Hi, I am a 43 yr. Old female having some
problems with my left side of neck,
shoulder and blade, radiating down left
arm/forearm to my hand. I am
experimenting muscle spasms in all areas
mentioned above, this is all due to
accident I recently had falling out of my
high-rise truck. Lol by the way my truck
was parked in driveway, I slipped getting
out of the truck door (i know it sounds
strange right). Any way I have been
seeing an orthopedic surgeon, he has given
me a cortisone shot in left arm and it has
had no results so far, also put me on pain
meds and ibuprofen. In the meantime
suggested I go for some pt, well I went
and they said it would not help and called
my Dr. And suggested a mri.... Ortho
Dr. Ordered the mri and here are the
results below:
july 8, 2004
*mri left shoulder
history: shoulder pain
comparison: none
%uFFFDi skipped the rest and went to
impression%uFFFD
impression:
1. Mild tendinopathy anterior insertion
supraspinatus tendon.
2. Mild degenerative changes
acromioclavicular joint left shoulder.
(to me this seemed okay with left shoulder
I think so far?) <~~ my personal input
*mri cervical spine
history: pain and spasm left neck into
left shoulder
comparison: cervical spine x-rays from
ortho surgeons
technique: sitting sagittal t1 and t2
sequences. Axial t2 seq.
C2-3 level is considered normal
c3-4 level is considered normal
c4-5 level is considered normal
c5-6 level demonstrates a small posterior
central disk herniation, which touches the
anterior thecal sac. The spinal cord is
displaced posteriorly to the right. This
is due to a large left paracentral to left
lateral disk herniation at the c6-7 level,
which extends in to the left lateral
recess and left neural foramen. This
pushes on the spinal cord displacing the
spinal cord posteriorly to the right.
There may be mild cord compression.
There appears to be severe left neural
foraminal stenosis. The axial images do
not go completely through this disk
herniation. Additional axial images for
c4 through t1 may be helpful to further
evaluate the c5-6 and c6-7 levels
entirely.
Impression:
1. Small posterior central disk
herniation c5-6 level. This may actually
represent a superiorly extruded disk
fragment from the c6-7 level where there
is a large left paracentral to left
lateral disk herniation. This displaces
the spinal cord posteriorly to the right
with possible mild cord compression.
There appears to be severe left neural
foraminal stenosis at c6-7.
2. C6-7 disk herniation is not entirely
imaged on the axial seq. Additional
axial images for c4 through t1 may be
helpful for further evaluation.
%uFFFDadditional mri orderedon: july 12,
2004 at stand-up mri facility%uFFFD
results below:
mri cervical spine
clinical indications: pain radiating to
left shoulder.
Comparison: to july 8, 2004
technique: sitting axial t2 sequences from
c4 through t1, sagittal t2 sequences.
Additional sagittal and axial t2 seq.
Were obtained to fully evaluate the c5 and
c6-7 levels.
Findings:
c5-6 level demonstrates mild degenerative
disc disease. There appears to be a
small posterior central disc herniation,
which may actually be separate from the
larger superiorly extruded disc fragment
at c6-7. There is mild central canal
stenosis with mild right neural foraminal
stenosis.
C6-7 level demonstrates a large left
paracentral to left lateral disc
herniation, which extends into the left
spinal cord and into the origin of the
left neural foramen. This is displacing
the spinal cord posteriorly to the right.
There may be mild cord compression.
This extends to the origin of the left
neural foramen with moderate to severe
left neural foraminal stenosis and
possible impingement of the left c7 nerve
root. This fragment is extruded
superiorly towards the c5-6 level. There
does appear to be a small separate disc
herniation at c5-6, which is separate from
the larger superiorly extruded c6-7 disc
fragment.
C7-t1 level is considered normal.
Impression:
1. Mild posterior central disc herniation
at c5-6.
2. Large left paracentral to left lateral
disc herniation at c6-7. This is
displacing the spinal cord posteriorly to
the right with possible mild cord
compression. There is moderate to severe
stenosis of the origin of the neural
foramen with possible impingement of the
left c7 nerve root. The disc fragment
extrudes superiorly towards the c5-6
level.
End of reports!
1. Next visit to my ortho Dr. He now
gave me another cortisone shot on my left
side of neck and for me to visit him in a
week. If the shot does not work, we need
to go to next step.
2. Dr. Said next step is an epidural
steroid injections! Can anyone give me a
hint to how this procedure is done and
what type of doctor does this? Could
this be helpful in my case or useless?
If this does not work on to the final
step.
3. Next and final step he suggested a
spinal fusion of c6-7! Wow, is this
really the final step it seems extreme to
me can you give me some helpful hints to
other treatments if possible? I am
really scared please help me!!!! p.S.
Sorry for the non capital letters in my
message I guess this is just the way it
turned out???
May help reduce pain long term in 50% of
patients vs. 98% for surgery. If you
have a doctor who is doing these without
fluoroscopy, you should run the other way
quickly. The cervical spine is not to be
placed at risk due to a doctors
inexperience with modern pain management
techniques nor with the standard of care
which is the use of fluoroscopy.
There are two approaches: through the
exiting point of the nerve from the spine
(transforaminal) and through the back of
the spine (interlaminar). The
transforaminal approach uses a very small
diameter needle entering from the side of
the neck with the patient lying face up
under frequent fluoroscopic (xray) views.
These may be done with local anesthesia
or very mild sedaton in most centers.
Once the needle is in place, contrast
(iodine containing dye) is injected in
real time live fluoroscopy to assure no
vascular uptake. Once this is assured, a
small volume of steroid is injected.
The interlaminar approach uses a larger
needle which is inserted with the patient
lying face down or sitting in a chair, but
with xray being used for placement. The
needle is advanced through the ligaments
of the spine and into the epidural space
where dye is injected to assure proper
needle placement. Then a small amount of
steroid is injected.
With the interlaminar injections some
chest pressure and pressure down both arms
is briefly felt.
The injections may be repeated but should
not be repeated under any circumstances
closer than 2 weeks together because of
progressive adrenal gland suppression and
the potential for the development of
shock.
If one injection does nothing for the
pain, there is absolutely no reason to
repeat the same injection hoping for a
different result.
Epidural steroid injections are very
commonly performed and are generally
deemed safe when performed by a competent
physician. Ask if the physician is a
member of isis (pronounced eye-sis) which
is the premier organization for training
of physicians in this technique. If he
is, then he will probably be a safer
physician than those who have never heard
of isis.
|
sufferer
New User, Becoming EHEALTHy
Joined: 30 Jul 2004 Posts: 5
Posted: 07-31-04 09:44am
If I were you, I will ask your surgeon to
give you some reference to patience who
have successfully gone through same.
Sounds like a major operation to me and he
cannot refuse you. Then you should
interview the references yourself before
deciding.
It is no joke to have three vertebrate
permanent fused together. What about
herniations at the 2 ends?
We would love to hear the results of your
interviews and your final decision.
I have 2 lumbar disc herniations and
degenerations so says the doctor and as
per mri. Doctors and their machines are
very good when it comes to diagnoses. But
when asked so what is my chances of full
recovery he says 0% as what is degenerated
cannot be regenerated and what is bulged
cannot go back. If serious enough he can
consider surgery.
I thank him and went home. It may be
medical science but it is still medical
caca as far as I am concerned. Doctors
always underestimate the body's own
healing process because they can't explain
it. There is more to pain than the
mechanical model employed by doctors. I
know degeneration alone dont cause pain
(otherwise all the seniors in the world
will be in pain).
Try to delay the surgery as long as you
can and continue to search for self
healing through exercise and other
modalities and in the meantime control the
pain through medications, massage etc.
One web site that may be of benefit is
health2us.Com
|
sufferer
New User, Becoming EHEALTHy
Joined: 30 Jul 2004 Posts: 5
Posted: 07-31-04 09:53am
Just out of curiosity what is this
epidural steroid injection stuff? Is it
temporary relief or a cure? I know my
wife had epidural when she gave birth.
|
algosdoc
Experienced User , Rather EHEALTHy
Joined: 23 Mar 2004 Posts: 186
References Posted: 07-31-04 12:28pm
It is illegal under federal law to divulge
the names or contacts of a physician. No
"references" are permitted.
Epidural steroids are antiinflammatory
agents which result in long term relief
50% of the time.
|
DESAVIEW888
New User, Becoming EHEALTHy
Joined: 11 Jul 2004 Posts: 23 Location: MALAYSIA
Posted: 07-31-04 21:16pm
Smart, very smart. So doctors cover all
bases. Imagine it, illegal to get
references.
All of us have heard of so much abuses by
doctors. And what is the term for doctors
and hospital induced pains and
illnesses?
Dont doctors have feelings? Who wouldn't
want to at least interview the successful
patients before having three vertebrate
fused together? Just thinking of post
operation problems is enough to scare me.
|
algosdoc
Experienced User , Rather EHEALTHy
Joined: 23 Mar 2004 Posts: 186
Fortunately... Posted: 08-01-04 10:13am
Fortunately you live in malaysia where you
can cure your disc herniation by warm
fuzzy thoughts and by eating non-acidic
food. Your views on the laws of the us
are myopic and uninformed. Doctors did
not make these laws, the federal
government did. Plus, as any
intelligent person knows, a doctor
selecting a specific person to be a
reference is extremely biased. Also, if
you have ever in your life studied any
statistics, you will understand one or two
or three people with good or bad results
is not in any way predictive of outcome.
Perhaps in malaysia statistics are not
taught in your schools, but if you need
basic fundamental education in the area,
the internet has more than enough
reference material available.
Btw, can you quote the references for the
scientific studies that relate disc
herniation pain and eating acidic foods?
p.S.
Sorry for the non capital letters in my
message I guess this is just the way it
turned out???
