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C5-C6 issue affecting my shoulder?

Spine Health | Last Active: Feb 29, 2020 | Replies (42)

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@fdchik22

So sounds like he is an amazing doctor who knows his stuff very well. I will have an open mind about my care because I'm just ready to get some genuine help. I have had 2 EMG's already as well in both arms and they tried my neck area but it was extremely painful so they couldn't go forward with the test. So adding everything up multiple MRI's, EMG's, physical therapy, epidural and other injections with no relief. My most recent MRI on cervical showed this last time on the report.

C2-C3: Minimal disc desiccation. No spinal canal or foraminal stenosis.
C3-C4: Mild disc desiccation. Minimal posterior midline disc osteophyte complex. No resulting spinal canal or foraminal stenosis on either side.
C4-C5: Disc desiccation with very minimal disc bulge. Mild bilateral uncovertebral hypertrophy. No spinal canal or foraminal stenosis on either side.
C5-C6: Disc desiccation with diffuse disc bulge. Degenerative changes cause very mild spinal canal stenosis and left foraminal stenosis. There is no right foraminal stenosis.
C6-C7: Disc desiccation with posterior disc broad-based protrusion effacing the anterior thecal sac. There is mild spinal canal stenosis resulting. Mild left and mild right foraminal stenosis is seen as well.
C7-T1: No disc pathology. No spinal canal or foraminal stenosis on either side

The one previous showed this:
C2-C3: Normal
C3-C4: Moderate central disc herniation which indents the thecal sac and touches the anterior surface of the spinal cord. No cord deformity. No foraminal narrowing.
C-4-C-5: Small central T2 abnormality could represent a annular fissure or small herniation. No spinal or foraminal stenosis.
C5-C-6: Moderate disc herniation with some mild flattening of the anterior thecal sac. Mild spinal stenosis. No foraminal stenosis.
C-6-7: Mixed signal abnormality in the disc is broad-based. Probable large bulge with possible superimposed annular fissure or poorly visualized herniation. Mild flattening of the anterior thecal sac. No foraminal stenosis.
C-7-T-1 Normal

Do you know what any of this means? That's just my cervical there is some in my thoracic as well as lumbar. I'm at my wits end and just don't know what to do, I'm trying to wait and let this neurosurgeon respond but I don't seem to be a priority for him or his office. Sorry for venting just nice to chat with someone who understand what I'm dealing with. I'm just ready for some answers because the research I find and what doctors tell me is very contradicting, even different doctors have different answers for what is causing all my symptoms and issues. Symptoms are severe pain and pressure between shoulder blades as well as numbness and tingling. Severe shoulder and neck pain at times it's difficult to even hold my head up. More and more difficulty with my grip strength and lifting things away from my body especially on the right shoulder. Severe to mild headaches 5 out of 7 days a week I mean this is getting way out of hand and I can't get the doctor to even read my freaking MRI that to me is unacceptable. So according to what you said I should plan on being up there at least a couple days? I have to fly or drive so just curious, I wish I was closer.

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Replies to "So sounds like he is an amazing doctor who knows his stuff very well. I will..."

@fdchik22 This should help you understand your report. When visiting Mayo, they recommend in general to allow a week for everything. You will be given a printed schedule of appointments, but you can try to get them done earlier if there are openings. You just go ahead of time, and check in, and they will call you if they can take you early. That happens frequently as patient schedules can change for various reasons. There are lots of hotels and most have free shuttles. If you drive there, get to the parking ramp (deck) early as it fills up mid day. It was a 5 hour drive for me. Here is a discussion on visiting Mayo. https://connect.mayoclinic.org/discussion/suggestions-for-a-stay-at-mayo-rochester/ and from the Mayo website, https://www.mayoclinic.org/patient-visitor-guide/minnesota

Surgeons tend to look at the images on the MRI instead of paying attention to what the report from the radiologist says. I wrote definitions of the terminology and gave you a translated version in common language. I can't interpret what this means in your case as only a medical specialist can do that, but you can get the general idea and compare that to where you have symptoms. Sometimes you get contradicting recommendations from different surgeons. I know that shoulder blade pain comes from C5 C6 area. That is what a surgeon told me. The shoulder blade is connected to the spine by muscles and also to the shoulders. I also had bad headaches generated by spine issues called cervicogenic headaches, and aches on the back of my head caused by neck muscle spasms. If you want to go to Mayo, you will need to set up an account and send in copies of your imaging on CDs, and then wait for their response. Getting other opinions is normal for surgery and usually recommended. Once you get in Mayo, they get everything done right away, and you don't waste weeks waiting for appointments, and waiting again for the next test, etc. Often they schedule same day appointments when a specialist wants further testing. I know this can be confusing and frustrating, but you will need to advocate for yourself.

There are 7 numbered cervical vertebrae and the discs are named for being between the vertebrae and there are joints that allow the vertebrae to slide on twisting on bending. The discs act as cushions and the joints allow the movement.

Nerve roots emerge above their numbered vertebrae.

Here is an excerpt from this link that explains where the nerve roots send their signals.
https://www.healthline.com/health/dermatome#dermatomes-chart
Cervical spinal nerves
C2: lower jaw, back of the head
C3: upper neck, back of the head
C4: lower neck, upper shoulders
C5: area of the collarbones, upper shoulders
C6: shoulders, outside of arm, thumb
C7: upper back, back of arm, pointer and middle finger
C8: upper back, inside of arm, ring and little finger

From your MRI report:

“C3-C4: Mild disc desiccation. Minimal posterior midline disc osteophyte complex “
This is a small herniated disc with some bone spurs centered at the midline, but not causing stenosis C 4 dermatome

“C4-C5: Disc desiccation with very minimal disc bulge. Mild bilateral uncovertebral hypertrophy. “
Increase in size of uncovertebral joints. C5 dermatome

“C5-C6: Disc desiccation with diffuse disc bulge. Degenerative changes cause very mild spinal canal stenosis and left foraminal stenosis.”
Degenerated disc bulge causing compression in the central canal and left foramen nerve root. C6 dermatome

“C6-C7: Disc desiccation with posterior disc broad-based protrusion effacing the anterior thecal sac. There is mild spinal canal stenosis resulting. Mild left and mild right foraminal stenosis is seen as well.”
Posterior mild disc herniation compressing the membrane around the spinal cord and spinal cord and the nerve roots on both sides.” C 7 dermatome

This link has a page with several videos that explain how to read MRIs and there are also some for reading MRIs with nerve root or spinal cord compression.
https://neckandback.com/videos/understanding-an-mri-of-the-normal-cervical-spine/
Terms in your report:

Dessication is drying out of the disc.
Foramen are the spaces between every vertebrae where the nerve roots exit the spinal cord.
Central Spinal canal is the tube where the spinal cord floats in fluid where is passes through each vertebrae in the spine.
Stenosis is narrowing where a nerve root (foraminal) or spinal cord (central canal) is getting compressed.
Uncovertebral are joints.
Thecal sac is a membrane around the spinal cord.
Anterior is toward the front.
Posterior is toward the back.
T2 is a contast lighted view of the MRI.
Signal abnormality of a disc is how the MRI passes through it unevenly because of degeneration, etc.
Annulus is the tough fibrous outer covering of a disk, annular fissure is a tear in the annulus.
Nucleus is the jelly like center of the disk that squishes out through a tear in the annulus.
Disc osteophyte complex is when the herniation of the disc causes bone spurs to grow next to it because of the inflammation from the ruptured nucleus of the disc.