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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

I'll post my interpretation here and you'll probably get someone else giving you their interpretation on the other post. We have a lot of knowledgeable people here so what I miss they'll fill in.

1st..the differing intensities of the bone is showing that your vertebrae are not as solid as they should be and you probably have some early osteoporosis. Your spine at the neck is losing it's normal curve and the vertebrae at C4-5 is smaller than usual probably due to arthritis.

Before starting the different vertebrae, a lesson in anatomy first. You have a disk between each vertebra sitting at the front side of the vertebrae toward your throat. The spinal cord runs down through a hole in each vertebra towards the back. On each side, there is an opening(foramen) where the nerves peel off the spinal cord(like a peeled banana) and go out to the arms or throat or head or where ever. A disk that ruptures through it's outer banding can rupture forward, sideways towards the nerves or backwards towards the spinal cord. Arthritis can affect the bone of the vertebrae anywhere but usually is at it's worst at the joints..facet joints on the back and the uncovertebral joints on the sides. So now, by the numbers...

C4-5-the disk had ruptured backwards and is pushing backwards so hard on your spinal cord that is has left damage to the spinal cord visible on the MRI scan. The place where the nerves exit the vertebra is moderately closed up by arthritis from the uncovertebral joints. This was put first as the cord damage is the most important finding.

C3-4-there is a bar like formation of bone spurs from arthritis touching your spinal cord on the front side of the cord and the arthritis in the uncovertebral joint on the right had caused the opening for the nerve to exit to be somewhat closed up.

C5-6-you have the same kind of bone spur formation here as well but this time it is making an indentation in your spinal cord. The exit holes for the nerves are again affected by arthritis in the same joints as above but this time it's severely closed up on the right and mild on the left side.

C6-7- almost the same situation with regards to your spinal cord here as in C5-6. The exit holes are again closed up but this time it's severe on the left and moderate on the right.

You need surgery. There is no mention of the width of the spinal cord but cord compression is a very serious problem that will eventually lead to paralysis. And where they have shown "severe" compression on the nerves, they too are at risk of paralysis(nerve death). An ACDF is the easiest of the spine surgeries to go through and produces the minimum amount of pain as spinal surgeries go. They remove the disks and fuse the vertebrae together with the aid of bone grafts, usually from a donor, enhanced with a product called BMP that speeds the growth of bone. Some people have reactions to BMP but it is treatable and makes the fusion take faster. And the bones are then screwed together with plates to make it even more secure while the bone grows. Once that is done, he can then remove the bone spurs touching the cord and open up the exit holes to free up the nerves.

If you don't have the surgery now, you will have to monitor any signs of loss of function and sensation in your body. Numbness, tingling, pins and needles sensations are the most common forms of loss of sensation. Loss of function includes weakness, muscles that don't work like they should(I was unable to move my legs forward very well and took baby steps), clumsiness in your hands, balance problems and the bad signs...problems with bowel or bladder function(not being able to go or can't wait). Those last 2 are an emergency as it can be permanently lost and greatly affect the quality and longevity of your life.

What is happening is that you are slowly developing paralysis either by the different nerves dying or your spinal cord dying from the compression causing the loss of blood supply. Once the blood supply is lost, you can't get it back. But the good thing is that it can take a lot of abuse before dying like that and you do have time. Ask just how compressed your cord is. The spinal cord should be between 11 and 12 mms wide. I was down to 6mms and still walking and I know someone here on the board who was down to 4mms and still kicking. But you are really taking a chance when it gets that compressed and my doc thought I was "urgent" but not an emergency. Another neurosurgeon thought I could wait a little longer. It's all up to the doc and you when to do the surgery. But I don't see anyway you are going to avoid it so you might as well do it ASAP rather than wait and risk further damage or permanent damage. I later broke 3 vertebrae in my neck and had to fight back from left sided paralysis and it is sooooooo hard. I wouldn't wish that on anyone. I will have to exercise those muscles forever and they will slowly get weaker and weaker no matter what I do.

Good luck and come back with any questions or just to say hello or give support to others. Many are going through the same thing as you.

gentle hugs............Jenny
I'm glad I could help. The width of the spinal cord is usually listed in the report or is measured on the actual film...the CD shows everything too small to get a good measurement. But your symptoms tell the story. The problems with your bladder and bowel tell you that it is very serious. You could end up this way for life if it is not attended to soon. My neighbor let a similar situation go as he had 2 surgeries and refused to go back for a third. He now wears diapers as he cannot hold his bowels at all and is permanently using a catheter for his bladder as it no longer will allow him to urinate. A future you may face if you don't have something done fairly soon. Here in the USA, bladder and bowel function disturbances are considered an emergency situation and surgery is done immediately.

The artificial disks are only used here in the USA in 1 vertebra in the neck. They are testing 2 and it is used elsewhere but my surgeon told me that they are finding that the disks start to deteriorate and leave metallic and plastic dust around the cord and they fear it will migrate into the brain. So 1 artificial disk low down in the neck is all that is permitted until the dust problem is solved.

There are systems that do allow more motion in the neck but it involves a surgery from the back of the neck to install(I have it)and the surgery is much more painful than the front surgery of ACDF. They use long rods to fuse the vertebrae and they have some give to them but I can tell you, it's not what you think. I am fused from C3 to T1, 6 vertebrae, so it is useful but it doesn't give that much flexibility. Once the bones fuse, that is that...the bone fusion takes away the ability to move, not the hardware. All it does is make it a little more comfortable so you don't have that feeling like you have a stiff rod in your back. The rods move better with the muscles but the bones are still stiff. That is the main difference. Your neck still is frozen solid.

But your problem is not a disk problem anyhow. You have disk compression as a problem in one area only(C4-5). Two other areas have spinal cord compression due to the bone spurs of arthritis(C5-6 and C6-7). An artificial disk will not help there as it is not the disk. If the only problem was at C4-5, then an artificial disk would help. But your surgeon needs to remove all the arthritis in the vertbrae of C5,6 and 7 and that may take so much bone away that you would need the fusion to prevent the vertebrae breaking. So by fusing together C4, 5 and 6 he can remove as much of the bone as needed and then clean up the bone spurs at C3 and C7. The disk at C5-6 is not bad but in order to fuse it and clean out the bone spurs, he'd have to remove it.

I believe the surgery I had, a laminoplasty, might be what you are looking for but it is done only by a few surgeons. In that surgery, they do go into the back of the neck and it is very painful for the first couple of days, but they remove the bone over the back of the vertebrae opening up the area that holds the spinal cord, break the side bones(the lamina bones), then they re-attach the lamina bones with bone sutures and prop them open with a bone graft. What it does is it makes the space for the spinal cord almost twice as big as it was so the cord can move away from the bad disk or the built up bone spurs without removing anything. The side nerves can also be opened up. No fusion is done so there is no loss of movement. I think this is what you are looking for. There is no long wearing of a neck brace and you can go back to work in a couple of weeks. I woke up with no numbness, bladder and bowel problems gone and pain and weakness gone. The problem is finding a doctor who does the surgery in your part of the world.

If you would like, I can ask my neurosurgeon's office if he knows anyone in your area who does the surgery as he is known world-wide. Or if you can come to the USA, I would be glad to help you make arrangements to meet with my doctor. If you are interested in coming here, I would gladly send your MRI and reports to him and see what he thinks. I believe you might be an excellent candidate.

I hope this is of help to you.

gentle hugs............Jenny

PS. I don't know if I mentioned it but I had the laminoplasty and it was great but then broke my neck 3 months later...nothing to do with the surgery.

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