Back experts? What the hell does this mean?

[jimnyc]

I've had nagging back pain for the past 3 weeks or so and it's just getting worse. I have sharp pain going from the left side of my neck all the way down my left arm. It throbs like it hurts in my bicep and forearm but the damage appears to be in the spine. Chiropractor sent me for an MRI and the following quote is the results. I'm supposed to meet with a surgeon on Wednesday to read the film and decide if surgery is necessary. Anyone have experience with what reads like greek to me?

MRI of the cervical spine was performed on May 22, 2006 utilizing T1, T2 and STIR sagittal and T2-weighted fast spin-echo and gradient echo axial sequences. Disk herniations are present at C5-6 and C6-7.

The C6-7 disk herniation is central and left sided, is large and indents the ventral lateral aspect of the spinal cord displacing it posteriorly and stretches the exiting left C7 nerve root.

The C5-6 disk herniation is small and central with no root or cord deformity.

No signal intensity change is seen in the cord. There is some mild reversal of the cervical lordosis at the C5-6 level. The foramen magnum remainder of the study is unremarkable.

Impression: There is a large left-sided disk herniation displacing the spinal cord and stretching the exiting left C7 nerve root. A small, shallow, central non cord deforming disk herniation is present at C5-6.

 

[KarlMarx]

MRI of the cervical spine was performed on May 22, 2006 utilizing T1, T2 and STIR sagittal and T2-weighted fast spin-echo and gradient echo axial sequences. Disk herniations are present at C5-6 and C6-7.

The C6-7 disk herniation is central and left sided, is large and indents the ventral lateral aspect of the spinal cord displacing it posteriorly and stretches the exiting left C7 nerve root.

The C5-6 disk herniation is small and central with no root or cord deformity.

No signal intensity change is seen in the cord. There is some mild reversal of the cervical lordosis at the C5-6 level. The foramen magnum remainder of the study is unremarkable.

Impression: There is a large left-sided disk herniation displacing the spinal cord and stretching the exiting left C7 nerve root. A small, shallow, central non cord deforming disk herniation is present at C5-6.

I'm not a doctor, but I play one on USMB.... j/k... I found this diagram which shows how they designate each of the vertebrae in your spinal column. I also Googled some of the terms and pieced together this diagnosis, free of charge, that will tell you what it's worth!

Your back injury is in the upper part of your back and the C5-6, C7 etc refer to the individual vertebrae in your spinal column. I think it means that you have some herniation in disks between those vertebrae. One vertebra (C7) has a large herniation which is pushing your spinal cord to one side and putting pressure on one of the nerves that comes out of the spinal column. That nerve is probably the one that goes down your arm. That explains why you are having problems with your arms and in your neck region.

The "cervical lordosis" is the top region of the spine, where the "C" vertebrae are located. That is, around the neck and perhaps the shoulder region.

Foramen magnum: The large hole at the base of the skull which allows passage of the spinal cord.

posteriorly - means displaced to the back

Here's a PDF document http://www.neurosurgeon.org/pem/pdf/20040418_SpineAnatomyandSpineGeneral.pdf that describes the anatomy of the spine...

I hope that this helps....

 

[5stringJeff]

You have two herniated disks. The one between C6 and C7 is most likely the one causing you trouble.

Here's a WebMD article that might help explain:
http://www.webmd.com/content/article/65/72630.htm

 

[Mr. P]

There is a large left-sided disk herniation displacing the spinal cord and stretching the exiting left C7 nerve root.

It means you will have to have surgery, sometime.

 

[CSM]

It means you will have to be castrated as your balls are obviously too big for your spine.

 

[jimnyc]

I hope that this helps....

Absolutely, thanks! I'm sure the Doc can explain things fully when I see him but of course they leave me hanging with my thoughts, which can be a really scare thing!

Jeff - Thanks for the link, yours helped as well.

Mr. P. - Is there anything else they can do now besides that to relieve the pain that you know of? It's literally non-stop, 24 hours a day. I was hoping he could do something to relieve the pain today and at least allow me to sleep again.

CSM - "Who's got the biggest, balls of them all" AC-DC They sang that about me.

 

[Mr. P]

Absolutely, thanks! I'm sure the Doc can explain things fully when I see him but of course they leave me hanging with my thoughts, which can be a really scare thing!

Jeff - Thanks for the link, yours helped as well.

Mr. P. - Is there anything else they can do now besides that to relieve the pain that you know of? It's literally non-stop, 24 hours a day. I was hoping he could do something to relieve the pain today and at least allow me to sleep again.

CSM - "Who's got the biggest, balls of them all" AC-DC They sang that about me.

Drug treatment: Pain-relieving, anti-inflammatory, and muscle-relaxing medications may all be helpful for relieving back pain. Although medications are typically taken orally, some can be injected directly into the painful part of the back. For severe, ongoing back pain problems, a pump that continually delivers pain-numbing medication into your spine can be implanted directly into your back. Doctors do not recommend the use of stronger narcotic pain relievers such as Oxycontin for long periods of time as they can be addictive.

Surgery: Even surgeons say that surgery should be kept as a last resort for treating back pain. When all else fails and you're still in agony, various surgical procedures can be performed that range from minimally invasive to full-blown, open-your-back-up-and-fix-the-problem surgery. Surgery can be used to treat disk disease or spinal stenosis.

http://www.webmd.com/content/article/67/80001.htm

Treatment calls for pain relief, rest, steps to reduce inflammation, and measures to restore strength and normal activity. Severe cases of disk degeneration may permanently affect the nerves that control muscle movement, but herniated disks generally heal themselves and surgery is rarely necessary.

If the disk is just temporarily distorted, the potential for complete recovery is excellent. If the outer membrane actually breaks or ruptures and loses some of its gelatinous center, the damage may be permanent.

Doctors usually prescribe bed rest of up to two days and pain-killing medication such as aspirin, ibuprofen, or another nonsteroidal anti-inflammatory drugs (NSAIDs). In some cases, corticosteroids (given either as a pill or injection around the spinal nerves) and/or muscle relaxants may be needed. People with backaches should remain active, being careful not to perform movements that cause pain or discomfort. Prolonged bed rest is a bad idea and may actually delay healing. A doctor may call for a back brace or neck collar to limit movement and ease the pressure on sensitive nerves while the disk heals. In severe cases, full or partial traction may be needed.

read more...http://www.webmd.com/content/article/65/72632.htm
Good Luck, Jim. I know how bad back pain can be.

 

[CSM]

I really do hope you get relief...despite the dark humor.

 

[Abbey Normal]

I'm sorry you are in such constant pain, Jim. That's the worst.

 

[jimnyc]

Just got back from the doctor and at least finally got some pain meds, so I'll be flying high on 'Oxycodone' in a short bit as I just took one! He also prescribed some steroid pills crap that's supposed to help. I'll meet with him again in a week and if there's no improvement he wants to do a 'Microdisectomy'. The herniation is very large and pressing right against the spinal cord. I'm trying to attach one of the photos from the MRI:

 

[dilloduck]

Just got back from the doctor and at least finally got some pain meds, so I'll be flying high on 'Oxycodone' in a short bit as I just took one! He also prescribed some steroid pills crap that's supposed to help. I'll meet with him again in a week and if there's no improvement he wants to do a 'Microdisectomy'. The herniation is very large and pressing right against the spinal cord. I'm trying to attach one of the photos from the MRI:

How's you hospitalization insurance? It may determine if you have surgery or not.

 

[jimnyc]

How's you hospitalization insurance? It may determine if you have surgery or not.

Not a clue! I'm covered under the policy of my 'wife'. I know the insurance is good but just not sure how it all works with this particular doctor.

BTW - My doctor is/was supposedly dating Katie Couric. He's got a damn good rep throughout this area in this expertise. And he apparently does well with his practice!

Admirer #2 is New York orthopedic surgeon Dr. Seth Neubardt, who earns an estimated $15 million a year.

http://tv.yahoo.com/news/ne/20051026/113033880009p.html

 

[dilloduck]

Not a clue! I'm covered under the policy of my 'wife'. I know the insurance is good but just not sure how it all works with this particular doctor.

BTW - My doctor is/was supposedly dating Katie Couric. He's got a damn good rep throughout this area in this expertise. And he apparently does well with his practice!



http://tv.yahoo.com/news/ne/20051026/113033880009p.html

Sweet---will he give you some juicy gossip? :huh:

 

[Abbey Normal]

Admirer #2 is New York orthopedic surgeon Dr. Seth Neubardt, who earns an estimated $15 million a year.

What's sad is that Katie Couric might make more than he does.

 

[Mr. P]

Just got back from the doctor and at least finally got some pain meds, so I'll be flying high on 'Oxycodone' in a short bit as I just took one! He also prescribed some steroid pills crap that's supposed to help. I'll meet with him again in a week and if there's no improvement he wants to do a 'Microdisectomy'. The herniation is very large and pressing right against the spinal cord. I'm trying to attach one of the photos from the MRI:

Glad ya got some relief, Jim. Dr. P will send a bill. ..but, I'd never EVER date Katie commie!

 

[KarlMarx]

BTW - My doctor is/was supposedly dating Katie Couric.

Oh well... in spite of that unfortunate fact, I'm sure he's still a good surgeon!

 

[jimnyc]

I've been doing a ton of research on this possible 'microdiscectomy' procedure that the Doc would like to perform should it be necessary. It doesn't seem as invasive as most would think but anything near my spinal cord involving the word 'fusion' scares the hell out of me! He claims it's a piece of cake and routine but it's not routine for me!

 

[jimnyc]

I've been doing a ton of research on this possible 'microdiscectomy' procedure that the Doc would like to perform should it be necessary. It doesn't seem as invasive as most would think but anything near my spinal cord involving the word 'fusion' scares the hell out of me! He claims it's a piece of cake and routine but it's not routine for me!

Ok, I'm getting even more nervous now. I meet once again with the surgeon today and there hasn't been much change since I last saw him. Sitting hurts the most but the pain is there all day long regardless of what I'm doing. I suppose that means he'll recommend the surgery. I've been reading a lot and found a thread on another site that scared the crap out of me! Here's one of the questions and the answer!

i am have micro surgeryon C6 c7 on Dec 27th. I am really terrified of the surgery. The one qwuestion that i have is not with the surgery. Do they have to put a catheda in my penis. I think this is worrying me more that the surgery!!!!

Dear Tony Evangelous:

Yes they do. However, you will not notice as you will be asleep from anesthesia.

Sincerely,

CCF Neuro MD

http://www.medhelp.org/perl6/neuro/messages/30101a.html

 

[KarlMarx]

Ok, I'm getting even more nervous now. I meet once again with the surgeon today and there hasn't been much change since I last saw him. Sitting hurts the most but the pain is there all day long regardless of what I'm doing. I suppose that means he'll recommend the surgery. I've been reading a lot and found a thread on another site that scared the crap out of me! Here's one of the questions and the answer!





http://www.medhelp.org/perl6/neuro/messages/30101a.html

They probably put a catheter up there so that you don't pee on the operating table... it may be standard procedure... remember, when you're under anesthesia, you can't "hold it", you just go....

 

[jimnyc]

These doctors are driving me nuts as the pain gets worse and worse. I'm ready to start gnawing on my arm in the hopes it'll just fall off.

I met today with the neurologist and the surgeon and all agreed surgery is the next step (which I thought we decided a few weeks ago). The left tricep and bicep are starting to get 'atrophy'. They said they would like to do it ASAP, as in next week, and sat me down with the woman who schedules everything, who told me they were booked until the 27th!

So now I get to sit here and suffer and wait till the 27th for some relief. The pain killers help some but not enough.

The doc said they go in with about a 2 inch incision on the side of the neck, remove the disk, put a piece of bone in it's place (they said they used to get it from the patients hip but now use bone from donors), and then connect the little spinal bones together with a hunk of metal. Luckily for me though he said it won't set off metal detectors at the airport. He did mention something to look forward to though, something about some morphine afterwards! He said no smoking for 4-6 weeks after surgery either as it makes the success chances lower by 20%. Jeez, they should just euthanize me!