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Spine and Back Health

Cervical discogram results/meaning?

10/15/2007

Question:

I was in a car accident 12-06. I have had unreal headaches and my shoulders, neck and back pain have not stopped. I recently had a cervical discogram 9-07 between C3-T1. I am not sure that I totally understand these results. The doctor suggested surgery when I am ready. What does this mean? And will I ever heal without surgery? How long until I will feel normal again?

Here is what the discogram stated: C4-C5 disc space height has some mild narrownig. contrast injection extravasated through a small posterior annulat tear. This extended soightly toward the right. Considered positive with annular tear. C5-C6 disc space height fairly well preserved. Contrast injection remained largely confined to the disc space but there is some bulging posteriorly and perhaps some extravasation towards the right though this could be iatrogenic. The disc is soft as well. Positive response.

I was struck by another automobile in the front right part of my car. The other car was speeding and flipped. I was looking to the right when this accident occured. I had an immediate headache and my neck hurt along with my back. I just want to make sure to make the right decision with surgery and if this is the only way the pain will subside. I have tried physical therapy and trigger point injections. Some days are tolerable but some I days I cannot take the pain. Is this annular tear and bulge this painful? The MRI immediately following the accident last year was negative. Why did this not show up? Would it show up now on an mri or ct scan? I am in my mid 20`s I still have yet to have children. What is an annular tear exactly? And a bulging disc? Is this going to get worse over time? Thank you for your time.

Answer:

Thank you for your question. On this site, we try to answer general questions about spine health and spine problems. You appear to have some very, very specific questions about your back, which can only be answered properly by a physician who is familiar with your history, physical exam, and test results. Your questions about the testing results you've been given or the risks, benefits, and alternatives for proposed treatments of your condition need to be directed to your treating physician(s). You should insist that they answer these questions in a way that you are able to understand before you consent to any treatment. If your physician is unable to help you understand these issues, you should get a second opinion. Good luck!

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Response by:

David J Hart, MD David J Hart, MD
Associate Professor of Neurosurgery
School of Medicine
Case Western Reserve University