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Question: Dear Dr,
I have been having attacks of intense burning pain down both arms certain ways I move my neck. They happen suddenly and lately have been accompanied by shortness of breath and inability to lift my left arm during the attack. I can move my fingers and hand but not lift my arm. The right arm works ok but is weak during the attack. Also I have been noticing the pain getting more intense and lasting longer. The longest lasted almost 6 hours. The only relief I got was to put myself in traction. (the traction device hangs over a door and I was told to use only 5 lbs) I also used heat intermittently with the traction. I saw a neurologist and he ordered an MRI, following you will find the results. I see her in 10 days for a follow-up but my eyes have a twitch when I read and I am getting short of breath. Should I let her know? Or is it safe to wait 10 more days to get her recommendations? Do you think i need surgery? If so what kind?
Study Details
Reading Physician Reading Date Result Priority
Kereshi, Borko, MD 3/15/2017
Narrative
MR of the cervical spine
Clinical history: 45 year history of neck pain, LEFT arm pain radiating to the hand. RIGHT arm burning sensation to the forearm.
Technique: Routine MR of the cervical spine was performed. There was no IV gadolinium used.
Comparisons: MR cervical spine December 12, 2013
Findings: There are 7 cervical segments. There is slight anterolisthesis at C5-C6. Cervical lordosis is otherwise well-maintained. There is mild to space narrowing from C4 to C6 and moderate at C6-C7. Mid and lower cervical facet hypertrophy is present.
C2-C3: No significant degenerative changes.
C3-C4: No significant degenerative changes.
C4-C5: Small posterior disc osteophyte complex with LEFT foraminal disc bulge causing mild LEFT worse than RIGHT neuroforaminal narrowing. Mild canal narrowing is present.
C5-C6: Moderate disc osteophyte complex with mild LEFT first and RIGHT neuroforaminal narrowing. Mild canal narrowing is present.
C6-C7: Moderate disc osteophyte complex with a LEFT posterior lateral disc protrusion which likely contacts the exiting nerve root. There is moderate LEFT and mild RIGHT neuroforaminal narrowing. Mild to moderate canal narrowing is present.
C7-T1: Small disc osteophyte complex with minimal bilateral neuroforaminal narrowing and no significant canal narrowing.
Impression
Multilevel degenerative changes of the mid lower cervical spine as detailed above, worst at C6-C7 with moderate LEFT neuroforaminal narrowing and a protruding disc likely contacting the LEFT exiting nerve root.
Dictating Workstation: HMINWKS17
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I have been having attacks of intense burning pain down both arms certain ways I move my neck. They happen suddenly and lately have been accompanied by shortness of breath and inability to lift my left arm during the attack. I can move my fingers and hand but not lift my arm. The right arm works ok but is weak during the attack. Also I have been noticing the pain getting more intense and lasting longer. The longest lasted almost 6 hours. The only relief I got was to put myself in traction. (the traction device hangs over a door and I was told to use only 5 lbs) I also used heat intermittently with the traction. I saw a neurologist and he ordered an MRI, following you will find the results. I see her in 10 days for a follow-up but my eyes have a twitch when I read and I am getting short of breath. Should I let her know? Or is it safe to wait 10 more days to get her recommendations? Do you think i need surgery? If so what kind?
Study Details
Reading Physician Reading Date Result Priority
Kereshi, Borko, MD 3/15/2017
Narrative
MR of the cervical spine
Clinical history: 45 year history of neck pain, LEFT arm pain radiating to the hand. RIGHT arm burning sensation to the forearm.
Technique: Routine MR of the cervical spine was performed. There was no IV gadolinium used.
Comparisons: MR cervical spine December 12, 2013
Findings: There are 7 cervical segments. There is slight anterolisthesis at C5-C6. Cervical lordosis is otherwise well-maintained. There is mild to space narrowing from C4 to C6 and moderate at C6-C7. Mid and lower cervical facet hypertrophy is present.
C2-C3: No significant degenerative changes.
C3-C4: No significant degenerative changes.
C4-C5: Small posterior disc osteophyte complex with LEFT foraminal disc bulge causing mild LEFT worse than RIGHT neuroforaminal narrowing. Mild canal narrowing is present.
C5-C6: Moderate disc osteophyte complex with mild LEFT first and RIGHT neuroforaminal narrowing. Mild canal narrowing is present.
C6-C7: Moderate disc osteophyte complex with a LEFT posterior lateral disc protrusion which likely contacts the exiting nerve root. There is moderate LEFT and mild RIGHT neuroforaminal narrowing. Mild to moderate canal narrowing is present.
C7-T1: Small disc osteophyte complex with minimal bilateral neuroforaminal narrowing and no significant canal narrowing.
Impression
Multilevel degenerative changes of the mid lower cervical spine as detailed above, worst at C6-C7 with moderate LEFT neuroforaminal narrowing and a protruding disc likely contacting the LEFT exiting nerve root.
Dictating Workstation: HMINWKS17
Back to the Test Results List
Brief Answer:
Decompressesive and stabilizing surgery seems necessary.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
Pain and sensory changes in arms after certain neck movements means that the spondylolysthesis found by MRI examination is not stable.
Dynamic x-rays ( flexion, extension and neutral ) of your cervical spine are necessary to evaluate the degree of lysthesis.
Since lysthesis is clinically unstable and there are compression degerative changes, in my opinion surgery is necessary.
Surgical procedure in such case should decompress the neural structures and stabilize the spine.
I think the situation waits until you see your Neurologist, in mean time, you can wear a soft cervical collar to minimize your symptoms.
Hope you found the answer helpful.
Let me know if I can assist you further.
Kind regards.
Decompressesive and stabilizing surgery seems necessary.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
Pain and sensory changes in arms after certain neck movements means that the spondylolysthesis found by MRI examination is not stable.
Dynamic x-rays ( flexion, extension and neutral ) of your cervical spine are necessary to evaluate the degree of lysthesis.
Since lysthesis is clinically unstable and there are compression degerative changes, in my opinion surgery is necessary.
Surgical procedure in such case should decompress the neural structures and stabilize the spine.
I think the situation waits until you see your Neurologist, in mean time, you can wear a soft cervical collar to minimize your symptoms.
Hope you found the answer helpful.
Let me know if I can assist you further.
Kind regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Spaho,
Thank you for your input, when it comes to the spine as many opinions as possible are always a good thing to have. Surgery is a difficult decision to make. I hear horror stories and also good stories of complete recovery. So, thank you very much. XXXXXXX Price
Thank you for your input, when it comes to the spine as many opinions as possible are always a good thing to have. Surgery is a difficult decision to make. I hear horror stories and also good stories of complete recovery. So, thank you very much. XXXXXXX Price
Brief Answer:
Follow up.
Detailed Answer:
You are welcome.
I agree with you about surgery and its risks, however, when it comes to instability of spine, risks of delaying surgery are greater.
Hope I helped you to get a correct decision.
Wishing you good health.
Follow up.
Detailed Answer:
You are welcome.
I agree with you about surgery and its risks, however, when it comes to instability of spine, risks of delaying surgery are greater.
Hope I helped you to get a correct decision.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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