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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Uncovertebral joints - upward extensions of the lower cervical vertebrae that form joints with the vertebrae above them. For your purposes, think of them as bony bodies that grow alongside the vertebrae. When they are hypertrophied they have gotten too big, probably by laying on additional bone. They are thus expanding backward into the foramina.

Foramina - at each level of the cervical and thoracic spine (except the C1-2 level), a nerve leaves the spinal cord on each side. For example, at the C4-5 level, the C5 nerve is heading off to the shoulder and arm, especially controlling the deltoid (back/top of shoulder) and biceps muscles. When the nerve leaves the cord it passes through an opening - "foramen" in Latin - where it is subject to being pinched by various disorders. The section of the nerve immediately after leaving the cord is call the "root", and a problem in this area is called "radiculopathy" (more Latin, meaning "root problem").

Canal stenosis - behind your vertebrae is an opening called the spinal canal. Within that canal is a sheath of fiber called the "thecal sac", though which flows the cerebrospinal fluid (CSF). Suspended within the fluid is the nerve bundle called the spinal cord. "Stenosis" means narrowing, and it can happen when any part of the spinal structure intrudes into the canal. This might be a disk (as happened to you at C5-6), disk/osteophytes (bone spurs growing off the vertebrae), hypertrophied facet joints (coming from the sides) or hypertrophied ligaments coming from behind. Also, some people (like me) are just born with undersized spinal canals.

Let's look at your two problematic cervical levels...

C5-6, where you had the ACDF some years back. I'm a little surprised that your have an osteophyte (literally "bone growth") problem. I would have thought that the surgery would have removed the osteophytes growing off the back of your vertebrae and that, since that level is fused and no longer moves, there would be no cause for osteophyte re-growth. Guess I would be wrong. Still, it does not seem that there is any longer an immediate problem at that level. Unfortunately, the damage done at that level may well be permanent. Did you go a long time between first noticing symptoms and when you had the surgery done?

C4-5, where you now seem to be developing a problem similar to the one at C5-6. The disk is forcing itself back into the canal, mostly on the right side, and simultaneously impinging on the foramen through which passes the C5 nerve root. The radiologist uses the adjective "severe", which is a flashing red light. Unfortunately, he only says the CANAL is being narrowed. Remember that you have the thecal sac inside the canal, the spinal fluid inside the sac, and the spinal cord inside the fluid.... so it's possible for considerable canal narrowing without the cord being affected. THIS IS SOMETHING YOU WANT TO CLEAR UP. He also said that you have "at least moderate" foraminal narrowing. "Moderate", in radiologist-speak, is one step below "severe", so saying something is "at least moderate" is another way of saying "possibly severe". ANOTHER THING YOU WANT TO CLEAR UP.

If the C5 nerve is being affected, it should have a range of symptoms in the neck, shoulder and arm. When my C5 nerve was pinched, the first sign I had of that was when I could no longer lift a 12-pack of soda (deltoid muscle). I also couldn't "make a muscle" with my biceps. I would guess I lost 70% of the strength in those two muscles (until the problem was surgically fixed).

I see your C4-5 problems possibly causing neck pain, plus a variety of shoulder/arm problems. If the cord is impacted, then anything below that level is fair game. Also, there are likely residual problems from C5-6 years ago. I cannot say whether or not your bladder problems might be related to the cervical cord narrowing. As Jenny has a more global understanding of these things, you would hope to hear from her.

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