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    Suggest treatment for spinal stenosis

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Posted on Mon, 17 Jul 2017 in Brain and Spine
Question: QUESTION 1- Need layman's terms as what's happening
QUESTION 2- Can you put in order of "Most Important" to least or "Severity" or Most Crucial
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C2-C3 FINDINGS:
1- No compromise of the craniocervical junction. There is no disc herniation or spinal stenosis.
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C3-C4 FINDINGS:
1- Mild disc space narrowing with uncovertebral joint spur causing mild central stenosis.
2- Moderate left and severe right foraminal stenosis.
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C4-C5 FINDINGS:
1- moderate disc space narrowing with moderate spur disc complex causing moderate central stenosis and cord compression.
2- Some high T2 signal in the cord on either side just below disc space level suggests myelomalacia.
3- Moderate left and moderate to severe right foraminal stenosis
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C5-C6 FINDINGS:
1-Moderate disc space narrowing with broad-based spur disc complex greater to left of midline causing moderate central stenosis and cord compression worse to left of midline,
2- At the upper C6 level there is high T2 signal on either side of midline w/in the cord probably myelomalacia.
3- Mild left and moderate right foraminal stenosis.
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C6-C7 FINDINGS:
1- Moderate disc space narrowing and broad-based spur disc complex causing moderate central stenosis without cord compression.
2- Mild right and moderate left foraminal stenosis.
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C7-T1 FINDINGS:
1-mild degenerative disc & endplate change
2-mild bilateral foraminal stenosis. w/out significant central stenosis.
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C7-T1 FINDINGS:
1-mild degenerative disc & endplate change
2-mild bilateral foraminal stenosis. w/out significant central stenosis.
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THANKS
doctor
Answered by Dr. Neeraj Kumar 29 minutes later
Brief Answer:
Visit to a neurosurgeon for examination and surgical advice

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
You are having disc prolapse (DISPLACEMENT OF DISC BETWEEN SPINAL BONES INTO SPINAL CANAL CARRYING SPINAL CORD) at multiple levels with maximum effect at C4-5 and C5-6 levels with cord changes too.
C3-4 and C6-7 have less compression and no associated cord changes.
Neurosurgery advice is required and possibility of operative intervention is more likely.
Physiotherapy and neck collar may be useful.
Drugs like pregabalin or amitriptyline or gabapentin can be increased depending upon response.
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Neeraj Kumar 48 minutes later
Question 1- Please discuss my moderate to broad "spur disc complex" and is this causing my Central stenosis
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Question 2- Please discuss my foraminal stenosis, is this more or less of a "concern" than the Central stenosis
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Question 3- Please discuss my "probably myelomalacia:
doctor
Answered by Dr. Neeraj Kumar 2 hours later
Brief Answer:
The terms have been explained in detail

Detailed Answer:
Hello,
Question 1- Please discuss my moderate to broad "spur disc complex" and is this causing my Central stenosis.
Ans: Disc material and bone outgrowth is causing decrease in central canal space of spinal canal causing compression of cord.

Question 2- Please discuss my foraminal stenosis, is this more or less of a "concern" than the Central stenosis.
Ans: The nerve coming out of spinal cord passes through a space called foramina. due to disc prolapse this space is also narrowed or decreased causing nerve root compression and associated pain.

Question 3- Please discuss my "probably myelomalacia:
Ans: The compression of cord by disc is causing damage to nerve tissue of cord called as myelomalacia.

Hope all your queries are answered satisfactorily.
You can ask further queries.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neeraj Kumar 5 hours later
I AM NEW HERE
>
IF YOU GIVE ME MORE THAN A 1 SENTENCE ANSWER, I WILL TIP YOU WELL
>
Last set of Questions: I was diagnosed with Cervical Spondylosis with Myelopathy-Primary (CSM)
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QUESTION 1 -Can you explain the possible reason(s) for the dramatic UPSURGE in the SEVERITY of my CSM "BURNING" nerve pain symptom and its location,
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from being located in "mostly" just my right "pinkie" and a "little" in my left "pinkie" (along with numbness, "mostly" just in my right outer palm and "little" in my left outer palm)
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that in In ONE (1) MONTH
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to SPREAD in LOCATION and PAIN INTENSITY to ADDITIONALLY include
the dorsal ulnar cutaneous distribution in my BOTH my left and right hands extending through-out the entire sensory territories of the ulnar portion of the posterior aspect.
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NO other part of my body was affected!
>
>
QUESTION 2- Can you explain the possible reason(s) for The Effects of wearing a "Hard Collar"
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From the moment I put it on and raised the chin support, each “click” of the adjustment “knob” raised my chin and “stretched” my neck upwards about one-quarter of an inch per “click.”
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Each “click” stretched my neck upwards; taking more of the weight of my head off my neck. Several “clicks” in effect “mimicked” what cervical decompression surgery with ”fusion” would do by what "could only(?) be explained as allowing the nerves to decompress.
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For 6 MONTHS, I could feel, a noticeable reduction of the burning nerve pain
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However, in that SAME ONE (1) MONTH
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I felt a dramatic REDUCTION in the collar's effectiveness to relieve the severity of my CSM symptoms
doctor
Answered by Dr. Neeraj Kumar 16 hours later
Brief Answer:
Get examined and evaluated by a neurosurgeon

Detailed Answer:
Hello,
The cervical myelopathy with myelomalacia means that the disc compressing cord is damaging cord and there is neuronal loss there too.
Continous compression will damage nerves going to lower limbs and for bladder control too.
The symptoms in hands are due to nerve root compression at C5-6 and C6-7 levels.
Neck collar is not a treatment but may provide some relief. It can only stabilize the spine and reduce the nerve root compression.
The actual disc prolapse and compression persists which is the root cause.
In case of failed trial with physiotherapy and medications, surgery is the optimal option.
Visit to a neurosurgeon for evaluation regarding surgery.
The progress in symptoms may be due to increased herniation.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Neeraj Kumar 13 minutes later
I have seen a surgeon and I have had neuro-surgery.
Thank you for your answers
doctor
Answered by Dr. Neeraj Kumar 4 minutes later
Brief Answer:
Continue physiotherapy and medications

Detailed Answer:
Hello,
If you are having symptoms post surgery, then you need to focus on physiotherapy.
Damaged neurons could not be revived.
Medications like pregabalin, gabapentin or amitriptyline will help in reducing neuropathic pain.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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