Cervical Potenosis Paper

MRI of the lumbar spine obtained on 05/19/15 revealed at L2-3, endplate osteophyte formation and disc bulge contribute to a mild degree of spinal canal stenosis and a mild degree of bilateral neural foraminal compromise. At L3-4, a disc bulge eccentric leftward and endplate osteophytes formation are responsible for a mild degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a moderate degree of left neural foraminal encroachment. At L4-5, there is a diffuse disc bulge and endplate osteophyte formation which effaces the ventral aspects of the thecal sac and are responsible for a moderate-to-severe degree of spinal canal stenosis, a mild degree of right neural foraminal encroachment, and a severe degree of left neural foraminal encroachment. At L5-S1, a shallow disc bulge and endplate osteophyte formation contribute to a mild degree of left neural foraminal encroachment, without compromise of the spinal

cervical discectomy and fusion performed on 04/14/15. The latest progress report noted that the patient has neck pain, upper back pain, and shooting pain down the arms. The exam revealed that the DTRs were mildly diminished in the left upper extremity. The strength and sensation were mildly diminished in the left upper extremity as well. Spurling sign was also weakly positive on the left. It is noted that the patient has tried and failed conservative treatment, including medications and PT. However, review of the records revealed that the postop PT was put on hold due to his increased pain. In addition, the MRI Report showed that the disc space was normal and there was no significant disc herniation at the requested level i.e. C7-T1. The spinal canal and neural foramen are patent. In addition, EMG Report revealed that there was no evidence of peripheral nerve entrapment or underlying peripheral neuropathy on nerve conduction studies. Considering the minimal/mild physical examination findings and normal imaging and EDS testing; the medical necessity of C7-T1 cervical ESI has not been established. Recommend

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One common cause of neck pain that is progressive in nature is a herniated disc. At the very least, a herniated disk will require intervention by a specialist that deals with corrective procedures concerning the spinal column, and in the worst case scenario, there may be a need for surgery. If left untreated, a herniated disc will intensify in the level of pain that it causes. It will also limit mobility. As the body attempts to make adjustments to compensate for the pain and weakness that is common with herniated disks, it increases the chance of additional injuries in other areas.

Our spine is made out of vertebrates and soft cushion in between. When the spine weakens, it allows this flexible area to be damaged, allowing the leakage of the gel within the spine to bulge. This is called a Herniated Disc. It can occur at all levels of the spine, where the lumbar spine being the most common. Secondly, this event seldomly occurs in the cervical spine, which is the neck area, and in the upper back, which is part of the thoracic spinal area.

In between each vertebrae of the spine lies a fibrocartilaginous cushion, known as an intervertebral disc. However, when there is an issue occurring that causes the intervertebral disc to not function properly as a cushion between the vertebras of the spine, such as intervertebral disc herniation, other complications can arise. Neck and back pain is a common issue faced by adults of various ages. Back pain is accountable for second most frequent cause for visits to the hospital, fifth most common reason for admission to the hospital, and the third most common cause of surgical procedures (Taylor, Deyo, Cherkin, & Kreuter, 1994) Intervertebral disc herniation of the spine is often the culprit of this pain. In this paper the etiology, pathology, clinical course, signs and symptoms, prognosis, occupational therapy treatment protocol, and the overall effect on the person affected by a herniated disc will be discussed.

Some issues are loss of fluids in the discs, tears or cracks in the outer layer (capsule) of the disc and the jelly like material leaks out which may cause the disc to bulge or even rupture which then you have no cushion between the vertebrae. The most common as in my case is repeated heavy lifting or physical work. Also people that are obese tend to have symptoms of DDD.

Human spine consists of twenty six vertebrae separated by twenty four intervertebral disks. These disks absorb shock during everyday activities such as running, walking, sitting, turning, and bending. The intervertebral disks have two parts: an outside part called annulus fibrosus, which is made up of strong fibrous cartilage; and inner part called nucleus pulposus, which consists of water and collagen fibers and is often described as “gelatinous” substance. When outer annulus fibrosus thins out due to an injury or age-related weakening, the inner nucleus pulposus can slip out, causing pain and discomfort because it can press on the spinal cord and nerves. This condition is called herniated nucleus pulposus (HNP).

Traditionally, spinal problems are believed to always have specific patho-anatomic diagnoses just like other pathological conditions such as cancer, diabetes, heart disease, etc. Since the articles about cervical (Boden 1990)and lumbar spine (Boden 1990 and Jensen 1994) and demonstrating multiple imaging pathologies were found in pain-free individuals, and about 65% increase of spine care cost from 1997 to 2005 has produced worse health outcomes despite imaging technological advances (Martin et al 2008). This has led to a paradigm shift that between 70-90% of neck and back problems is actually non-specific in nature (Deyo et al 2008?). The non-specific nature of neck/back pain does not mean that they all have the same clinical features. For example, the patient’s experience of pain can have different neurophysiologic pain mechanisms at work that result in substantially different clinical and financial

Cervical arthritis generally occurs when the cervical vertebras within the neck deteriorate. When this is accompanied by a deterioration of cartilage, the condition is very painful. The disks within the neck provide support and make the neck flexible. The cartilage acts as a shock absorber so that normal movement is not painful.

MRI of the cervical spine from 2012 (no official report) revealed cervical disc disease at C5-C6 and C6-C1 with moderate disc degeneration and moderate foraminal narrowing, worse on the right/

MRI of the cervical spine obtained on 03/05/15 revealed a posterior disc herniation at C3-4 impressing on the ventral thecal sac and borderline central spinal stenosis. Peripheral disc encroachment toward the foramen is unchanged. A subligamentous posterior disc herniation at C4-5, is impressing on the thecal sac and borderline central spinal stenosis. Peripheral disc encroachment is seen toward the foramen. At C5-6, a subligamentous posterior disc herniation impressing on the ventral thecal sac with peripheral encroachment toward the right neural foramen, borderline central spinal stenosis and right greater than left neural foraminal narrowing findings are unchanged. At C6-7, a left lateral subligamentous disc herniation is demonstrated encroaching into the left neural foramen with mild left foraminal narrowing, which is newly present. A focal midline subligamentous disc herniation at C2-3 again impresses on the thecal sac.

2.11. Vertebral disc diseases result from the thinning or bulging of disc, drying out and

Progressive destruction of the vertebral bodies as a result of the disease may lead to vertebral

The inter-vertebral discs also become more fragile as one ages. Furthermore, older discs are not able to properly cushion joint structures, bones and nerves.