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New MRI results - 5 years later, what is my next step?

Been a bit of time since I had any MRI performed on my neck. I've been noticing more problems this past year and a half after an accident, but I had no idea how severe they were. My last MRI in 2015 showed a couple of herniated discs (which are now not showing up on my new MRI, but are bulged discs now I think), stenosis at a few levels & nerve root compression at one level (which did not show up this MRI as well I think). Ironically, I had to ask my chiropractor, of all people, if I could get a MRI because it was bothersome to me. The Orthopedic Doctors just brushed me away because they wanted to follow "Insurance Protocol" with treatment. 

So, here is where I was vs where I am today:

MRI from 2015

C2-C3 level the disc is normal

C3-C4 broad based disc hernination with significant cord impingement

C4-C5 disc bulge without significant stenonsis, very mild stenosis

C5-C6 disc bulge resulting in cord compression and bilateral C6 root impingement

C6-C7 central disc herniation resulding in significant cord impingement

C7-T1 dis is unremarkable

MRI in 2020

C2-C3: Small broad-based posterior disk osteophyte complex no spinal canal stenosis or neural foraminal narrowing

C3-C4: Posterior disk osteophyte complex that flattens ventral thecal sac that is bilateral facet hypertrophy. Mild spinal canal stenosis. There is moderate bilateral neural foraminal narrowing.

C4-C5: There is a posterior disk osteophyte complex flattening the ventral tecal sac. There is left-sided unconverterbral hypertrophy. There is mild spinal canal stenosis. Mild left neural forminal narrowing.

C5-C6: There is a posterior disk osterophyte complex flattening the ventral thecal sac. There is left-sided incovertebral hypertrophy. There is mild spinal stenosis. Mild left neural foraminal narrowing.

C6-C7: Posterior disk osteophyte complex flattening the ventral thecal sac with severe spinal canal stenosis. There is a bilateral converterbral hypertrophy with severe bilateral neural foraminal narrowing.

C7-T1: No disc disease, spinal stenosis or foraminal stenosis

Other: No other significant findings

Degenerative changes worst at C5-C6 and C6-C7


So now the question is, what is next? I asked my chiropractor and they said I'm lucky to even be responding to their treatments but the loss of some of my functions while driving is concerning. They suggested I can try their disc decompression unit to see if it helps any, but if it didn't, they'd send me for a neurosurgery consultation. Naturally, I tell my family about this and I'm given the "You don't want surgery. We really don't think you should explore that and should  let your body heal, etc." So I don't have much support from them. But at this point, I'm limited to being in the house almost all the time. Any suggestions from anyone here?

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Comments

  • Personally, I would see a spinal specialist, neurosurgeon or orthopedic, there are many treatments that you may qualify for.

    I had cervical surgery 2 years ago, and I know the pain I had before surgery, the surgery helped me greatly.

    Chip

  • luckyman316 - I agree with Chip in his thoughts of getting an opinion from a spinal specialist, neurosurgeon or orthopedic surgeon.  I gather that you have tried the conservative treatments.  The term "Insurance Protocol" brings back horror memories for me.  I had an insurance company stall me for years and now I've ended up with permanent spinal cord damage.
     Call it a second opinion if you want, but I think you deserve another pair of qualified eyes looking at your case.

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  • Thank you both for the comments. Yeah, might be time to get that neurosurgeon consultation. To good news is, my actual pain is not as severe as it is the weakness coming from the neck. That's when I start to get worried. So far I've tried PT and chiropractor care. I have yet to try meds or steroids (I have to be careful with those as I have a liver condition). I have a few at home devices and exercises I can do that seem to help, but it's basically a band aid for me at this point.

  • @luckyman316 Personally, numbness or weakness is more of a concern to me than pain. That’s what every surgeon has told me as well.

  • That is exactly what I think too. Of course, I got my MRI results back in the mail and it's just images but no actual printed out results on a report which disappoints. Glad I went to the chiropractor to get the actual results and kept a printout. Sounds like they do have it in the system though. I always get scared looking at these pictures, because it always looks like there is something else. Probably best to not diagnosis myself (like one picture looks like a brain and I'm thinking "What is all this on my brain?" but I didn't ask for a brain MRI.... lol)

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  • I have looked at so many images from my scans that I have lost count, the one thing I have figured out is, I have absoutley no idea what they show, I don't even look anymore.

    Chip

  • Wanted to follow up on this:

    Saw a nureosurgeon today who diagnosed me with the start of Cervical Myelopathy. Basically gave me 2 options for the issues in my neck anyway (4 bulged discs and stenosis at all levels, the worst being at C3-4 & C6-7_. Since I've seen "slight" improvement after some PT and Chiropractic work, to wait it out 6-12 months and see how I do from there. OR, he can do a surgery to fix my issues at C3-4 ans C6-7 and this would involve him cutting me open from the front, removing 2 discs and replacing them with artificial discs (may be made from Cadever Bones). I'm at a loss as to what to do next......

  • That's a very hard decision.

    Take care and keep us posted

    Chip

  • luckyman, i had the same problem pain and numbness and tingling, the latter concerned me most. I spent 3.5 years doing PT, massage, injections etc.. The pain resolved sorta or should I say got better. I finally seen the neurosurgeon and low and behold I had severe DDD, sever stenosis, myelomelacia with a syrinx formation, deformed spinal cord etc... My first MRI was in 2016 and showed a protrusion and extrusion. When i finally seen surgeon  Nov 2019 he advised my spinal cord had been compressed a really long time. I guess what I am saying is see the specialist and go from there. Best of luck.  Btw I had the surgery in Dec 2019 and am 3 months recovery thus far.

  • Thanks for sharing @decirp I saw some of your posts. 3 months recovery huh? How soon were you able to return to some normal activity from this (ex. driving)? Were there things that you were being limited to doing prior to surgery that you can do now post surgery? From what I've seen, yours was a fusion... mine seems to be total disc replacements they want to learn towards. Either way, severe stenosis is not a fun diagnosis.

  • hey luckyman sorry for the delay response my email has been acting strange lately so not getting updates.  To answer your question i didnt drive for a few weeks, not because i didn't feel like i could only because i knew it was best to rest. I was given the ok to go back to the gym and workout with very light weights after about a month. Still feeling a little sore at times behind the neck but doc said because of how long the spine was compressed its going to take a while for the nerves to wake up. Surprisingly enough so far the best results i have got are that all my stomach pain, cramping, bloating and nausea has all gone away. Had many tests trying to figure out what was causing all my stomach issues for year, would ya know turns out was nerves in my neck .  So nice to get those results as I wasnt expecting that. I'm actually doing less now then before my surgery only because I am cautious, prior to my surgery i figured i would be living with the pain so took alot of nerve blockers, pain killers etc and continued working and trying to enjoy life. To be honest I don't know what was worse at times the neck, arm pain or the stomach pain and not being able to eat.  Its very boring going through the healing process but what is happening in the world right now not much to do anyways. Im now back at work modified and hoping to be back in action within the next 3 months. Sorry for rambling and Ill be sure to check in. Oh and disc replacement wasn't an option for me because of how messed up my neck was. My surgeon also advised me at my follow up that even if i was a candidate for disc replacement, which I wasn't he would recommend fusion, not enough data yet on replacement and he stated fusion has come a long way now with new techniques. I did see one of the top Neuros in my area perhaps that is why i waited so long. All the best hit me up if ya have further questions or just want to pick my brain. Did you have the surgery? Wish i could have had mine sooner, less nerve damage.

  • Hi Luckyman,

    I had a "pinched nerve", apparently from sleeping on the cold ground one night, woke with radiculopathy in my right arm, which lasted for about a month and a half. My doctor couldn't see me until hell began to show signs of freezing over, so I found a chiropractor. He told me I should get an MRI, and the MRI showed severe stenosis at C5 and C6 and at least one herniated disc. One neurosurgeon told me that I should definitely get a 2-disc fusion, asap. He was ready, knife in hand. Another was less alarmed, and said I could either wait for it to happen again, or get a 2-level disc replacement surgery now. I opted for now, and am presently 4 months post op. 

    The decision for me was made once I realized it wasn't going to get better on its own. The pain was manageable, but my arm was weak, and my hand felt numb. My stenosis was an active condition, meaning that over time it was bound to increasingly obstruct the nerves to my muscles, and probably flare up at some unpredictable time and cause more pain. And who knows? You could get in an accident and suddenly find yourself in deep trouble. I decided that if I want my arm function back, and I want to stay active, I need the surgery. Once I decided to do it, there was no question that sooner was better than later. As decirp said, recovery can depend on how long the condition has been present. In retrospect I saw that mine started 6 years ago (playing basketball). Having let some of the symptoms persist for that long may mean that I won't get everything back. But I am very glad I had the surgery. My arm muscle strength is returning. It was not going to get better on its own, and I wasn't ready to shelve my physical activity.

    Disc replacement has a shorter expected recovery time than fusion, but they can't always do it. Mine ended up a hybrid, one level replacement, the other fusion. If you do decide to do it, try to find a reputable hospital with resources. If something goes wrong, or if there is a billing problem with insurance, it's good to have a hospital with resources. And, of course, find a surgeon whose done the procedure many times, with success.

    -Eric

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