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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Welcome to the board. I would suggest you get another opinion from a neurosurgeon. I assume the orthopedic surgeon was an orthopedic spine surgeon. You only want to see specialists that treat neck and back issues only.

Obviously I cannot tell what is going on with your shoulder, but I can offer you the following possibility. We can assume that with bulging discs and bone spurs, you have some degenerative disc disease going on at the cervical spine level.

The discs are the soft gelatinous cushion between the bones (vertebrae) of the spine. Also located at each vertebral level is a small synovial joint called the facet joint. The discs, along with the facet joints, are what allow us to bend and twist the spine.

The discs are composed of something like 90+% moisture. As we age, the discs lose moisture and begin to dry out. This causes the discs to flatten and causes the bones to get closer together. Sometimes you will see on a MRI report that there is "disc space narrowing." As this happens, the body tries to compensate by laying down bone in an attempt to stabilize the section of spine that is affected. This often results in bone spurs forming on the facet joints, which causes them to enlarge. When the disc bulges, disc material moves out of the disc space, which also takes up space that is meant for the spinal nerves. When these changes occur, all this extra material that takes up space can push into the thecal sac, which contains the spinal fluid and the spinal cord. If it pushes hard enough, it keeps the spinal cord from functioning normally. This can result in damage to the cord itself or a disease of the spinal cord that softens it and can lead to paralysis.

It is the spinal canal that narrows. This process puts pressure on the spinal cord, keeping it from functioning normally. When this occurs, it is necessary to perform surgery to take the pressure off the cord.

Regarding your shoulder: spinal nerves innervates nerves that control movement and nerves that control what we feel. Apparently your issues are most severe at C4, C5 and C6. The nerves at C4 innervates the area just above the collarbone; C5 innervates the collarbones down to the top of the shoulder blades, outside front of the arms; and C6 innervates the outside portion of the arms and the thumb side of the hands. If these nerves are "pinched" they cannot function normally...which results in pain, tingling, numbness...and it can cause muscle wasting. I suspect this is why your shoulder looks like it is collapsing. The nerve compression is just on the nerves affecting the one side, so the other shoulder is still functioning normally.

When there is spinal nerve compression, it can be felt at the site of compression or anywhere along the path of the nerve. You can look online for a "dermatome map" to see which body part is innervated by a specific your case, C4, C5 and C6. You may also have some other nerve compression going on -- these are just the ones you mentioned.

The epidural steroid injections are almost always the first treatment tried. You are limited to three per year due to the damaging side effects of the cortisone. If your spine cord compression is severe, chances are good that you will end up having surgery. But let's wait on that until after you see the doctor again.

You should get a copy of the MRI and the report and begin a file for your own use. I also recommend you make an appointment with a spine surgeon from a different clinic, for a second opinion. This is especially important if you end up needing surgery.

A word on the topic of surgery: none of us want to have spine surgery. First, you of must remember that every person's "issues" are different. A herniated disc in one person could be something that one could live with, but in another person, it could cause severe and permanent nerve damage. It all depends on its location within the spine. One cannot underestimate the importance of the spinal cord to human life. It is the highway that connects the brain to the body, and the body to the brain, controlling all sensory and motion of the various nerves of the peripheral nervous system. When there is an interruption in signal, it can result in paralysis of a limb or worse.

When the spinal cord is impacted by stenosis, sometimes it is necessary to have surgery to remove whatever is impacting it...or run the risk of permanent paralysis or even death. In severe cases like this, to me, it is an easy decision to choose to have surgery.

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