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Intense pain. Report reveals disc osteophyte, central canal stenosis, left foraminal stenosis. Advised physical therapy. Right?

My hubby has been going through this for 14 months and it is so bad that he has many times threatened to kill him self because of the pain. I watch him sleep in a recliner(only place he can get any sleep) and cry and moan all night long. This is what the report says Small amount of increased T2 in the cord focally at the C6-C7 disc space level C6-C7: Broad-Based Ventral impression on thecal sac due to Disc osteophyte complex. AP dimmension of the central canal reduced to approx. 9mm. Moderately severe LEFT Foraminal narrowing. Impression: Disc osteophyte complex producing a ventral extradural defect at c6 c7 This results in minimal central canal stenosis . But there does apeer to be a small amount of edema in cervical cord at this level. Moderately severe LEFT foraminal stenosis At C6-C7 They want him to get physical therapy and he can t hardly walk or pick anything up. Does this sound right?
Asked On : Fri, 15 Feb 2013
Answers:  3 Views:  123
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

It is obvious from the description that your husband is suffering with cervical disc disease. The initial management of this condition is always by nonsurgical methods.

Some people may get relief from symptoms with conservative management which comprises of
Soft 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: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

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. 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.

If the symptoms do not resolve with the above measures, consult an orthosurgeon/spine surgeon and follow their advice.

Hope this information is helpful. Good day

Answered: Sat, 24 Aug 2013
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Radiologist Dr. Indu Kumar's  Response
Apr 2014
Thanks for writing to HCM

Your doctor has rightly advised for physiotherapy first.
Pain is due to degenerative disease of spine in the form of disc prolapse.
Disc prolapse is causing problem and disc prolapse occurs due to weakness of annulus fibrosis.
Treatment is physiotherapy and surgical.
Long term results are same in both the modalities.
Physiotherapy strengthen back muscles and it prevents further herniation of disc.
Surgery should be last resort.Epidural steroid treatment can be considered.
Get well soon.

Take Care
Dr.Indu Bhushan
Answered: Sat, 24 Aug 2013
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Spine Surgeon Dr. Niranjan Kavadi's  Response
Thank you for your question.

The MRI picture you have described is typical of cervical stenosis. Such an extreme pain with trouble walking and picking things up indicates advanced disease. Canal diameter of 9 mm with increased signal on T2 is indicative of severe stenosis and needs an urgent evaluation by a spine surgeon.

Also as he has mentioned thoughts to kill himself, to ensure his safety don't leave him alone.

Please let me know if I can be of further assistance.
Answered: Sat, 24 Aug 2013
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