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Am I In Danger Of Rupturing A Disc And Becoming Paralyzed? Shoulder Pain, Cervical Fusion, Nerve Root Compression.

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Posted on Sat, 16 Jun 2012
Question: female, 55, 5 3", 150 lbs. Anterior cervical fusion 1990 c6-7. MRI Impression: 1. Large right T1-2 disc extrusion with nerve root compression
2. c6-7 solid appearing disc fusion
3. slight anterolisthesis of c7-T-1 with mild disc disease
4. moderate c5-6 disc protrusion central and left sided without definite nerve root compression
5. minimal central and right sided c4-5 broad based disc protrusion
6. minimal central c3'4 disc protrusion
11/23/11 mri done
can't seem to get an appt for at least a month for an orthopedic surgeon. Am I am danger of rupturing a disc and becoming paralyzed? I am in constant pain in my right shoulder and pain down the right arm and numbness in handand fingers. should I demand a consultation?
There is also straightening of the cervical lordosis. c67 intervertebral body fusion is evident. The foramen magnum is unremarkable and there is no intrinsic abnormality of the cervical cord. c23 and c34 disc levels are unremarkable aside from small 1mm central disc protrusion at c34. Bilateral facets are unremarkable. At c45 there is a 1 mm broad based central and right sided disc protrusion. No focal nerve root compression or cord compression noted. Bilateral facets are unremarkable. At c56 there is moderate discal narrowing, mild 2mm broad based central and left sided spondylosis/spoindylitic disc protrusion impressing upon the ventral aspect of the cervical cord. Bilateral facets are unremarkable. There is solid appearing c67 disc protrusion. No spinal canal or foraminal stenosis seen. C7-T1 disc level is unremarkable. T12 disc level has a large 4 mm right sided disc extrusion with narrowing of the right lateral recess and proximal neural foramina wich could predispose to nerve root compression. T23 disc level is unremarkable
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Answered by Dr. Raju A.T (8 hours later)
Hi,

Thanks for your query, also to the detailed description of the condition which is very helpful to me in coming with a straight opinion.

The discs and the vertebral joints above the level of T1 are showing mild involvement except the C6-7 fusion which is due to anterior fusion done. I strongly suspect the changes in the aforementioned levels could be secondary to the anterior fusion and the disease at the T1-2 level.These changes as observed now can be reversible once if the disease at T1-2 is treated. Hence in order to prevent further progression of the disc disease into the upper levels of the spine early intervention in the diseased segment is a needed.Though its not an emergency now, but the early the safest.

Since you already are experiencing the symptoms of nerve root compression like pain in the right shoulder and right arm along with numbness in the hand I would recommend early consultation and management.If the symptoms you have are due to physical compression only then they could be reversible but if there is nerve death due to compression of vasa nervorum ( blood vessels to the nerve ) the recovery is least .Chances of paralysis are rare but permanent persistence of symptoms you have now can be expected here.

I suggest you to demand and fix an appointment and get the condition managed appropriately soon.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Regards,


Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 4475 Questions

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Am I In Danger Of Rupturing A Disc And Becoming Paralyzed? Shoulder Pain, Cervical Fusion, Nerve Root Compression.

Hi,

Thanks for your query, also to the detailed description of the condition which is very helpful to me in coming with a straight opinion.

The discs and the vertebral joints above the level of T1 are showing mild involvement except the C6-7 fusion which is due to anterior fusion done. I strongly suspect the changes in the aforementioned levels could be secondary to the anterior fusion and the disease at the T1-2 level.These changes as observed now can be reversible once if the disease at T1-2 is treated. Hence in order to prevent further progression of the disc disease into the upper levels of the spine early intervention in the diseased segment is a needed.Though its not an emergency now, but the early the safest.

Since you already are experiencing the symptoms of nerve root compression like pain in the right shoulder and right arm along with numbness in the hand I would recommend early consultation and management.If the symptoms you have are due to physical compression only then they could be reversible but if there is nerve death due to compression of vasa nervorum ( blood vessels to the nerve ) the recovery is least .Chances of paralysis are rare but permanent persistence of symptoms you have now can be expected here.

I suggest you to demand and fix an appointment and get the condition managed appropriately soon.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Regards,