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Cervical spine MRI shows diffuse degenerative changes. Lower back pain, pain and tingling in arms. Questions to ask neurologist?

Nov 2013
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Hi dr XXXXXXX XXXXXXX heurologist My mri-of servical spine

Histort:48 year old female,upper neck and shoulder pain for 6 months,radiation down arms,radiculophaty.

A non-contrast mri scan of cervical spine shows diffuse degenerative changes.

C4-C5 shows left central dysvopphyte with minimal cord impigment with aut myelomalcia.

The C5-C6 shows moderateright centraldyscophyte causing moderate cord impigment with aut myelomacia.There is moderate to severe bileteral forminal narrowing impigning both exiting C6 nerve roots.

TheC6-C7 shows dyscophate formation causing mild to moderete cord impingment.There is severe left forminal narrowing impiging the exitind left C7 nerve root.There is moderete right forminal narrowing.


Diffuse degerativne changes.The canges are moderate to severe at the C5-C6 andC6-C7 level causing cord impigment with aut mylomalcia as describe.In addition,there is marked forminal narrowing atC5-C6 levels bileteraly and left C6-C7 level impinging the exiting nerve root.

Mri thorasic spine:

A non- contrast mri of thoracic spine shows diffuse mild to moderate degenerative changes more pronaunced in lowervthoracic spine including disc space narrowing, disc degeneration,osteophyte formation and facetchypertrophy.

The T7-T8 shows tiny right central disc herniation with aut cord or nerve root impigment.No other

Mybproblems are from beagining my both arms more right and neck problems including lower backband upper pain .this is happening from last summer i lockt my shoulder doing somthing then year beafore ibfelt and injured right hand and back.

All time from last year i have pain in wrist elbow,fingers shoulder tingling tru arm pins and needles more right side righ fist i cant close anymore and weenes i went to neurologist in march for testing nervs kcm-mashine testing he said my nervs are fine .
I went to reumatologist he told me i have big time carpel tunel syndrom i told him neurologist rule that aut he said that is not right he told me also i devlop RSD-syndrom and that i have to go back to neurologist.
When i go back to neurologist what should i ask him i am prity conffused going back and foward to these doctors .
Can you please tell me evrithing i should ask neurologist because it is jast one time visit same one in 7 months waiting i don't like to wait agen same time if i miss somthing important in question and what he can help me for this rsd syndrom what is the best therapy for it.
Thank you
Your's E.I.
Posted Sat, 17 Aug 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 2 hours later

Thank you for posting your query.

I appreciate the details of MRI and clinical symptoms provided by you, it helps a lot.

I can understand the confusion on account of conflicting opinions given by the rheumatologist and neurologist.

Based on the description, your symptoms are suggestive of cervical disc prolapse with compression of nerves and spinal cord. These nerves travel from the neck region to arms, forearms and hands. All your symptoms, including weakness, numbness and pain can be explained by the MRI abnormalities.

I agree with your neurologist that you do not have nerve conduction studies were normal.

As of now, the initial treatment would be conservative, with medications such as pregabalin or gabapentin. Physiotherapy and use of soft cervical collar would also be useful. If you do not improve or get worse, then surgery in the cervical region may be required.

So, the following questions may be asked to the neurologist:

1. What is the diagnosis, and cause of your symptoms?
2. Whait is the best treatment option at this stage?
3. If he advises medications, then, how long would the medications be necessary?
4. If surgery is needed, how early should it be done?
5. What are the exercises thst need to be done? Any activities to avoid?

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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