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New to spine universe - problems with neck

Started by janhad on 02/07/2010 12:10pm

Hi I am new to this site and don;t really know where to start and apologise if this is a long post! I live in the UK and was diagnosed with cervical spondylosis about 5 years ago. Over the last 18 months my symptoms have been getting a lot worse so my family doc referred to a spine doc (orthopaedic surgeon). I initially went to see them and was subsequently given some physical therapy over 10 weeks, 2 courses of hydrotherapy, acupuncture and a nerve root block injection. All these have not helped and I am due to go back and see the spine doc in a couple of weeks. In the meantime, I asked to get copies of my MRI scans (in the UK you don't automatically get copies - and had to pay the hospital for copies!). I have since got these as I really wanted to know what was actually going on in my neck, as things had got decidedly worse and had a pending hospital appointment..
My first MRI was taken in December 2008 - "mild degree of cerebellar tonsiallar herniation. Cervical cord appears normal. There is a degenerative retrolisthesis at c5/6 with a resultant indentation on the anterior aspect of the theca without any cord compression or cord signal change. Neurocentral joint arthritis particularly on the right side of c5/6 is also present. Moderate degree of foraminal encroachment bilaterally as a result of these changes, this appears more obvious on the right. Facet joint arthritis is also present".
2nd MRI October 2009 - "retrolisthesis of C5 against c6 vertebral body with circumferential disc bulging abutting the spinal cord and causing mild flattening particularly of the left and central aspect of the spinal cord. Moderate narrowing of the right and moderate to marked narrowing of the left intervertebral foramen.At c5/6 circumferential disc bulging leading to mild narrowing of the left intervertebral foramen. The c6/7 foraminal narrowing on the left seems to have slightly increased.
Opinion - c5/6 subluxation with cord abutment and deformity and particularly left sided foraminal narrowing. C6/7 disc degeneration and minor foraminal narrowing. Posterior osteophyte formation."
I would be really grateful if anyone could possible make it easier for me to understand what is going on in my neck as the consultant I saw initialy did not let me know what was the matter in easier terms! I am a little confused and upset as there seems to be conflicting results, ie. mention of cerebellar tonsillar herniation in the first MRI, but this is not mentioned in the second one! Please help!!!!

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Hi Janhad,

I too live in the uk and have had problems with my neck since 96. Had a c5/6 disc replacement back in 2008. Still having problems. The only thing I can suggest about your mri scans, is discuss them with your surgeon!!! You can google all the quotes, and it scares the living daylights out of you! My last one on 15th jan suggested a trapped spinal cord posterior at c5/6 where the disc was replaced! I looked at the report when I was waiting for another consultant to see me about an op he had performed last august! Googled it and it said any sudden movement could cause paralysis??? EEk! Check out your local hospital to see if there is a spinal support group? My hospital has one, which meets every 3 months and it's great to meet people who know what your going thru x

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Its sounds like there are several possible causes of your pain. Keep in mind, most people will see changes in spinal anatomy over time.

Since your first MRI you have seen a further bulging of your disc at C5/6 accompanied by the movement of one of the vertebra away from the adjoining vertebra, that is pushing on your spinal cord (Called Retrolisthesis - think of an oreo cookie where the top cookie has moved to the side exposing the creamy filling - or in this case your disk). You are also seeing a narrowing of the space that your nerve roots go through which can also cause pain. You also have an osteophyte or bone spur which if pushing onto a nerve can also cause pain.

cerebellar tonsillar herniation is better known as chiari malformation although if its mild enough they don't give it that classification or call it Grade 0 Chiari. On the second MRI, they may not have captured imaging of the brain stem area, which is why they did not show it - or its so mild that its not worth mentioning based on your other anatomical issues that are more likely causes of the pain - its definitely worth asking the surgeon why it wasnt mentioned on the second, as chiari malformation could be a cause of your symptoms.

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Also noted 1st MRI had arthritis which is normal - did you have an injury years before? 2nd MRI: degenerative disc which is the thinning of the disc that can also contribute to nerve compression. The bulge mentioned is causing some problems too and I hope it's addressed by now. You have quite a few things going on that explain why you have not responded to traditional therapy. I would recommend a few things before fusion as sometimes they can work 1) spinal decompression (to let that bulge go back in) usually physical therapist or chiro can do that 2) Non-invasive Laminiectomny and they go in a cut off the bulge (my brother in law had that but was lumbar so cervical could be different). It sure helped him 100%. I know pain though and pain has a source. Find the source and you help the pain. Talk to your surgeon in great details. Research each diagnosis so you are familiar with them and have a list of questions for that surgeon. I have had cervical problems for years and no results with only increased problems here in the US. I actually was thinking of going to Europe as they consider disc replacement easily and/or surgery and no one will here! Just because I'm high risk - as if I'd sue - I just want pain relief and can't function on these medications!. Well - I'd do anything to get rid of the pain because I'm at the point of no return. If I didn't have a son to think of there would be nothing for me to stay and try. so keep on trying, don't give up and get answers! My prayers are with you as you go. I pray that you will get your health and life back and enjoy it fully.
Dee

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