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What Do My Lab Test Reports Indicate?
Question: Can you please look at my neck scans all theee and compare them for me please. had a accident on the 7th of March so have whiplash and a decision was taken to do another MRI. Can you answer the following questions for me please
1)what way is the disc protruding and can this be fixed with surgery. 2) is there spinal cord damage or is impinging on the spinal cord. Symtoms for me present like stenosis.both arms are effective.. a servere tightness in the upper muscles on both arms..very very stiff. How would my surgeon decide if an injection would suffice. Should he not view me prior to making that decision. I believe these injections are not straight forward. Please advise
I would appreciate if somebody answer the following questions above:-
My surgeon is suggesting a nerve block and states the disc at c4c5c6 are severely degenerated.. he also suggested surgery
1)what way is the disc protruding and can this be fixed with surgery. 2) is there spinal cord damage or is impinging on the spinal cord. Symtoms for me present like stenosis.both arms are effective.. a servere tightness in the upper muscles on both arms..very very stiff. How would my surgeon decide if an injection would suffice. Should he not view me prior to making that decision. I believe these injections are not straight forward. Please advise
I would appreciate if somebody answer the following questions above:-
My surgeon is suggesting a nerve block and states the disc at c4c5c6 are severely degenerated.. he also suggested surgery
Brief Answer:
Surgery can improve your symptoms. Injection should be tried first.
Detailed Answer:
Hello again XXXXXXX
I have read your new query and understand your concerns.
I saw again the MR reports you uploaded too,
Here are the answers to your questions:
1. At C5-C6 level the disc is severely degenerated and narrows the spinal canal more anteriorly than posteriorly. This can be surely corrected by decompressive surgery.
2. There seems to be myelopathy or spinal cord damage at first stages related to compression caused by the protruded disc, besides the stenosis.
The best thing to do before deciding any surgical procedure is to have an accurate neurologic examination and neurologic findings to be correlated to MRI findings.
If there is strong correlation surgery is likely to succeed in improving symptoms.
In my opinion, spinal injection should be tried before surgical intervention, because it is a simple procedure and there are good chances to improve significantly your symptoms, since conservative treatment seems to have failed.
If injection fails to improve your symptoms, then surgery is the last resort.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Surgery can improve your symptoms. Injection should be tried first.
Detailed Answer:
Hello again XXXXXXX
I have read your new query and understand your concerns.
I saw again the MR reports you uploaded too,
Here are the answers to your questions:
1. At C5-C6 level the disc is severely degenerated and narrows the spinal canal more anteriorly than posteriorly. This can be surely corrected by decompressive surgery.
2. There seems to be myelopathy or spinal cord damage at first stages related to compression caused by the protruded disc, besides the stenosis.
The best thing to do before deciding any surgical procedure is to have an accurate neurologic examination and neurologic findings to be correlated to MRI findings.
If there is strong correlation surgery is likely to succeed in improving symptoms.
In my opinion, spinal injection should be tried before surgical intervention, because it is a simple procedure and there are good chances to improve significantly your symptoms, since conservative treatment seems to have failed.
If injection fails to improve your symptoms, then surgery is the last resort.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you
I would appreciate if you let me know if there has been a progression in the scans over the last two year.. I have sent you all the scans
What would happen If I did not have the nerve block or the operation
could my symtoms get worse
I would also like to ask you how long should I wait after the crash.. could there still be inflammination after the crash in March of this year
is there any difference between the scan in February and mayof this year
is there a chance that the spinal cord could get damaged more if I don t have surgery
thanks
meant to ask..what is decompressive surgery and does this require fusion. what is the success rate of surgery and what is the success rate of nerveblocks
I would appreciate if you let me know if there has been a progression in the scans over the last two year.. I have sent you all the scans
What would happen If I did not have the nerve block or the operation
could my symtoms get worse
I would also like to ask you how long should I wait after the crash.. could there still be inflammination after the crash in March of this year
is there any difference between the scan in February and mayof this year
is there a chance that the spinal cord could get damaged more if I don t have surgery
thanks
meant to ask..what is decompressive surgery and does this require fusion. what is the success rate of surgery and what is the success rate of nerveblocks
Brief Answer:
Explanations below.
Detailed Answer:
Welcome back XXXXXXX
From the different scans, seems there is small progression of stenosis, but it is difficult to give an exact value since there's no possible measure the scans. ( because there are photos not DICOM images ).
If left untreated your condition most probably will progress and symptoms will worsen.
In general there's a two months conservative treatment trial before deciding about more invasive procedures.
Decompressive surgery in your case could be removing the disc by anterior approach, or relieving the spinal cord by posterior approach ( laminectomy), in both cases with or without fusion. Fusion or not is decided regarding to cervical column stability.
The success rate of nerve block is approximately 50 %, in mean time surgery results in a success rate about 90-95%.
Hope I've been understandable. Best regards.
Explanations below.
Detailed Answer:
Welcome back XXXXXXX
From the different scans, seems there is small progression of stenosis, but it is difficult to give an exact value since there's no possible measure the scans. ( because there are photos not DICOM images ).
If left untreated your condition most probably will progress and symptoms will worsen.
In general there's a two months conservative treatment trial before deciding about more invasive procedures.
Decompressive surgery in your case could be removing the disc by anterior approach, or relieving the spinal cord by posterior approach ( laminectomy), in both cases with or without fusion. Fusion or not is decided regarding to cervical column stability.
The success rate of nerve block is approximately 50 %, in mean time surgery results in a success rate about 90-95%.
Hope I've been understandable. Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
when you say worsen.. do you mean I couldbecome paralized.or lose feeling
thanks a lot for your explanation
can nerve block damage me
could the cord become worse
I have no weakness and no loss of strength in my arms.. just severe soreness and tightness in the arms which is obviously coming from the neck
My neck is stable.. is this a good sign
I find you extremely heloful
what if I go straight to surgery..as mentioned I have very little pins and needles no numbness just severe stiffness
one more question..is this spinal stenosis of the neck..gosh this is very serious.
are there any other nerve tests that my surgeon should take prior to doing a nerve block..the fact that I have no numbness or major tingling what will this do
thanks a lot for your explanation
can nerve block damage me
could the cord become worse
I have no weakness and no loss of strength in my arms.. just severe soreness and tightness in the arms which is obviously coming from the neck
My neck is stable.. is this a good sign
I find you extremely heloful
what if I go straight to surgery..as mentioned I have very little pins and needles no numbness just severe stiffness
one more question..is this spinal stenosis of the neck..gosh this is very serious.
are there any other nerve tests that my surgeon should take prior to doing a nerve block..the fact that I have no numbness or major tingling what will this do
Brief Answer:
There can be done an EMG ( nerves conduction study).
Detailed Answer:
Hi again XXXXXXX
Worsening of your condition means there could be worsened the stiffness, you could start feel arms and legs pain and numbness, could have difficulty in performing everyday tasks, could have urinary problems and yes, there is a small possibility you getting paralysed.
Going straight to surgery or not, is a decision that belongs to you.
Thare can be done an EMG of your arms to help identify the exact nerve roots responsible for your symptoms, besides neurologic examination.
Take care.
There can be done an EMG ( nerves conduction study).
Detailed Answer:
Hi again XXXXXXX
Worsening of your condition means there could be worsened the stiffness, you could start feel arms and legs pain and numbness, could have difficulty in performing everyday tasks, could have urinary problems and yes, there is a small possibility you getting paralysed.
Going straight to surgery or not, is a decision that belongs to you.
Thare can be done an EMG of your arms to help identify the exact nerve roots responsible for your symptoms, besides neurologic examination.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
thanks very much for this..
what is a EMG..and does it take long..
I got a fright when you said spinal cord damage early..surely this is very dangerous..
I have lumbar pain issues also and I just wonder if it would be worth getting a lumbar MRI again as I have pain in both legs..and foot..wonder if this is coming from the neck.
thanks so much
I am attaching a copy of my MRI report of my lumbar area.
would be grateful for your opinion..
XXXX
one more question.. is early surgery for the neck better even though I don t have pins and needles very little and I attend physiotherapy weekly..it is the bilaterial arm pain when moving that is the worst..also I have heard that nerve blocks can be risky and also that sometimes surgeons don t operate if it is too near the spinal cord..i am out of work because of these degenerate issues
thanks
what is a EMG..and does it take long..
I got a fright when you said spinal cord damage early..surely this is very dangerous..
I have lumbar pain issues also and I just wonder if it would be worth getting a lumbar MRI again as I have pain in both legs..and foot..wonder if this is coming from the neck.
thanks so much
I am attaching a copy of my MRI report of my lumbar area.
would be grateful for your opinion..
XXXX
one more question.. is early surgery for the neck better even though I don t have pins and needles very little and I attend physiotherapy weekly..it is the bilaterial arm pain when moving that is the worst..also I have heard that nerve blocks can be risky and also that sometimes surgeons don t operate if it is too near the spinal cord..i am out of work because of these degenerate issues
thanks
Brief Answer:
Explanations below.
Detailed Answer:
Welcome back XXXXXXX
An EMG is a nerve conduction study, it is a simple short-time test and it helps in localization of th nerve root(s) that are suffering. EMG findings, as the other tests, should be correlated to clinical findings.
Lumbar MRI shows there is herniated disc disease at its first stages causing minor compression on two lumbar nerve roots at left side.
As I said before, surgery in your case is the last resort.
If your symptoms improve with conservative treatment ( NSAID drugs, physical therapy, and injections), surgery is postponed.
Nerve block as other medical procedures, contains a risk degree, but minimal in professional hands.
There are no surgical limitations related to spinal cord approximity of lesions, especially herniated disc disease.
Hope I helped you.
Take care.
Explanations below.
Detailed Answer:
Welcome back XXXXXXX
An EMG is a nerve conduction study, it is a simple short-time test and it helps in localization of th nerve root(s) that are suffering. EMG findings, as the other tests, should be correlated to clinical findings.
Lumbar MRI shows there is herniated disc disease at its first stages causing minor compression on two lumbar nerve roots at left side.
As I said before, surgery in your case is the last resort.
If your symptoms improve with conservative treatment ( NSAID drugs, physical therapy, and injections), surgery is postponed.
Nerve block as other medical procedures, contains a risk degree, but minimal in professional hands.
There are no surgical limitations related to spinal cord approximity of lesions, especially herniated disc disease.
Hope I helped you.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
you are very good..and I find you answers very clear along with all the other anwers I get from this site.. very clear and to the point
My physiotherapist does not want me to have a nerve block as yet as she thinks that there could be swelling still from the whiplash and thinks I should give this time..she is excellent.. my surgeon who is also excellent said that if the compression on the both arms does not go away that I need to consider nerve block..he just wrote to me as he know s me and deals with my spinal issues..this could go either way.. it is however very disabling.. is it safe to swim..i find moving my arms very sore..it is a sharp pain..is there any risk in the nerve conduction study?
I would really appreciate if you could clarify if there is a big difference in the scan s between the January and May neck scans.. I was in a car accident on the 7th March and got quite a bang.. I went into another car...and the air bag went off..i hope the spinal cord injury did not happen at this time..or do you think that this is due to the degenerate disease..thanks so much
meant to ask what is the reversal lordis a sign of.. thanks
also do you think steroids would help and one more question.. by delaying surgery could you cause nerve damage..i just have sharp pain now..does surgery reverse this.thanks
My physiotherapist does not want me to have a nerve block as yet as she thinks that there could be swelling still from the whiplash and thinks I should give this time..she is excellent.. my surgeon who is also excellent said that if the compression on the both arms does not go away that I need to consider nerve block..he just wrote to me as he know s me and deals with my spinal issues..this could go either way.. it is however very disabling.. is it safe to swim..i find moving my arms very sore..it is a sharp pain..is there any risk in the nerve conduction study?
I would really appreciate if you could clarify if there is a big difference in the scan s between the January and May neck scans.. I was in a car accident on the 7th March and got quite a bang.. I went into another car...and the air bag went off..i hope the spinal cord injury did not happen at this time..or do you think that this is due to the degenerate disease..thanks so much
meant to ask what is the reversal lordis a sign of.. thanks
also do you think steroids would help and one more question.. by delaying surgery could you cause nerve damage..i just have sharp pain now..does surgery reverse this.thanks
Brief Answer:
Explanations below.
Detailed Answer:
Hi there XXXXXXX
Steroids injections help furthermore if there is swelling, but the most important thing to evaluate before any invasive procedure is to take account of your symptoms, if there's no worsening or progression of symptoms, conservative treatment should be continued.
Swimming is a good exercise to do in your case.
Nerve conduction study is a simple cheap procedure without any risks.
I think the spine condition worsened due to the accident.
Reversal lordosis is the reverting of the normal bending of cervical column in your case due to whiplash or muscles strained.
Steroids could help in reducing swelling.
The nerve damage is more possible if symptoms are worsening, and delaying surgery could not result in complete recovery.
Hope I helped you. Best regards.
Explanations below.
Detailed Answer:
Hi there XXXXXXX
Steroids injections help furthermore if there is swelling, but the most important thing to evaluate before any invasive procedure is to take account of your symptoms, if there's no worsening or progression of symptoms, conservative treatment should be continued.
Swimming is a good exercise to do in your case.
Nerve conduction study is a simple cheap procedure without any risks.
I think the spine condition worsened due to the accident.
Reversal lordosis is the reverting of the normal bending of cervical column in your case due to whiplash or muscles strained.
Steroids could help in reducing swelling.
The nerve damage is more possible if symptoms are worsening, and delaying surgery could not result in complete recovery.
Hope I helped you. Best regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
could early intervention make it worse..i have often heard of people coming out much worse after sugery
Do you have an opinion of Lidocaine patches for my condition.or any other medication..
are all of the other discs in the neck ok..my fear is will one operation lead to antoher..this often happens..
what is the difference between an epidural and a nerve block for the neck in particular..thanks so much
I have one more question..
I have notice that I need to urinate a lot over the last week..you mentioned that this could be compression
should I report this to my surgeon
could my disc be pressing on the nerve
thanks
Do you have an opinion of Lidocaine patches for my condition.or any other medication..
are all of the other discs in the neck ok..my fear is will one operation lead to antoher..this often happens..
what is the difference between an epidural and a nerve block for the neck in particular..thanks so much
I have one more question..
I have notice that I need to urinate a lot over the last week..you mentioned that this could be compression
should I report this to my surgeon
could my disc be pressing on the nerve
thanks
Brief Answer:
Urinary problems should be discussed with your Doctor ASAP.
Detailed Answer:
Hello again XXXXXXX
Spinal surgery when indicated correctly, results in good outcome in approximately 90-95% of cases.
Failed surgery results in cases that aren't selected properly, and in those cases worsening of condition may happen.
Other discs of your neck seem desicated, but not compressing the spinal cord, so with proper treatment, this state can be conserved.
Offcourse there are risks as with any other invasive and surgical procedures.
Lidocaine patch or other possible treatments ( Fentanyl patch eg.) are all solutions against the pain, but not solve the stenosis problem.
A nerve block is an injection pointed towards a suffering nerve root, an epidural is an injection on the outside surface of the spinal cord and adjacent nerve roots (more than one).
Unfortunately urinary problems indicate progression of compression and stenosis, so, you should report this issue to your Surgeon as soon as possible.
Urinary problems should be discussed with your Doctor ASAP.
Detailed Answer:
Hello again XXXXXXX
Spinal surgery when indicated correctly, results in good outcome in approximately 90-95% of cases.
Failed surgery results in cases that aren't selected properly, and in those cases worsening of condition may happen.
Other discs of your neck seem desicated, but not compressing the spinal cord, so with proper treatment, this state can be conserved.
Offcourse there are risks as with any other invasive and surgical procedures.
Lidocaine patch or other possible treatments ( Fentanyl patch eg.) are all solutions against the pain, but not solve the stenosis problem.
A nerve block is an injection pointed towards a suffering nerve root, an epidural is an injection on the outside surface of the spinal cord and adjacent nerve roots (more than one).
Unfortunately urinary problems indicate progression of compression and stenosis, so, you should report this issue to your Surgeon as soon as possible.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi
thanks very much for your answer. I have actually reported this to my surgeon and I hope to meet him next week so that he can do a full neurological test..
I do not have any strength lost or weakness or numbness yet..i did before but my physiotherapy worked on all this.
I have not lost bladder control..just frequency in passing urine
How long does it take for neck surgery to heal..would this be a big operation from what you can gather..my surgeon has clearly indicated on his letter that I need to consider surgery if my symtoms don't improve...
is the stenosis been caused by the protruding disc.
I have read about stenosis..is this what I have...
Is there a possibility that by having an operation in one disc could lead to another.
Is it better to see a neurosurgeon or an orphaedic surgeon for these issues..my own surgeon is a spine surgeon but one of the best in his field.
thanks for all your help and support...
I meant to ask one more question..
my surgeon has told me I needed to consider surgery if my smytoms do not get better..he also said he wanted to give it abit more time because of whiplash injury so he did not want any early intervention. Is it true that a surgeon will not go in and operate only if there is a high chance of success..also another question..he said the neck was stable..is this a good sign.. hopefully some good news..thanks so much
thanks very much for your answer. I have actually reported this to my surgeon and I hope to meet him next week so that he can do a full neurological test..
I do not have any strength lost or weakness or numbness yet..i did before but my physiotherapy worked on all this.
I have not lost bladder control..just frequency in passing urine
How long does it take for neck surgery to heal..would this be a big operation from what you can gather..my surgeon has clearly indicated on his letter that I need to consider surgery if my symtoms don't improve...
is the stenosis been caused by the protruding disc.
I have read about stenosis..is this what I have...
Is there a possibility that by having an operation in one disc could lead to another.
Is it better to see a neurosurgeon or an orphaedic surgeon for these issues..my own surgeon is a spine surgeon but one of the best in his field.
thanks for all your help and support...
I meant to ask one more question..
my surgeon has told me I needed to consider surgery if my smytoms do not get better..he also said he wanted to give it abit more time because of whiplash injury so he did not want any early intervention. Is it true that a surgeon will not go in and operate only if there is a high chance of success..also another question..he said the neck was stable..is this a good sign.. hopefully some good news..thanks so much
Brief Answer:
Surgery most probably successful in your case.
Detailed Answer:
Welcome back XXXXXXX
You have cervical spine stenosis, but fortunately it is not so advanced, because there's no advanced myelopathy and there's still cerebrospinal fluid around the spinal cord at stenosis level.
It doesn't matter to much if you choose a Neurosurgeon or a Orthopedic surgeon, the important thing is the Doctor should be prepared and experienced.
Not having weakness, numbness and instability, all these are in favor to a good outcome after surgery.
Doesn't seem to me that your case need a extensive surgery, an anterior discectomy is sufficient second my opinion.
However, all spinal surgical procedures create an opportunity for instability and adjacent levels vulnerability, so there's need for precautions after surgery.
If surgery is most probably to fail than to succeed, then no Doctor suggests intervention.
Hope I helped you. Best regards.
Surgery most probably successful in your case.
Detailed Answer:
Welcome back XXXXXXX
You have cervical spine stenosis, but fortunately it is not so advanced, because there's no advanced myelopathy and there's still cerebrospinal fluid around the spinal cord at stenosis level.
It doesn't matter to much if you choose a Neurosurgeon or a Orthopedic surgeon, the important thing is the Doctor should be prepared and experienced.
Not having weakness, numbness and instability, all these are in favor to a good outcome after surgery.
Doesn't seem to me that your case need a extensive surgery, an anterior discectomy is sufficient second my opinion.
However, all spinal surgical procedures create an opportunity for instability and adjacent levels vulnerability, so there's need for precautions after surgery.
If surgery is most probably to fail than to succeed, then no Doctor suggests intervention.
Hope I helped you. Best regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
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