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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Re: Hi All-New Here
Nov 21, 2012
Thanks for your concern, but while my clocks say it's 7:30 AM, my mind thinks it's 6:30 PM, so either way, I am awake now :)

<< At C-4-C-5, right uncovertebral osteophyte results in moderate to severe right foraminal stenossis. Small central disc protrusion is present without significant central canal stenosis. >>

Your cervical vertebrae have a ridge on the edges of the top side that the intervertebral disks can fit partly into, like a sort of saddle. This is called the uncovertebral "joint", and helps to stabilize the cervical spine. Since it's an area of pressure/friction, it can develop bone overgrowths (osteophytes) that can push backward into the spinal canal or diagonally backward into the foramina, which are the openings in the spinal cage through which pass the peripheral nerves after leaving the spinal cord.

In your case, the osteophytes are causing possibly "severe" narrowing of the right C4-5 foramen. This could mean that your C5 nerve is being pinched. The symptoms could be pain at the point of impingement (the neck) or referred symptoms downstream. Referred just means that the symptoms APPEAR to come from the shoulder/arm, but the PROBLEM is in the neck. Your C5 nerve does not go down to your hand (that's C6-C8), but it does supply the deltoid and biceps. When my C5 was pinched, I lost maybe 3/4 of the strength in those two muscles.

<< At C5-C6, right paracentral disc protrusion deforms the spinal cord without compression. Right uncovertebral osteophyte results in moderate to severe foraminal stenosis. >>

At the next level down, the disk protrusion is bad enough to BEND the cord. The radiologist makes the distinction that the cord is NOT COMPRESSED, though. This can happen because the cord - situated within the spinal canal - is surrounded by spinal fluid, and thus has some "leeway" for moving away from intrusions. I don't know how important the deformed-but-not-compressed distinction is. You still have enough pressure on a bunch of very sensitive nerves to bend them.

Same problem with the right foramen at this level. The C6 nerve may affect the triceps muscle (among others, the nerves actually combine and diverge at this level), and also goes down to the thumb.

<< At C6-C-7, left paracentral disc protrusion is present without significant central canal stenosis.Left uncovertebral ostephyte results in moderate to severe foraminal stenosis. >>

Disk protrusion not so bad at this level. Foraminal problem is on the OTHER SIDE (go figure). The C7 nerve would particularly affect the two big fingers.

I could well be wrong about this, but I doubt that the uncovertebral osteophytes were caused by the accident. They would take too long to form. Maybe a borderline condition that the accident pushed over the edge? Something the doc could tell you. The bulging disks could have been caused by the accident, or possibly not.

As for your symptoms, common sense says that symptoms will be downstream from nerve impingements. Therefore, foot trouble must be caused by cord deformation (unless you have lumbar issues, as well). The foraminal stenosis cannot cause a foot problem, only neck pain and shoulder/arm symptoms. My amateur opinion is that you have - or had - symptoms resulting from both cord deformation and foraminal stenosis.

I suspect that most docs would not recommend surgery - at least, not based on what the radiologist says, although many surgeons routinely ignore the radiologist's report. The gait problems are very much a red flag, but if they've GONE AWAY, then docs will be encouraged that all the symptoms will eventually go away. Some surgeons might want to do ACDF's (disk removal and vertebral fusion), at least at C5-6. Others would take an intermediate approach and recommend foraminotomies - less invasive surgeries that come in from behind and try to just shave off the osteophytes. Whether or not foraminotomies can access uncovertebral osteophytes is something I'm not sure of, but you could certainly ask.

My last guess is that, while your symptoms may improve, you have reached the point in your, um, "development", where you are now AT LEAST borderline for cervical spinal problems, and that this is a permanent condition.

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