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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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what does it mean when you have high 12 levels on your blood

Resolved Question:

what does it mean when you have high 12 levels on your blood work
even if i don't take b12 supplements
again i have a bit of a high esr middle crp and a possitive lupus test but they say i don;t have lupus negative ana
mind you this is on one lab not the other labs - not hospital but outside lab
muscle weakness is that a nerve or muscle damage
Submitted: 11 months ago.
Category: Neurology
Expert:  Dr. Frank replied 11 months ago.

neuromd2012 :

Hello

neuromd2012 :

welcome to Just Answer

neuromd2012 :

you are offline, so I will leave you an answer on the question and answer section

neuromd2012 :

please get back to me if you have questions

neuromd2012 :

we had discussed the concept of autoimmune neuropathy, and your blood work is suggesting that as well

Customer:

could you just remind me again- i did not know this was neurology i thought it was general blood work doctor

neuromd2012 :

hi

neuromd2012 :

I am an internist and a neurologist

neuromd2012 :

so we can discuss your blood work as well

neuromd2012 :

you had a negative ANA

Customer:

could you remind of your answer

neuromd2012 :

oh

Customer:

what is the nerve or muscle attached to the scapua which may be damaged

Customer:

that pulls up the arm to eat

neuromd2012 :

we discussed Tarlov cysts last time

neuromd2012 :

so you have a few muscle on your scapula that do that

neuromd2012 :

supraspinatus is the major one that is usually damaged

neuromd2012 :

the suprascapular nerve

neuromd2012 :

innervates the supraspinatus muscle and can be damaged as well

neuromd2012 :

supraspinatus is usually damaged in the shoulder joint itself, it is called a rotator cuff tear

Customer:

i thought is was a rotator cuff

neuromd2012 :

right that is the most common reason

neuromd2012 :

you have problems with elevation of the arm

Customer:

but is the suprascpular nerve a shoulder doctor or a nerve doctor

neuromd2012 :

unable to brush your hair

Customer:

yep i also see my bicep is bigger and what ever i do i can't get is smaller

Customer:

can't sleep on my shouder or arm

neuromd2012 :

that is a classic complaint in rotator cuff tears

Customer:

i do the scaplar exercises and i see a winged scapula

neuromd2012 :

the bicep tendon passes underneath the rotator cuff tendon

neuromd2012 :

I see

neuromd2012 :

well you need an orthopedist to address your shoulder problem, an MRI of the shoulder would help here

Customer:

i did an mri already

neuromd2012 :

do you have a tear?

Customer:

they say partial i already had a labreal tear which came back

Customer:

i walk with a walker because i feel i can;t hold myself up

Customer:

someone said proximenal muscel weakness

Customer:

i saw in the picture muscle atrophy

Customer:

i dread going thru surgery again

Customer:

then i read it may be brachial plexus injury

Customer:

doesn;t the c5-c6 or c6-7 do something with the arms or shoulder weakness

Customer:

and then i read i may have an imingment

neuromd2012 :

HI. yes it does, the C5/6 and C6/7 contribute to the brachial plexus

neuromd2012 :

impingement in the shoulder

Customer:

so is this a neurologist or shoulder

neuromd2012 :

it could be that you have proximal weakness in your shoulder from the nerve problems in your neck

neuromd2012 :

you need an EMG test of the nerves coming from your neck

neuromd2012 :

to make that determination

neuromd2012 :

usually with the nerve problem

Customer:

and then what do they do

neuromd2012 :

you have numbness in your hand

neuromd2012 :

if it is a nerve problem at the neck, then you would need consideration for surgery on the cervical spine

neuromd2012 :

if physical therapy has not helped

Customer:

this has been already alot of years- in canada you can't even see a surgeon

Customer:

does the weakness go into your lower body

Customer:

why do i feel pain around my bra strap area - i can't wear a bra anymore

Customer:

and i feel like i feel my rib cage popping maybe it is the shoulder bone

neuromd2012 :

the pain would be more consistent with the pinched cervical nerve

neuromd2012 :

or you are correct, it could be winging of the scapula

neuromd2012 :

putting pressure in the serratus anterior muscle

neuromd2012 :

and giving you rib cage pain

Customer:

again who deals with that

neuromd2012 :

if it is a scapular problem, the orthopedist has to fix that

Customer:

is that a muscle or nerve injury

neuromd2012 :

that can be both. the nerve injury leading up to the muscle atrophy

neuromd2012 :

and then the pain from the scapular atrophy

neuromd2012 :

I would suggest you see a neurologist for the EMG test if not done previously

neuromd2012 :

and find out if you have a cervical root problem, a pinched nerve (suprascapular nerve)

neuromd2012 :

or if this is muscle atrophy from the shoulder (that sounds less likely here with only a labral tear)

Customer:

this is what i don;t understand

Customer:

we don't know what a suprascapular nerve is ( i read about it )

neuromd2012 :

the suprascapular nerve comes off the brachial plexus very near the C5 root

neuromd2012 :

if you have a perineural sheath cyst

Customer:

we really only know c5-c6 c 6-7 etc...is that where the suprascapular nerve is

neuromd2012 :

on that root, it could be effecting the suprascapular nerve

Customer:

is that the same surgery that a neurologist we give or is this a shoulder doctor

neuromd2012 :

that is a neurosurgeon

neuromd2012 :

that has to fix the perineural sheath cyst

neuromd2012 :

but first you need a neurologist

neuromd2012 :

to look at the function of your nerves,

neuromd2012 :

by doing the EMG test of the nerves

Customer:

so the perinerual sheath cyst is fixed an actual cyst?

Customer:

this is very confusing for me

Customer:

could the pain in my spine be from muscle atrophy or kidney or osteporisis

Customer:

i am very weak now from the top down

neuromd2012 :

this is very complicated. I cannot diagnose you without seeing you.

Customer:

what is c6-7 with cord abudment mean

neuromd2012 :

your weakness sounds like a neuropathy

neuromd2012 :

that means that your cervical disc is pushing on the spinal cord from the back. it comes from bone loss, something called cervical spondylolysis

neuromd2012 :

the disc gets compressed, and pushes back onto the outside of the spinal cord

neuromd2012 :

that can also press on nerves and give you shoulder weakness and muscle atrophy

neuromd2012 :

C6/7 is not the right level for scapular winging

neuromd2012 :

it would have to be C4/5 or C5/6

neuromd2012 :

I hope I was able to answer all of your questions

neuromd2012 :

Dr Frank T

neuromd2012 :

please rate my service if satisfied.

neuromd2012 :

bye

Customer:

when you get back et

Customer:

axillary neve thoracic nerve and suprscapular nerve and musculoctaneous nerve

Customer:

i am looking at diagram of a shouder

Customer:

is that from the neck - again is that a neurologist or shoulder

Expert:  Dr. Frank replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Frank replied 11 months ago.
did you come back?
Customer: replied 11 months ago.

yes i am looking at diagram of the shoulder


the axillary nerve


long thoraci nerve


suprascpuoar nerve


musculoctuaneous nerve


is this from the neck or shoulder


i feel like i don;t have arms- there just attached to my shoulder by a thread and i have a straight spine the biceps are fat and my arms get thinner\


it is really wierd and my elbow go in


 

Expert:  Dr. Frank replied 11 months ago.
let me know how I can help. Dr Frank T
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 11 months ago.

what is nerve adbntment on c6 c7 mean


 

Expert:  Dr. Frank replied 11 months ago.
It means that the nerve root coming from the spinal cord is being pressed upon by either a disc fragment or the facet joint which has swelled. The word "abutment" means pushed against. I hope that answers your question, please rate my service. Dr Frank T
Customer: replied 11 months ago.
what is moderate loss of disc height with small posterior osteochondral boars and small otephytes projecting fomr the anterior vertebral body
there is mild narrowing of the centrall canall c5-6
on c4-5 the is mild oss of disc hieght with smalll marginal ostephytes

this is on a cat scan
Expert:  Dr. Frank replied 11 months ago.

Hello again. you are describing features consistent with the diagnosis of cervical spondylolysis, a change in bone remodeling that occurs secondary to arthritic processes in the cervical spine. I will attach a webpage on this issue that has more information than I can type here. please review it and then get back to me if you have questions, please remember to rate my service, as that is how I am compensated for my work Dr Frank t

http://emedicine.medscape.com/article/306036-overview

Customer: replied 11 months ago.
just read it]
does it mean i have compression
it also said i have stightening of the noral cervical lordosis
c2-3 no significan\c3-4 no significanc405 mild loss of disc height with small
marginal ostephytes

my mri said wey more and another cat scan said wey more
i am sending out to a second radioogist
Expert:  Dr. Frank replied 11 months ago.
hi. So you have some vertebral disc flattening, which did not come on suddenly, at C5/6 and probably C4/5. They note MILD changes in your vertebral canal at C5/6, but there is nothing on this report that suggests you need aggressive surgery, etc. It would depend on your symptoms, but this type of change usually is seen by physical therapy first.
Customer: replied 11 months ago.
my mri says
difuse disc buldge c3-4
c5-c6 small posteor ostephytes comple indenting the venral sac and resuting in mild narrowing of th spinal cord
again left unconvetebral spurring which ey slightly narrows the left neural foramen
stable moderate to severe spina cancal stnois c6-7 and a stble postria disc
middiffuse disc at c7-t1
an th perinerua nerve sheahs cysts
much more on the mdi

Expert:  Dr. Frank replied 11 months ago.

The MRI suggests more pathology, especially at C6/7 with moderate to severe canal stenosis, or narrowing, that is not seen on the CT. That suggests that there is not an osteophytic (bone) bar on the posterior part of the disc at C6/7, as it is not visualized on the CT, which is better at looking for bone changes. The nerve sheath cysts also may not be seen on the CT scan, as they are soft tissue density only.

I hope that answers your question. Please rate me positively so I can be compensated for my work Dr FrankT

Customer: replied 11 months ago.
sorry doe it mean i have compression on the nerve or spine?i
Expert:  Dr. Frank replied 11 months ago.
It does not state in any of these reports that you have compression on the individual spinal nerves or on the spinal cord. The MRI report mentions moderate to severe spinal canal stenosis, that might suggest compression of the spinal cord if severe, but it does not mention that at all, and any neuroradiologist would mention if there was encroachment onto the thecal sac of the cord, or the cord itself.
Customer: replied 11 months ago.
so why am i in so much pain in the neck
Expert:  Dr. Frank replied 11 months ago.
you have cervical spondylolysis. This is arthritis of the cervical spine. In a 55 year old woman, the most likely reason is related to demineralization of the bone as related to menopause, low vitamin D levels, low serum calcium levels, not enough sunlight can be a contributor. Having a family history of arthritis. If you read the webpage I attached, it lists the reasons, the treatments, etc.
Customer: replied 11 months ago.
i found your other wed sight
i don't see this web sight your are talking about
i
Expert:  Dr. Frank replied 11 months ago.

HI. did you see this webpage????

http://emedicine.medscape.com/article/309014-overview

please remember to rate my service, as that is how I am compensated for my work Dr Frank T

Customer: replied 11 months ago.
the web sight says prepettalla bursitis
Expert:  Dr. Frank replied 11 months ago.

sorry, you have the wrong webpage. here is the one on cervical spondylolysis

http://emedicine.medscape.com/article/306036-overview

Customer: replied 11 months ago.
can any of the dics cause weakness to the legs
Expert:  Dr. Frank replied 11 months ago.
There are some situations where cervical disc disease can cause weakness in the sense of a decreased ability to walk long distances. But you expect to see spasticity, or stiffness in the legs in neck problems, not flaccid weakness and loss of muscle (atrophy). You also would expect bladder and/or bowel problems. That is not the case with you based on your imaging reports. Dr Frank T
Customer: replied 11 months ago.
hoiw does one get the image for c1-2 3 atlas
Expert:  Dr. Frank replied 11 months ago.
the best way is a CT scan of the atlanto-axial junction.
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 11 months ago.
in a cat scan of my neck it said i had
right lingual tonsilitis is present
and air fluid level is seen in maxillux sinus
Expert:  Dr. Frank replied 11 months ago.
Hello

The right lingual tonsil is inflamed, you have (or had) tonsillitis .If you open your mouth in front of a mirror, on the right side at the base of your tongue (stick your tongue out and say ahh), you will see the tonsil.

An air fluid level in the maxillary sinus means moderate to severe sinusitis, and you have a cystic space there. You need an ENT doctor to drain that sinus. this is at the level of your nose, either to the right or left (you did not say)

Customer: replied 11 months ago.
what is smal broad ased posterior disc osteophyt complex is identified and minimal uncovebral spuring without significan spinal cana or neural foramnl stenoise there is slight effacement of the ventral thexal sac
small venral osteophytes ae seen from c4-c6 without significan impingement upon the esopasug hypoharyn or orohrynd
c56 there is mild loss of intervetebral dis height/ a small brod based postrior disc ostphyte compe along with mild face hypertophy and unvocebral spurring are indentifeid resulting in mild narrowing of th bilatal neurl forminia
mild canal stenosis
there is marked loss of intervebral disc space t c6-7 with a broad posterior disc ostephyte complex and mild facet hypertophy and uncoverebral spurring resulint inat east moderae spinal canal stenosis and mild to moderate bilateral neural foraminal narrowing
the air fluid seen in the right maxillary sinus
Expert:  Dr. Frank replied 11 months ago.
Hi. I have gone through this with you before, correct? Did you repeat the posting by accident?

This is again the findings of spondylolysis. Please review the answer above
Customer: replied 11 months ago.
no i got the report read by a second radilogist which showed up the other things so i wanted to know if it was different
which shows the symptoms of paind down arm into the fingers the mri or cat scan
Expert:  Dr. Frank replied 11 months ago.
HI. this report is really quite similar to the other CT reading. Your major problem is at C6/7, which has the potential to give you bilateral (both sides) pain into your arm,(back of the arm/triceps weakness) and numbness on the hand into the fingers. you also have some bone spurs higher up as we discussed. This report remarks on anterior osteophytes (bone spurs) that have the potential to impinge on your esophagus and your laryngeal muscles (but do not per the report). But other than that, the two reports are identical. This is all bone changes, the discs are slightly flattened, but not herniated. This is expected in spondylolysis
Customer: replied 11 months ago.
thankyou for explaining
last thing my mri showed much more and the tarvol cyst
tarval cyst don't show up on the cat scan
can you actually not list your arm from the c6-7 or would that be shoulder
the middle finger typing feels numb that is the c6-7 right
Expert:  Dr. Frank replied 11 months ago.
HI. 1) the middle finger is numb in a C6/7 disc. (C7 radiculopathy) it is more index and thumb in a C6 radiculopathy
2) Tarlov cysts are best seen on MRI, I believe they cannot be seen easily on CT, but maybe if they are very large, I do not really know that answer.
3) lifting your arm is more C6 (from the bicep, bending at the elbow) or C5 (C4/5 disc) from the deltoid, supraspinatus, and other shoulder muscles.

ok?

Customer: replied 11 months ago.
thankyou
does middle finger numb come from a disc
what nerve is compressed when you roll over in bed on your arm/shoulder
i think it is damaged for good- i felt numbness donw my arm
Expert:  Dr. Frank replied 11 months ago.
middle finger numbness can come from a disc, it can also come from other areas of the pathway, like in the plexus, or somewhere in a nerve if it is compressed at the elbow or wrist, it becomes more complicated, but from your imaging, it would be the neuroforaminal stenosis that is noted at C 6/7
That is still the problem when you roll over, it is probably not a nerve in or near the shoulder.
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 11 months ago.
sorry you mean it is a nerve in the shoulder
or the bicep bone?
so when you say c6 c5 nerve in the disc or the bicep muscle in the arm/ shoulder
when i am typing i have weakness numbness pressing the keys i think first three fingers actually it seems like all the fingers are numb
my elbow snaps and my scapula snaps pain in the clavicle bones arthritis
my elbow actually snaps out tendenosi
i can't snap the fingers
Expert:  Dr. Frank replied 11 months ago.
very difficult for me to give you an answer from here as to your problem without an examination, or the results of the EMG. You can have a problem anywhere from the discs that you know you have, the nerves as then travel down to the shoulder, around the shoulder joint, and all the way to the hand. You need a nerve conduction study to tell. (EMG).
Customer: replied 11 months ago.
what is os of the normal cervical lordosis with strightenin of th crvical spine mean
if i dorp things is it from the neck or shoulder
Customer: replied 11 months ago.
i am going to read you another cat scan
2010
c50c6 there is disc narrowing and a mild disc buldge as wesll as mild posterior endplate narrowing and mild disc build as well as posterior endplate osteophte ridge without spineal stenoisis the nurel foramina appear patent
c6-7 there is a dic space narrowing and a diffuse posterior endplae degenerative osteophyti ridge . this flatens the ventral spinal cord. mid formainal narrowing is present at this level.
Expert:  Dr. Frank replied 11 months ago.
Hello. so the report is again basically the same as later in your life, this is cervical spondylolysis as I mentioned, and it will change over time, I will attach a webpage on treatment for this condition. I hope I answered your question. dr Frank T
http://www.ncbi.nlm.nih.gov/pubmed/23042063
Customer: replied 11 months ago.
i tried to open it
iit said something about dizziness
Expert:  Dr. Frank replied 11 months ago.
http://emedicine.medscape.com/article/1144952-overview


sorry wrong article
Customer: replied 11 months ago.
can there be a nerve in the scapula snapping scapula
Expert:  Dr. Frank replied 11 months ago.
there is a nerve, the suprascapular nerve, that can be damaged, it originates off the cervical spine at the levels that are damaged given your reports
Customer: replied 11 months ago.
is it from the neck or shoulder
Expert:  Dr. Frank replied 11 months ago.
starts in the neck and moves down the back into the shoulder blade area
Customer: replied 11 months ago.
can it make the shoulder scapula snaplike over the rib cage
why do i feel nerve pain in my neck or is it called the carotid bone
and it bobbles back and forth and under the jaw bonee
Expert:  Dr. Frank replied 11 months ago.
you can have something called "winging of the scapula with this condition. I cannot explain your jaw bone
Customer: replied 11 months ago.
IS THE ACROMICABICUAR OSTEPHYTES DUE TO THE BONE SPURS FROM AN IMPINGEMENT
I CAN'T LIFT MY ARMS TO EVEN SHOWER TO RAISE MY ARMS
IS THT WEAKNESS FEOM THE INJURY IN SHOULDER OR NECK
IS REDNESS IN THE FEET AFTER THE SHOWER NERVE DAMAGE AND HANDS
NERVE DAMAGE
T
Expert:  Dr. Frank replied 11 months ago.
Hi. the osteophytes of the acromioclavicular joint are bone spurs in the shoulder area, from trauma, and can make you have a situation where you cannot raise your arms. It is not the neck, but the shoulder.

redness in the feel and hands can mean nerve injury, significant for a neuropathy, where the nerves have lost there ability to control the blood vessesl when exposed to heat. There are too many reasons for a neuropathy to list, but if you have a reason let me know
Customer: replied 11 months ago.
IM' BACK
ON AN MRI IT SAID I HAVE MILD CORD COMPRESSION
DOES THAT NOT MEAN IT IS HITTING MY SPINAL CORD
C6-7 MODERATE TO SEVERE SPINAL CANAL STENOIS
WHAT IS INDENTING THE VENTRAL THECAL SAC MEAN
Expert:  Dr. Frank replied 11 months ago.
right you have mild cord compression, and that is also seen on the CT scan, the thecal sac is the coverings of the spinal cord (the dura) and your disc at C6/7 is in contact with the cord. (indenting the thecal sac)

Customer: replied 11 months ago.
WHAT WOULD IT BE FROM
Expert:  Dr. Frank replied 11 months ago.
it is all explained in that webpage I mentioned earlier, it is all from cervical spondylolysis, this is arthritis, loss of bone calcium, hormonal changes in the bone, genetic factors that lead to arthritis, etc. It can be accelerated with a history of cervical trauma (an old MVA).
Customer: replied 11 months ago.
I JUST GOT BLOOD WORK AND MY TSH IS 0.02 CAN THAT CAUSE WEAKNESS IN MY MUSCLES AND NERVE DAMAGE ETC'
Expert:  Dr. Frank replied 11 months ago.
do you have a T4 or a T3 level as well? that is too low a TSH. do you have thyroiditis?
Customer: replied 11 months ago.
THAT IS EXACTALLY WHAT I THINK I HAVE
HE DID NOT DO THE T4 OR T3 FOR SOME REASON
IS THYROIDITIS THE SAME HAS HASHIMOTOS THYROIDITIS
Expert:  Dr. Frank replied 11 months ago.
yes, you can be hyperthyroid with graves disease, or with certain stages of hashimotos.

You now need your T4 and T3 checked to exclude hyperthyroidism.
Customer: replied 11 months ago.
WHAT IS YOUR BACK GROUND
NOT MANY PEIOPLE KNOW THIS OR DOCTORS I HAD TO READ AND LEARN ABOUT IT MYSELF NO ONE EVEN TOLD ME I HAD IT
Expert:  Dr. Frank replied 11 months ago.
I hope I was able to answer all of your questions, please rate my service if satisfied. Dr Frank t
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 10 months ago.
what does dermatoma somatosensrory evoed potentioa studies
right c6t1 sensory n1p1 lateency 23/33 msc 1.9 mcv
rigt c7 sensory latency is absent
what would this men
c7-t1 there is a cystic mass in tje right c7-t1 beural foramen they are thought to represent neve root sheath divertuclae
wgatwould a cytic mass be
Expert:  Dr. Frank replied 10 months ago.
Hi Again. Dermatomal SSEPs are a type of neurophysiological test. The concept is that you send up volleys of sensory stimuli (electrical shocks) through the nerve, up to the cervical spinal cord, and ultimately to the brain that senses sensory signals. What you measure is a "standing wave" of electical activity that is generated at your spinal cord (n1p1 potential), by looking at the latency or how long it took for the signal to get to a certain spot, you can determine if the cervical root is working, so to speak. In your case, the C7 root was not carrying the signal to the spinal cord, and then up to the brain. And the cystic mass is probably a perineural sheath cyst, a benign change in the nerve root itself that is effecting its ability to function. You do not want surgery on this cyst. It will not help the conduction of the nerve, in my opinion. Dr Frank T
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 10 months ago.
this mri wa in 2010
what do you mean by operating on the cyst
do you not operate on the nerve or disc
Customer: replied 10 months ago.
hi i went to a neurosurgeon today
do you agree with focus on an operates would be is for preventative spinal and nerve compression and degeneration which will undoubtly result in further deteriorate in the next 5 years each year tht goes by most paitents worse
the operation is to help relaease the compresiion of the nerve not eh neck - this may only help the neck pain operative procedure wi focus on c5- shoulder nerve c6 thumb c and 7 vervrae collapsing which resils in symptoms already listed.
called cervia discentomy fusion-opertates and relives impingement of the nerve cord
iportment to remember surgery will not take away the painmost patiens do see an imporvement in pain nd functioality
c8 grio control
swallowing inssures realted to hashimotos
want to give me a vocal cord test and cat scan of the neck
tarval cyst dont know if causing the pain
Expert:  Dr. Frank replied 10 months ago.
Hello I cannot make out your text, it is too garbled. I understand that he wants a CT scan of the cervical spine, and wants your vocal cords tested, and that he doesn't know if your cervical perineural sheath cyst is related to the pain complaints. But cannot make out anything else.
Customer: replied 10 months ago.
how succesful is the fusion
is it better to do a disc replacement
Expert:  Dr. Frank replied 10 months ago.
statistical outcome studies now suggest that an artificial disc replacement done with an ACDF, is better than a fusion alone.
Customer: replied 10 months ago.
do you think canada does not know how to do it yet that is why i was not offered
also i was told that if you have osteponia it would not work- is that trueal
also if i had my thyroid removed how would it efect the opening of the neck
c6-7 c5-6 is the same the same area as my thyroid- there is scar tissue already
Expert:  Dr. Frank replied 10 months ago.
If your bone density is low, you are correct that the hinge from the disc may not set well. You need to discuss that with the surgeon after he looks at an xray or a densitometer analysis. Thyroid is only superficial, and should not create scar that will make your ACDF difficult, that is much deeper, it is at the same level.
Customer: replied 10 months ago.
if you have a fusion do they put screws and rods in
he said every 5 years a perons like me/ car accident the neck will get worse
this is tp repveent it from getting works will not maybe help the neck pain but will kelp the weakness
is that true- he does not know about the trlva cysts - i asked if he take out the fluid
why coindentaly the cyst are where the c6-7 anc c5 is - it must mean they are invovd no incendtaal finddings-there mus be a reaonsob why i got them
is there any other thing out there beside fusion and disc replacemtnt
Expert:  Dr. Frank replied 10 months ago.
If they just do a fusion, then you need the rods and screws. with the anterior discectomy, with an artificial disc, no rods. I will say there are people after an MVA that continue a downhill course of degenerative changes, but not everyone.
no one knows the mechanism behind tarlov cysts, they are thought to be congenital, but maybe the strain from your degeneration has caused them to enlarge??? Most tarlov cysts are thought to be asymptomatic. There are no other surgeries to consider than a posterior laminectomy with fustion or an ACDF with an artificial disc. It depends on the degree of multilevel degeneration, that is a surgical decision after reviewing the films. ACDF is good for single level, or two level disease, anything more, and most surgeons do it posteriorly.
Customer: replied 10 months ago.
what is the sucess rate
Expert:  Dr. Frank replied 10 months ago.
here is the answer to that question.

I hope I was able to answer all your questions, please rate my service if satisfied. Dr Frank t

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519403/

Customer: replied 10 months ago.
JUST GOT YUR REPLY
THE DOCTOR SAY THAT THIS IS PREVENTATIVE BECAUSE IT WILL PROGRESS MVA ACCIDENT
I READ THAT THE WEIGHT OF THE STUFF I HEAVY AND I MAY NOT BE ABLE TO CARRY IT AL
IS THAT TRUE ESPECIALLY IF I HAVE OTHER ISSUES
WHAT IS A HEMAGIOMA - I HAVE THT TO- NOW I AM GETTING A MRI OF THE THORAIC- MAYBE I HAVE TRLOVA CYST SDOWN THERE
SO DO YOU THINK THE TARLVOC CYSTS WERE FROM THE CAR ACCIDENT - WHICH CAME FIRST
I DON;T BELIEVE WE WERE BORN WITH IT
THERE MUST BE A CAUSE
Expert:  Dr. Frank replied 10 months ago.
A hemangioma is a benign vascular anomaly (abnormality), it is not a tumor, but a collection of vascular cells that are commonly seen in the vertebral column, usually at a certain point (the nutrient foramen of the vertebral body). They are usually asymptomatic (don't cause problems) but they can be "atypical" in areas that are unusual, and can cause pain if atypical.
Tarlov cysts can be secondary to trauma as well as congenital. They arise from the area where central myelin changes to peripheral myelin, and the beginning of the nerve root. I will attach an article about Tarlov cysts for your review.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989515/

Customer: replied 10 months ago.
WHAT DO THEY DO WITH A HEMANGICOMA -DO THEY SEE IT RIGHT ON THE VERTEBAE
WHEN I HAD AN MRI IN THE STATES ON THE CERVICAL SPINE
IT SAID A "CYSTIC MASS ' MAY BERESENT
WHYE WOULD THYE SAY CYSTIC MASS?

Expert:  Dr. Frank replied 10 months ago.
You leave a hemangioma alone. It is actually similar to a large red birth mark you see on people's skin, only it is on the surface of the bone.
I do not know about why they would call a hemangioma a cystic mass.
Customer: replied 10 months ago.
ALSO CAN NERVE PAIN MAKE YOU HOT- I AM ALWAYS SWEATING I THINK IT I MENAPAUSE BUT I REALY THING IT IS PART OF THE NERVES
Expert:  Dr. Frank replied 10 months ago.
Nerve pain does not make you hot, or if you have a sensation, it is in the distribution of the nerve, so an L5 root would give you "hot" sensation down your posterior thigh to your lateral calf (as an example)
Customer: replied 10 months ago.
SO THE HOTNESS I FEEL ON MY SPINE AND NECK IS NERVE PAIN
WHEN BOTH MY BICEPS ARE HUGE IS BECAUSE OF THE NERVE PAIN OR THE ROTATCFF TEAR

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