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Cervical MRI, radial annual tear, slipped disc, disc degeneration, conus medullaris, facet disease, pain, burning sensation, neurocompression

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Cervical MRI: Straightening to mild reversal of the cervical lordosis with disc pathololgy at C3-4,C4-5,C5-6 and C6-7 and neurocompression right midline at C6-7, in a broad based fashion at C5-6 and left of midline at C4-5 where there is a radial annular tear. Lumbar MRI: Disc degradation and spondylosis at L2-3 and L3-4 and disc degradation with posterior shallow disc protrusion at L5-S1. Facet disease. Conus medullaris lies posterior to the L2 vertebral body. I understand most of the conclusion results but I would like to have it explained in simple terms. I have constant pain and burning in the back of my entire left leg and an aching pain in the front of my left thigh. I have very limited range of motion in my neck, worse when I turn to the right and numbness and tingling in my left arm. I also have an electric shock sensation starting around the axis/atlas area going down to about T-3 or so when I look down. The sensation usually lasts only a few seconds but has lasted up to an hour on 2 occasions. I've had many rounds of therapy & injections and have tried vast amounts of prescription medications. I've recently had 4 epidural injections (2 cervical & 2 lumbar) and a month of physical therapy. The injections did nothing (as usual)and PT only aggrevated the symptoms. My PT did some reflex tests and I had no plantar reflexes in the left foot and a positive scapulohumeral reflex on the right side. He advised me to see a neurosurgeon. The surgeon said he can fuse my neck but there is nothing he can do for the leg since he can not see any neurocompression. What is your opinion?
Posted Tue, 8 May 2012 in Back Pain
Answered by Dr. Kiran Kumar 1 hour later

There are two health related issues with you.

1. Severe Cervical Disc Disease with disc prolapse at multiple levels and cord/root compression. Its evident at C 4-5, C5-6 and C6-7. These are the nerve segments which are responsible to supplying the arms. So any compression or irritation of the nerve roots will cause you tingling, numbness and sometimes weakness of the arms in a specific region supplied by that particular root. Movement of the head will aggravate it. The electric shock like sensation on the back of the neck up to T3 is also related to root compression in the cervical cord.
The only definitive treatment for your condition is surgical decompression of the disc. There is no medical therapy and physiotherapy will not benefit as there is neurological involvement.

2. You also have symptoms of burning and pain in the back of your entire left leg and aching pain in the front of your thigh. These symptoms of yours are not correlating with the MRI findings. If there is no cord/root compression at the lumbar level, its unlikely that the cause of your symptoms is there.
The sensory system which supplies the legs can even get involved at the cervical level. If there is compression, at the cervical level, of the nerve fibers which supply the leg, pain and burning can be felt at the leg.
Since you have a severe cervical disc disease, clinically we can attribute your left leg symptoms to your cervical disc disease and cord compression. Its reasonable to believe that all your pain symptoms - Neck, Upper Limb and Leg are related to your cervical disc disease and will benefit from surgery.

Hope this answers your query.

Please get back if you nee any further information

Thanks and Regards

Dr Kiran
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