I Have Two More Questions. One Relates To My Left

Posted on Tue, 23 Oct 2018

Tue, 23 Oct 2018 Answered on

Last reviewed on

Question : I have two more questions. One relates to my left knee and the other my cervical spine. My Orthopaedic surgeon says my arthritis is not yet bad enough for knee replacement but he’s sent me to a pain specialist to deal with my high level of pain. He can’t do an mri because I have a neurostimulator implanted for bladder incontinance. I have a report for a cat scan done on it as well as a report for a ct myelogram that was done on my cervical spine for my pain tingling and numbness down my right arm and hand. My right arm and hand are unbearable. Can I send you the reports for the ct dcans of my knee and cervical spine to get your opinion? I’m very frustrated that both surgeons are managing symptoms instead of root cause. I just want it fixed. I think my first priority bis now my cervical spine. I would like to send you the reports? Thank you

Follow up: Dr. Dr. Prasad J (13 minutes later)

I think I sent you another mail asking you to look at these two ct reports; one was a ct myelogram on my cervical spine. I belive I have a big problem on my c-5 c-6 spine area that if affectin my median nerve I believe it is causing pain tingling numbness and electrical shocks to my right arm and hand. Its unbearable now. What is your advice on my left knee and my cervical spine...specifically c-5 c-6. not letting me attach other report.

Answered by Dr. Dr. Prasad J (6 hours later)

Brief Answer:
Surgery the definite treatment...

Detailed Answer:
Hi,

Apologies for the late reply. I went through your details and the scan reports attached.

CT of the left knee reveals arthritic changes involving all three (knee, tibia and patella) articular surfaces. The changes are shown to be moderate in nature. Your treating doctor is able to assess the condition better based on your clinical signs and the radiograph images of CT scan. If you are able to walk around and carry out activities with no relative ease, I think knee replacement can wait. However if you are contemplating knee replacement I will prefer that you get it done in the next 5 years.

As far as CT cervical spine is concerned, there is definite narrowing secondary to disc bulge from c3 to c6 with nerve root compression significantly more at c5-c6. The severity of nerve compression is again assessed clinically through a neurological examination. Neurophysiological studies is an useful tests that will allow us know the significance of nerve compression. In my opinion, you might consider getting neurophysiological studies done.

In these situation, more often treatment is pain management through medications and physiotherapy. Though surgery is a definite treatment it's only recommended in selected case where the real benefits of procedure outweighs risks and side effects of surgery. Your treating doctor are in a better position to assess and confirm whether or not you should undergo under the knife.

Hope I have answered your question. Let me know if you need any clarifications.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar