you are experiencing cervical disc degeneration with the subsequent pain and further surgery but your reward, if one there be, will be an empathy for others that has no parallel.

On another note, and I know I've posted this before, is that though a discogram without anesthesia is painful and for me, a huge deterrent in going to Germany, it isn't as bad as it sounds. Yes, you may experience a level 10 pain but the duration of this pain is so short that before you can even say 'ouch' or some other expletive, the pain is over. I realize this post is about Mark but it was posts like his explanation of his discogram that caused such a fear in me over this test, I was willing to compromise my best interests just to avoid it. For any in this situation, it's really not as bad as it sounds. I would not hesitate to go through it again.

Mark, I hope your pain and discomfort continues to allow your usual high functioning. Please take care and take it easy!

Dale

[JeffreyD]

Mark,
Please know that Pauline and I are praying that you receive a spot-on, accurate diagnosis that will lead to catching the correct pain generator(s).

Don't forget to have an Augustiner Green Label for me (just one, now....).

God Bless,
Jeff

[Jim M2]

Mark,
Fascinating how we're all wired a little differently. I'm referring to the facial symptoms from the C3-4 disco. No mention of C4-5, was it negative? Yes, your blow by blow reports helps me understand the process. I'm following in your and Doreen's footsteps with the cervical problems. Whaaaa! Misery loves company!

Jim

[ans]

Definitely not what you wanted to hear. So sorry about this Mark.

Allan

[mmglobal]

Debriefed discogram w/Bertagnoli today. Severe degeneration at all 3 levels... disc in the middle looks ok, but it is getting abused by poor kinematics of surrounding bodies. No question that when I do surgery, all 3 will need to be done. Still a 'quality of life' decision. I can't consider surgery until after my May conference. If things stay as they are now... I'm ready to go.

All the best,

Mark

[ellecincos1]

Mark,

I'm so sorry that there's three discs with problems you must be very disappointed. Luckly you have a docter that could make you as good as new if you decide on surgery. Make sure you tell Dr. B that you want to be the next Bionic Man!!! Seriously, I hope the pain and problems all subside because you deserve it.

Myriam

[sahuaro]

Mark:
Not good news but at least now you know. Hopefully you will be able to address this in your own time frame.

[kim222]

Mark,

It's interesting about the "face tingling thing". I get the tingling/prickling feeling on the left lower cheek & below the jaw-line on my left side and that is the same side that my C3/4 bulges toward. I sorta chalked it up to my sternocleidomastoid muscle acting up in the front of my neck and possibly tugging on a facial nerve. Thanks for the info and the food for thought. It's good to hear someone's experience with the procedure. I hope your pain levels stay low until you can get the surgery!

Best wishes,

Kim

[mmglobal]

I have to tell you... that fall set me off in a way that really made me think that surgery would be needed soon. Since the trip, my neck has been better than normal and I would not be considering surgery as long as I'm this functional.

In the past, we've heard that people can be better than ever, after discography. I wonder about possibly rehydrating the disc via discography and getting some therapeutic benefit? (I also have experienced and heard about being much worse after discography... so don't go for discography instead of PT!)

Mark

[Hucky :)]

Mark,

I'm sorry you're having problems with your C-spine. Being a fellow C-spiney, I know what you're going through. They use the Mobi C at the Alpha Klinik don't they? Is this what you will have implanted when the time comes?

It just hasn't been yours and Diane's year has it

Hucky

[mmglobal]

Man oh man... the surgical decision is so tough. For years, I've been too high functioning to consider surgery. I still am, but the episodes are getting worse. The radicular symptoms are getting worse.

I'm having a pretty bad episode now. It's very interesting that the face symptoms are very active with this, but in a different way. I was not specific enough when I said that the discography lit up these symptoms in my typical pattern. The normal pattern was there, but the area lit up on discography extended down the left side of my neck. With this episode, left side of face is more active than normal. Interestingly, it's extending around my neck and shoulder area as I remember in the disco. Unfortunately, it's even worse than that and includes most of my shoulder most of my arm... greater on the inside than outside.

Purpose of the post is not to whine... I think people will find it interesting that I have this corrolation in a very atypical pattern that does not follow the dermatome charts. Also of note is the fact that my surgical decision is not any easier than any of yours. Most of the time, I'm saying that I'm in too good of shape to consider surgery. When I'm in episode, I'm saying that I know it's only going to get worse... I stand better chance of success if I go earlier rather than later.... what am I waiting for... the big episode that will completely knock me down and may be dangerous?

After the discography, I was saying that if I did surgery, I'd probably try C5-6-7 and leave C3-4 alone because re-entry for the c-spine is not a problem and that the symptoms associated with 3-4 are only annoying. With this development that gives me even clearer corrolation to 3-4 puts me back into the split 3-level spanning 4-levels category. I know several 4-level patients... but it's still a big surgery and a risk. This second, I'm leaning towards surgery... maybe in a few days this will be blown over and I'll again be too good to consider surgery.

What's a mother to do?

Yes, I'll have some cheese with my whine.

All the best,

Mark

[Maria]

Doesn't episodic stuff that blows over drive you crazy? Ya feel so bad and feel like surgery time then ya feel so good that it's like *no way Jose* or at least *later Jose*... I dunno... just wish you the best esp. with what sounds like a super sized surgery upcoming. Hope you get some serious relief ASAP.

[dshobbies]

Honestly I don't understand all of this in evolutionary terms. Dinosaurs efficiently roamed the earth for millions of years and have been speculated as the superior species had they not been wiped out by ?.

Mankind has specific weaknesses. Is it that medical science has prolonged life expecation faster than survival of the fittest could strengthen our spines, knees and hips? Are we a dead end branch in favor of a better engineered species? Do other primates have these problems?

I've heard that if we are wiped out because of ?, spiders will evolve into the BMOC. Did you know that black widow females eat their mates? Interesting, very interesting!

[mmglobal]

Dinosaurs didn't wander so efficiently. There were 2 different types of T-Rex's. The big ferrocious ones were prone to DDD... that's why they were so angry all the time. The others evolved into Barney.

[ans]

I'm sorry to hear this. Of course I have no experience of considering such decisions.

How about a six-year pain remission.

[Maria]

Giraffes.. they're still around... 7 cervical very elongated vertebrae with highly flexible joints and some muscles that anchor the neck for the movement. Had to google it as I had no idea...now I'm interested ..

[fuzzy]

Originally Posted by mmglobal

Dinosaurs didn't wander so efficiently. There were 2 different types of T-Rex's. The big ferrocious ones were prone to DDD... that's why they were so angry all the time. The others evolved into Barney.

LOL,

But seriously, you are such an expert at these matters and at the same time you struggle with this decison like all of us. That shows how difficult this is. I myself am very concerned about my own neck. It is constant amd simply is not getting any better and I don't know where the point is when it is "nessesay" to do a surgery. I doen't hurt much these days but I got all these probs in my feet that are triggered by my neck and embellished by bending of my lower back. Europe says sugery. USA says nothing. Actually I just got denied (again) an office visit at a usa neurologist ???? It seems they don't want to touch me these days? Why, because I went to Europe? Because of the ADR, they won't tell me the reason.

[Cheryl]

All I can say is that I feel your pain.

Thanks for sharing!!! I'll be following your story as I am not far behind you. I do not even consider myself functioning.


Keep us posted.

[mmglobal]

I've taken the next step and have asked for a surgery date. The kicker for me was on going to see Dr. Delamarter with a client. Flexion/extension xrays of my client's c-spine showed that all of the levels involved in the DDD were moving as a unit... basically looking like a long fusion and clearly overloading adjacent levels. Along with the still elevated neuro symptoms... it all ties into the "what am I waiting for... better chance of success earlier rather than later... this won't get better on it's own..."

If the surgery is a success, I'll be kicking myself for not doing it years ago.

If the surgery is not a success, I'll be kicking myself for doing it while I can still function so well.

Results will probably be somewhere in the middle???

Based on what I've seen with clients' cervical surgeries in situations like mine, I'm much less afraid of the surgery than I would be for big multi-level lumbar. While I need 3 levels, I consider it a 4-level surgery because it spans 4 levels. We did not test the healthy looking disc in the middle... now I wish we had... I don't know if I'll repeat discography... certainly not at bad levels... they are proven and now obvious... but that seemingly good level in the middle.... better to have 4 done, than leave one in the middle??? I don't know. My guess is that Bertagnoli will want to leave it alone.

Maybe December???

I'll keep y'all posted.

Mark

[ans]

Mark, I wish you well in this decision.

I never thought of levels with DDD moving in tandem and don't quite get how this is deleterious. No matter. I admire your courage and quick decision-making ability. And of course, let this be your last surgery ever needed.

Allan

[sahuaro]

Mark:
Wishing you all the best in your decision to move forward and hopefully get some good resolution. It is some cruel irony that you are presenting a unique situation!
Which disk will you be getting?

[mmglobal]

I'll get ProDisc-C

ANS, search for auto-adjacent level degeneration... I wrote about this around the time of Diane's surgery. The biomechanics are dorked up with collapsed or immobile segments, causing overload of adjacent levels... so they may be on the way out before we even get to ADR... that is why there are so many 2 and 3-level cases with there being a very clear pecking order... this one went first, then the next, then the next.

[fireyangel76]

Mark,
Wow I haven't been here for a bit...sorry to hear you are having problems again with your neck. Good luck with your decision and your surgery if you decide to go forward. Sounds like your between that rock and a hard place again....wish you the best.
Me, well, my neck is tweaked, my Dynesys is not as promised or alluded to, and I am off to fight Social Security soon.....wish me luck.
I may need the money to go some where else for medical!

[dshobbies]

Mark,

You know how sorry I am to hear that you've reached the point of surgery. Hopefully this will resolve all your pain and that's the end of it... of course besides your knee.

My thoughts are with you, Dale

How can I help?

[Jim M2]

Mark,
I'm wishing you the best in the upcoming surgery.

Like Cheryl I'm following a path similar to yours with ever evolving cervical symptoms.

When ever I hung up the phone or walked out of a doctor's office after committing to an invasive anything, I always felt unusually good for some reason. The good old pre-surgery roller coaster.

Take care, hope to see you soon,

[Maria]

Mark,
Wishing you the same success with this surgery as with your lumbar surgery however it's worked out in Dr.Bertagnoli's skillful surgical hands/mind!

[soljagal]

Mark,

I was recommended mobi c. Can you share what Dr B said the disadvantages of mobi c were?

BTW - I have an excellent neurologist who said that the face signals were a C5-C6 cord signal because the 'cranial nerve nucleus has a descending tract that crosses over the medial branch' something something something. It is a sign of cord compression.

[mmglobal]

Soljagal,

All of the differences from one device to the next come with advantages and disadvantages. I believe that for most 'average' cases, if you are a good candidate and get a good job done, all of the current crop of discs are likely to succeed. I don't want to speak for Bertagnoli... I'll just say that the doctors who prefer ProDisc embrace the greater stability that the more more constrained designs offer.

For me, I choose ProDisc-C because my construct will include 3 artificial discs and will span 4 levels. I believe that the stability issues are of greater importance in big multi-level procedures and also when there is instability present.

I have a surgery date... end of January. I was hoping that I'd go back to "I'm too functional now to consider surgery", but the flight home from Germany last week flared me up and I'm still pretty bad. I'm convinced about the increased symptoms and their relationship to the discs indicated by discography. I'm convinced about 'sooner better than later' for the pathology we see on the imaging... it's going to get worse and my chance of success is greater before the DDD advances further.

Thanks to all the well-wishers for your support!

All the best,

Mark

[mmglobal]

bumping to top for Gary

[Terry Allen Blackburn]

Mark:

I'm sorry you are going through such significant struggles. It's amazing to me how many lumbar's end up being cervical's as well. I wish you the best.

Terry Newton

[mmglobal]

Terry... yes, it seems that most of is having significant DDD in one area of the spine also have it elsewhere.

For those of you who are following this... read: http://www.ispine.org/forum/ispine/1...hest-pain.html

[mmglobal]

Not a good day. I spend a lot of time in doctors offices with clients. The "house of pain" that the waiting rooms are can be pretty oppressive. When I'm there with clients, I usually feel pretty good about the service I'm able to provide. Today, I returned to the house of pain... step 1, MRI... step 2, I already have the referral to pain managment doc. (Good news, I know him and like him. Read Marissa's story here.) I cannot express how depressing it is to be looking into pain management again.

I guess it's a bad news / good news story. I was asking for a referral to pain management to give it one last good try to avoid surgery. I want to return to PT and see what the PM doc might offer for managing the chronic pain in a more serious way. I take Voltaren and a occasional hydrocodone... no regular opiates... typically just a few a month... recently about 1/3 of the days or more.

The good news is that I don't think I'll be seeing the PM on a regular basis. The bad news is why. I don't have the radiologist's report yet, but there is much here that is obvious.

BIG SURPRISE... this is new. My last MRI 1.5 years ago shows a minor defect at Th1-Th2. Now I have this substantial herniation:


The C3-4 pathology looks substantial. lateral disc herniation is right side, neuro symptoms on left face and neck don't seem to correspond to the herniation, but discography showed huge annular tear with rapid extravasation of the contrast into the canal area. Injection at this level did fire up symptoms. Chemical irritation of left nerve root?



The following two images represent the worst level that I believe is my interscapular pain and symptoms in L arm. First I show the slice below the defect to demonstrate what the CSF (cerebrospinal fluid) layer should look like around the spinal cord. The next image is actually the slice ABOVE the first image. The cord compression is not severe, but it's wors than it has been and it's substantial.




OK... so it's back to the house of pain, but I think I'll be having the surgery... hopefully in May??? Anyone want to go with me?

[treefrog]

Anyone want to go with me?

ME!! I do, I do.

Wow, Mark, I'm sorry things seem to be getting worse. I hope PM can help you manage the pain, mine has been absolutely fantastic, I don't know what I would do without her.

[Terry Allen Blackburn]

WOW! is all I can say, as that compression does look significant. No wonder you hurt. I can only hope that you take the time necessary to care for you. Too often us caregivers spend too much time caring for others and neglecting ourselves. It sounds like you have a course of action in mind.

Be well.

Terry Newton

[Gil Denis]

Hi Mark
Wow nice MRI I have seen worse and so have you. I may want to join you?
I am doing a little better Skiing and working races,also a little construction work part time light duty.
I wish your pain to relive and hold on for now
Take care
Best Wishes
Talk Soon
Gil Denis

[Maria]

Sorry to hear you've more pain more of the time Mark tho at least it seems that perhaps there's a definitive timeline to do what when.

I'd love to go w/and see your surgery! Could I stand much time in the OR ~ no. Could I be propped on some kind of slant board for the spinally impaired but still very interested in viewing incredible spine surgeries~ sure!

At this point I think I'm pedally impaired as well..good days and bad days, just like the ol' back.

Thanks for sharing your films and cluing us in to what the changes are...very interesting tho sorry you're your own patient.

[fuzzy]

Mark, that looks similar to my C spine. And Yes, I have been thinking about this summer...

[Justin]

Jeez Mark. That's one heck of an MRI. Did you get the dictated report yet?

Maybe, Dr. B can work on us the same day?!?!

Good luck as you contemplate your surgical options.

[Kanutta]

Oh, Im sorry that your c-spine is acting up so bad, but it's probably time to look in to surgery now then, as you say yourself. It seems the time has come.
I spent 5 years in agony until I no longer could bear it, and went for the surgery.
I guess you go through the same fear and same pondering back and forth like all of us despite all your knowledge in this field.

As a fellow "neck person" I know how excruciating neck pain can be, maybe Norspan patches could help you a bit now...?

It's a low dose Buprenorphin, I have used it on and off for two years.
It seems it doesn't cause much physical addiction compared with other opioids, and it's real popular among PM docs here in Norway now.

[fortitudine]

I may join you too, Mark!

[mmglobal]

Got my MRI results yesterday. I was focused on the thoracic herniation because I'm in a new HMO and felt I needed documentation in order to get the oral steroids and thoracic MRI without having to wait for referrals to specialists. The original report did not even mention the herniation circled above! I had to push through a bunch of nonsense at the imaging center, but finally got an amended report. I went to the walk in clinic last night because I could not get in to see my doctor. I was not looking forward to trying to get the walk-in doctor to order things that should be refered to a specialist. I got a nice HMO surprise when my new GP walked in and said, "Hey, I'm not on tonight, but I saw you are here and thought you might want to see me." Nice guy!

I started predinsone dose-pack last night. New findings on MRI show:

T1-T2 disc extrusion visualized on sagittal sequences, extends cephalad 8.5mm x 3.5mm in a/p dimension. Transverse dimension cannot be calculated because of lack of axial images.

C3-4: moderate R uncovertebral joint hypertrophy (3.5mm in a/p dimension) resulting in moderate to severe R foraminal stenosis.

C4-5: mild bilateral uncovertebral joint hypertrophy and mile R facet arthopathy resulting in mild R foraminal stenosis.

C5-6: approx 65% disc space narrowing. 2mm disc bulge. 4mm L uncovertebral joint osteophyte resulting in severe L foraminal stenosis. 3mm R uncovertebral joint osteophyte resulting in moderate R foraminal stenosis. Residual a/p canal diameter 7.5mm w/mild central stenosis.

C6-7: approx 50% disc space narrowing. Mild bilateral uncovertebral joint hypertrophy resulting in moderate bilateral foraminal stenosis.

Bummer.

[phylly]

Mark,
I AM SO SORRY!!!!! It is such a bummer. Can you move forward with your surgery? I hope the medrol pack helps for awhile. Take care and try to rest.
Phylly

[Terry Allen Blackburn]

You MRI sounds like it's no wonder you are in pain. I hope that the non-surgical stuff you are doing helps so that you can put off the surgery as long as possible. Hang in there.

No one will do this as a professional courtesy for you with the amount of referrals you send their way?

Terry Newton

[Maria]

Hey Mark,
I'm glad you were able to get something to help you with your pain/flare up/whatever you're calling it after seeing the report...

My neck is really bothering me today after being at the hairdresser's on Thurs and extending my neck back over the sink then just bad positioning to watch TV I guess and Lola pulling so much while walking..

Anyway, what I have on my MRI is nothing and I feel super crappy today~ I mean nearly able to function w/this type of pain so I'm blown away you've made it this far w/o surgery... dang!

Glad you got a PCP that sounds really good and I imagine loves having as interesting and medically well versed a patient as yourself, esp in an HMO setting.

take care and hope the prednisone packs do the trick for a while.

[mmglobal]

Yesterday was day 4 of the dose-pack. It's been quite a struggle lately, but l came home yesterday evening feeling pretty good for the first time in quite a while. Zoey (granddaughter turning 2 later this month) was in her usual great mood and I was feeling good enough to chase her around and have a blast. After a short while it was clear that I was making a mistake. After a couple of hours... it really hit. All the gains from the dose-pack gone, and then some. Things have continued to advance today... symptoms rising to new levels. The most disconcerting issue is the numbness on L face is going past mild numbness and has been painful. Chest/arm pain have been crushing at times.

There may be an interesting discussion here. We hope that medications will relieve our symptoms so we may be more functional. In my current situation, I believe that I have a relatively new issue that comes with a substantial inflammatory process. Does medicating and regaining function allow me to further aggravate the problem, actually making things worse? Obviously, it's the activities, not the meds, but in this case, the activities are so benign, I'm not sure how I might have known what was too much? Hopefully, by the time I figure this all out, things will have settled down.

Thoracic MRI will be done Monday morning. That will tell a huge story. I'll keep you posted.

Mark

[fuzzy]

Good luck on the Thoracic MRI. I hope they don't find anything like the stuff they found my t spine that I wish I never would have known about.


I am still working on my file, Mark, just having trouble getting that paperwork I still need.

[Maria]

Mark,
As you know I've been on long term low dose use of Methadone for LBP and Neurontin and the wonderful ESIs that WC hardly wants to authorize...

Ok so if I were covering this pain and then flaring it up and my MRI results showed significant deterioration over a short period of time or even a longer period of time and then the pain/flare ups were becoming more nasty even tho I utilized meds to calm down the worse of it.. I believe I would have had surgery by now.

Fact is most of the time I've felt fairly well controlled given that I don't do much must factor in as well but I needed to feel really really bad like I did in the old days before entering into another surgery or see that my MRI/CT/discogram whatever testing is correlating with my symptoms for me to move on to surgery.

If the meds just cover acute flare ups but one is worsening both symptomatically and via diagnostic testing that seems to be reason to move on to surgery if it is warrented.

Now my neck is different story. I took 3 Fioricets and 1 skelaxin last night and still couldn't sleep for cervical pain. Today I feel like crap. But my MRI just shows an insignificant bulge at C5/6 according to the OSS.

This sucker hurts bad when it flares up...

Is this crushing arm and chest pain a new symptom?? It seems to be something you'd better mention to both the spine doc's you're consulting w/as well as you're PCP and maybe something you'd be best having checked out at Urgent Care or the ER (I know you were just there..). Have you had a recent EKG or any cardiac testing (I know you said these symptoms can be part of the cervical picture)... just don't want you to miss anything because you are *sure* it's all cervical/thoracic spine dx going on.. I don't mean to overstep any boundries as I recognize that you have Diane in your corner and she would push you to anything she thought necessary re the symptoms.

[dshobbies]

Mark,

I totally agree with the possibility of meds doing more harm than good. Already disabled with limited function, I medded myself up for a wedding where I danced a little too much. It put me over the edge and I became 100% disabled with no function at all. Then I found you

[mmglobal]

Thoracic MRI this morning... here is the axial slice at T1-T2. Like so many things spine... here is some cord compression. Could be no problem. Could be a big deal. Could get better with time.

[Maria]

Mark,
Just wondering what suggestions or recommendations your spine specialist is making re surgery to date based on symptoms/MRI findings.

Did you have a discogram yet for the cervical spine? I can't remember..would have to check back to see what you posted tho I think you did if I recall correctly~

Is this still sounding like a 4 level cervical surgery? Using what? Doing what?

Interesting stuff tho so wish it wasn't you or anyone else~

[dshobbies]

Just wondering Mark,

Is the word UNCLE in your vocabulary yet?

I'm so sorry you're dealing with all of this yet again.

[mmglobal]

Just keeping everyone up to date. Apparently, mine is going to be an unusual case. Hopefully someone can benefit from reading my story.

Radiologist report for thoracic MRI is in:

T1-T2: focal L paracentral disc protrusion extending to the L neuroforamen measuring 8mm in craniocaudal dimension x 4mm in anteroposterior dimension x 8mm in transverse dimension. This is causing moderate to severe L foraminal stenosis and slightly indenting the anterolateral thecal sac and thoracic cord.

T7-T8: 2mm focal central disc protrusion slightly indenting the anterior thecal sac and thoracic cord.

T10-T11: Disc desiccation and approx 25% disc space narrowing. Disc bulge measuring < 2mm. No stenosis.

While they did several axial slices at T1-2, the other levels only had 1 axial slice. I see many issues that are only visible on one slice… kind of makes you wonder why they are saving slices here? I don’t think this is an issue, but it would be nicer to get a more complete view as a matter of course.

These findings don’t change my decision making process at all. In the last year, the symptoms have risen to the level of requiring surgery. I hope I have not waited too long as I’ve watched borderline “mild to moderate’s” progress to “moderate to severe’s”. The prospect of as surgery that spans 6 levels is NOT attractive.

I’ll be trying to book within the next few months. I’ll most likely do a trip with clients for their surgeries and follow with my surgery a week later. Let me know if you want to come along.

Mark

[marion]

Hi Mark

so sorry to hear of your mishhap and really glad that its settling, keep us posted ! all the best

marion

[Maria]

Mark,
Saw that you had discography a few months back at least in going back on this thread.

Sounds like a wise decision to book yourself in at this point re findings/symptoms.

I'll catch up on one of your trips tho probably not this one unless my neck becomes something to deal with soon.

[New-disc]

Mark,

Your in my prayers!!

I also suffer from neck problems .. hand/arms going
numb.

Electric testing last Fri .... numbers in my
right arm came in weak.

If it's not one joint giving me a problem it's another.

Yikes!!

Todd

[sahuaro]

Mark:
Haven't chimed in because I truly don't know what to say. Your MRI results are distressing, to say the least. I hope the good docs have some good solutions.

[mmglobal]

The saga contines here: http://www.ispine.org/forum/surgical...-adr-blog.html

Surgery on Tuesday

[treefrog]

Oh, wow, that was fast. I guess I won't be joining you.

But, I'm glad that you are able to have surgery sooner, it certainly sounds like it is indicated. I really hope this is the last of surgery for you, and that you will no longer have pain. You need to be able to enjoy that beautiful little granddaughter, without pain getting in the way.

[Maria]

Fast work Mark.. my best to you with all and guess that means no Cadillac Margaritas before surgery.. maybe sometime after

[mmglobal]

bumping for newhere

[newhere]

Thank you mark