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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
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Experience:  U.S. Physician/Surgeon in Neurosurgery
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I have a ruptured cervical spinal disc that contacts & deforms

Resolved Question:

I have a ruptured cervical spinal disc that contacts & deforms my spinal cord at C7-T1. The MRI results state that the neural foramen are clear. I am experiencing pain in my hands, arms, neck, scapula, shoulders, and have frequent headaches that start at the base of my neck and go up to the crown on my head. I am also experiencing muscle spazims / twitching in my bicepts, tricepts, forearms, scapula area, and in my legs. A neurologist that is treating me wants to perform facet injections, and or radiofrequency neurotomy. I have done some internet research on these procedures and i have not found any information to suggest that the RFN procedure will treat my condition. All of the information that i was able to find seemed to suggest that the RFN procedure is usually reserved for individuals with neural foramen involvement & for facet joint pain. Can you please advise me if the RFN treatment is correct for my condition ? I have already had C3-C7 discectomy, decompression & fusion.
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Mark replied 5 years ago.
Have you had a EMG test?

Did your symptoms improve after getting the C3-7 fusion?
Customer: replied 5 years ago.

Yes, have had EMG & NCV tests. EMG results came back as abnormal. Evidence which would be most suggestive of a left C7-T1 cervical radiculopathy.

 

The fusion surgery was performed in Dec. 2005, i felt great for almoast 2 years.

Had very little pain, untill the new injury at C7-T1.

Expert:  Dr. Mark replied 5 years ago.
OK.

In this case, where you didn't have much pain until your new injury -- and EMG evidence of nerve irritation causing cervical radiculopathy -- the probable best method of treatment would be extending the surgical fusion one level more, to decompress the C7-T1 level.

It is unlikely -- if the EMG evidence and MRI evidence both point to the C7-T1 level, that other strategies will make a meaningful difference -- though such a determination can only really be made in person to ensure that your physical exam and clinical characteristic of pain matches the MRI imaging.

A neurosurgeon has to make this determination.

I probably would want to get a second opinion.
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
Dr. Mark and 3 other Health Specialists are ready to help you
Customer: replied 5 years ago.

Thank you Dr Mark. The neurologist that is treating me has given me a referral to go back to see the spinal surgeon that performed my first surgery, C3-C7 decompression & fusion. Since this is a worker's compensation injury this time, i have to wait for the insurance co. to approve the referral.

 

Again, thank you for your assistance & advise.

You have helped me to make an informed decision.

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