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Having chronic pain in chest, neck and arm. MRI showed multilevel degenerative disk disease. Required treatment?

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i am not able to see my doctor for two more weeks, i have chronic chest back neck and arm pain, can you explain this MRI to me please....my diagnosis and poss treatment and cause, i greatly appreciate your time:
There has been interval anterior fusion of C5 through C7 with compression
screws and plate with associated magnetic susceptibility artifact limiting
evaluation of these levels. Disk prosthetics are also identified in C5-C6
and C6-C7. Alignment of the cervical spine is straightened at the level of
the anterior fusion, but otherwise normal. All disk levels are desiccated
with mild disk space narrowing most evident at C4-C5 and C3-C4. Very
mild hypertrophic facet arthrosis is identified throughout the cervical spine.
Mild anterior atlantoaxial degenerative change also again identified.
The visualized brain stem and cerebellum are within normal limits.

C2-C3: Small disk bulge posterior osteophyte complex cyst minimally indents
the thecal sac anteriorly with minimal narrowing of the bilateral neural
foramina.

C3-C4: Moderate left and mild right posterior osteophyte disk bulge
complexes indent the thecal sac anteriorly with moderate narrowing of the
left neural foramina and mild narrowing of the right neural foramina
identified.

C4-C5: Mild bilateral disk bulge posterior osteophyte complexes minimally
indent the thecal sac anteriorly with mild narrowing of the bilateral neural
foramina.

C5-C6: This is a level of anterior fusion with disk prosthetic. Persistent
moderate left and mild right disk bulge posterior osteophyte complexes indent
the thecal sac anteriorly with moderate to severe narrowing of the left neural
foramina and moderate narrowing of the right neural foramina.

C6-C7: Anterior fusion with disk prosthetic noted at this level. Mild broad
based disk bulge posterior osteophyte complex results in no significant
anterior indentation of the thecal sac but there is moderate narrowing of the
left neural foramina and mild narrowing of the right neural foramina.

C7-T1: No significant disk bulge, herniation, central canal stenosis, neural
foraminal narrowing or nerve root effacement.

IMPRESSION: Multilevel degenerative disk disease with multilevel neural
foraminal narrowing status post anterior fusion of C5 through C7 as described
in detail above.


Posted Sun, 21 Apr 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 2 hours later
Hello,
Thanks for posting your query.
The MRI report you have given above goes with Cervical Spondylosis.
You have features of Disc Prolapse from C2 to C7 levels with moderately severe compromise of neural foramen. There is also facet joint hypertrophy.

Usually, the spinal cord and nerve roots are protected within the spinal canal. The spinal canal is guarded by the vertebrae which separated from one another by a cushion like intervertebral discs. With age, degenerative changes occur which leads to disc prolapse and spinal cord/nerve root compression.

The herniated discs compresses spinal nerves or spinal cord. Symptoms are experienced along the area of distribution/path of that particular nerve. This has happened at level of C4-C7 in your case.
Treatment includes
1. Use of cervical collar helps in immobilisation and brings relief.
2. Medical drugs like pain killers - acetaminophen/ibuprofen and muscle relaxants might be helpful.
3. Methylcobalamin supplements are also recommended for nerve compression symptoms.
4. Cervical isometric exercises are beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended under the guidance of a physical therapist.
5. Hot fomentation helps in relieving acute symptoms.
6. You can avoid using a pillow/ watching TV or working on computer.
Avoid prolonged sitting / leaning forward/ 2 wheeler driving for long distances.

A course of Muscle relaxants, interferential therapy (IFT) and/or Intermittent Cervical Traction (ICT) for a week followed by exercises will help you.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
 
Follow-up: Having chronic pain in chest, neck and arm. MRI showed multilevel degenerative disk disease. Required treatment? 1 hour later
Dr Tayal, thank you so much for your prompt and thorough answer, you are very helpful. Would you mind clarifying a couple things i still didnt understand. A neural foramen -- is that something that can be treated? Also Im not sure what is meant by facet joint hypertrophy and atlantoaxial degenerative change, what do those mean? Also, if my ACDF replaced the discs with donor bones, why would those levels being showing disc bulge? Thank you so much
Thank you so much! XXXXXX
 
 
Answered by Dr. Praveen Tayal 37 minutes later
Hello.
Thanks for writing again.
The neural foramen is a hole through which the nerves come out from the spine. The stenosis ( constriction) that has happened due to a disc bulge can be decreased to some extent with cervical traction. Regular physiotherapy will help in retarding the progress of these degenerative changes.
Facet joints are the areas where two adjacent vertebrae come in contact with each other. The hypertrophy is also a degenerative change.
Atlantoaxial joint also shows a degenerative change causing the painful neck movements.
After the ADCF surgery, the further degenerative changes may affect the left over disc space and cause the problem although the symptoms should be comparatively less severe.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards
Above answer was peer-reviewed by
 
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