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MRI scan shows There is straightening with reversal of the normal cervical lordosis at C4-C6. What does this mean?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Good evening! I have a couple of questions. I was involved in a car accident on September 27, 2013. I was at a complete stop when I looked in my rear view mirror and saw the driver of the car behind me coming at me while looking down - he was not paying attention. The speed limit on the road is 55 (be honest hardly anyone drives 55) most drive 60+. I was in the far right XXXXXXX ended up on the shoulder of the road on the left side of highway. He was driving an Audi, I was driving a Ford Expedition, my car was undriveable and was totaled. Okay now on to the health questions - I have been having pain in my neck, between my shoulder blades and lower back since and it does not seem to be getting any better, in fact worse. I am also experiencing tingling and weakness in both arms, all the way down to hands (in fact, dropped a bottle of water today). I am getting far more headaches than ever and as I stated my pain is seeming to increase (slight observation) my blood pressure is usually right around 120/70, since the accident (I am assuming because of pain) - it has been (at three of my drs appts) approx. 137/89. I have had an MRI and this is what it says (wondering if this could be caused by accident) because I have never had any of these issues prior to accident. "There is straightening with reversal of the normal cervical lordosis at C4-C6. Mild degenerative signal is visualized at the inferior endplate of c%. Mild anterior osteophytosis is visualized at C4-C5 and C5-C6. Otherwise vertebral body heights and marrow signal are preserved. There is moderate disc desiccation visualized at C4-C5 and C5-C6. The paraspinal soft tissues are unremarkable. C4-C5 - Mild disc osteophyte at a left central location causes mild narrowing of the ventral epidural space with discrete central canal narrowing. C5-C6 - Shallow disc osteophyte causes narrowing in the ventral epidural space without discrete central canal narrowing. Please help me understand what is going on - because I do not want to take pain pills forever and as I said earlier - this pain is getting worse. Thank you for your time
Posted Tue, 3 Dec 2013 in Back Pain
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer: You have CERVICAL DISC DISEASE. Detailed Answer: Hi, thanks for writing to XXXXXXX All your MRI findings are suggestive of Mild cervical disc disease with symptoms of radiculopathy. This means that the protruded intervertebral disc are causing pressure over the adjacent spinal cord and the nerve root at that specific level producing symptoms of tingling & numbness along with pain. These changes might have been present before your accident or might have been aggravated by the accident itself. The straightening with reversal of cervical lordosis is due to the muscle spasm secondary to the injury and inflammation. The general treatment guidelines for your condition are as follows - Use a soft cervical collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles. Medicines: Analgesics like Ibuprofen/Diclofenac/Naproxen are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms, once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE or PREGABALIN will help in alleviating the neuropathic pain (tingling & numbness in the upperlimb). Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time is recommended. Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Physiotherapy has to be done under the supervision of a physiotherapist. Moist heat can be useful Epidural steroids: are useful for patients with severe radicular pains in the limbs. Cortisone is a powerful anti-inflammatory preparation and so its injections in the "epidural space" can decrease swelling as well as pain. Hopefully, you should get well with the above measures. Hope I have addressed your query. Happy to help further Regards
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Follow-up: MRI scan shows There is straightening with reversal of the normal cervical lordosis at C4-C6. What does this mean? 58 minutes later
Thank you for getting back to me. Just a couple of more questions. In detailing issues I have been having I neglected some. Last week (first time) I was in the store and all of a sudden felt weak all over and felt as if I was going to collapse. I hurried out of the store, drove home (1.5 miles) sat down, got on the computer and next thing I knew I was waking up and it had been over an hour (hands still positioned on the computer where they had been). This happened again the other day but not to that extreme, I just felt the weakness and lightheaded (this time, at home) so I just went and sat down for a bit and it subsided. I have also noticed that if I stand for more than 10-15 minutes my lower back begins to ache like crazy and then the other day I was driving and after 30 minutes I got such intense pain in my entire back and the tingling, weakness and coldness (aching feeling in hands) in my arms came. The tingling and weakness and coldness that I get in my arms happens everyday. It usually happens after I have been holding the phone for more than 8-10 minutes. (I know this because of the job I do). Also sorry one more thing. When I get the intense pain back between my shoulder blades (which happens a lot) if I slouch and then like press the shoulder blades together I hear and feel a cracking and popping. Is this normal. I am sorry I just really need some answers. I guess this all just really bothers me because - I was having absolutely NONE of these problems until my accident. Have never had any issues of this sort before. I mean yes I have had headaches but not this much. Again thank you for your time. Oh wait, sorry one more question. Right now I am just seeing my regular dr. (I have no insurance) do you think I should see a specialist?
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer: Please find the answers & explanation below. Detailed Answer: Hi, Nice to hear from you. From the given description, I could feel your concern for the symptoms which you are experiencing. - Feeling of sudden onset of weakness followed by unconsciousness might be due to many causes. The commonest ones being Hypoglycemia and Vasovagal syncope. This symptom needs a detailed evaluation either by a General physician or a Neurophysician. - Tingling, weakness and aches in the hand signifies a pinched nerve in the cervical spine (neck) due to a protruding intervertebral disc. If this symptom is not improving with medications like Gabapentin/Methylcobalamine/Pregabalin for over a 3-6 weeks course, then you may need an "Epidural steroid injection". - The feeling of a cracking or popping noise during certain movements may be considered as normal (not serious) variant and is due to friction between soft tissues like tendons/muscles/ligaments and the overlying bone. I suggest you to consult your regular doctor initially and if he thinks that you need any specialist consultation, he refers you to a concerned specialist. Hope I have justified your query. Have a great day
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Follow-up: MRI scan shows There is straightening with reversal of the normal cervical lordosis at C4-C6. What does this mean? 5 hours later
Good morning, Ok - I am so sorry to bother you but I guess my major question relates to the accident. Being that I was not nor ever experienced any of these issues prior to my accident - would you say these symptoms are a result of the accident. Thanks
Answered by Dr. K. Naga Ravi Prasad 12 minutes later
Brief Answer: Yes, they may be attributed to the accident. Detailed Answer: Hi, As you didn't experienced any of the above symptoms before your accident, I definitely ATTRIBUTE them to be the result of the accident. Also, I would like to tell you that the cervical disc disease might have been existing in you in a SILENT form without producing any symptoms and the impact of the accident might have caused the symptoms to MANIFEST as a result of injury and inflammation in the soft tissues and bony structures of the spinal column. Hope I have made it clear for you. Good day
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