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First of all, I am currently 4 weeks S/P C6-7 Anterior decompression,fusion & foraminotomy. Prior to that, I had off-on neck pain intermittently several years(that I insisted felt like a pinched nerve) dx was tortecollis. Starting about 3 yrs ago my pain was daily, PCP referred to Ortho.1st MRIin 2003(using Multiplanar,multi-sequence imaging) "Impression" R posterolateral disk osteophyte complex @ C6-7, likely compromising R C7 nerve root in neural foramen. However, Ortho did point out on film a herniated disk.
After Transforaminal injection and EMG, Ortho referred me back to PCP-stating he would "call it a muscle something or other". Still having DAILY pain(and radiculopathy), found new PCP-I requested another MRI in early 2005. This MRI used completely different technique. "Impression"= R paracentral disk protrusion(measuring 3mmAP,10mm transverse dimension) with R uncovertebral hypertrophy & facet joint hypertrophy, causing deformity of thecal sac and encroachment of R exiting nerve roots. Could it be because of different MRI"techniques" or is it possible that my disk herniated that much more during that year & 1/2? I am experiencing daily pain now caused by my muscles that is at times more severe than prior to surgery(totally different pain). I am doing PT and home exercises religiously and have just scheduled trigger point injections. It still bothers me I had to wait ANOTHER 1 1/2 years to get "someone to listen" and subsequently was told by Neuro that surgery was my only option by that time. Is it possible that surgery may have been avoided if different MRI technique was used to begin with? Why was Ortho able to point out herniation but Radiologist didn't?

Optional Information: Female , Age: 34

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Status: Closed Value: $5

Hello I am the same age as you with the same problems.

Yes, it is very possible you herniated it after the first MRI. Also, a Radiologist needs to have specialized training to read Neuro films. I would say that any Othro or Neuro surgeon has the most experience in reading films in this area. My neurosurgeon told me, he NEVER trusted a Radiologist report!! He has to see it for himself! Surgery most likely was imminent for you,in the future. You never want surgery, unless it has become critical!

As for the type of MRI scan: look at this link http://splweb.bwh.harvard.edu:8000/pages/papers/zientara/fast/fastimaging.html

There can be some difference in the films. Also, the views taken, and if it was with, or without IV contrast.

Please private IM me. I am going for an experimental C6-7 surgery. I can give you more information. I have already had 2 lower back surgeries that were a disaster! Don't let them fuse you yet!

If this helped you please hit the green accept button.

Thank you and God bless and Good luck.

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Reply to Cynd's Post: The responder to my problem obviously didn't read my problem. And did not answer anything - except to say to "not let them fuse you yet", when my FIRST statement is that I am 4 weeks S/P cervical anterior decompression WITH FUSION and foraminotomy!!!!!!!!!!!!!!!!!!! I also stated that the Ortho DID point out to me the herniated disk on the films prior to further tx and then referred back to PCP. NO HELP!!!!!!!!!!!!!!!!

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I will accept these answers, as you actually gave me answers to my questions. I would like to ask one more thing: If ortho pointed out herniation on film and with my symptoms (which I've learned was radiculopathy down R arm and hand-cervical herniation was right and central which in the end was measured 3mm by 10mm) Is it "normal" to refer back to PCP rather than neuro? I guess that's my biggest "issue" with this whole thing. My Neurosurgeon did compare both sets of MRI films and did state that the first set was harder to read due to "size of pictures". I've also read that the recommended technique for this type of thing is the T1,T2 proton density weighted imaging, which is how the 2nd MRI was done(and showed the thecal sac deformity, encroachment of exiting nerve roots, etc.) Which brings me back to the question would it be "normal practice" to refer to PCP rather than Neuro?

I would have to go with you here, the ortho/ PCP should have referred you to a neurologist even with the first MRI since in any case there was a herniated disc ( as per the ortho's own admission) with some possible radiculopathy.
Thanks for letting me know that you intend to accept the reply.
A BONUS at your discretion would be appreciated too,
all the best,
regards
Dr. Gupta

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