Expert: Dr. Timothy K. Durnin - 7/9/2007

Question
At C5-6, there is moderate left sided neural foraminal stenosis due to asymmetric uncovertebral spondylosis. There is a tiny central disc protrusion indenting the ventral aspect of the thecal sac.

Answer
I think some syntax may have been lost in translation, let me have the report word for word, if it's still transcibed wrong, I would get it clarified by the doctor that ordered it or read it.

I don't blame you for asking, the radiologist or the transcriptionist scewed up with "asymetrical uncovertebral spondylosis". This makes no sense, spondylosis is simply disc thinning, asymetrical uncovertebral joints are congenital and have nothing to do with the disc. Get a new read, the last part simply means part of the C5/6 disc is pushed out and pressing against the sac that surrounds the spinal cord.

Neural foraminal stenosis simply means the canal that the spinal cord travels through is narrowed because of the asymetrical joints. Not much you can do for this, if it isn't a clinical issue I wouldn't worry about it. The disc protrusion/herniation is something to worry about and is effectively treated nonsurgically with flexion/distraction or towel traction.

Flexion-Distraction Therapy - What is it?


Flexion-Distraction, (F/D) is a gentle, chiropractic treatment procedure utilized for back and neck pain. Flexion-Distraction is a safe alternative to back surgery for those 95% of patients whose conditions do not demand surgical intervention. The doctor is in control of the treatment movements at all times.

Flexion-Distraction is utilized for many conditions such as:

Failed Back surgical Syndromes
Disc Herniation/Ruptured Disc / Bulging Disc / Herniated Disc
Sciatica / Leg pain
"Whiplash" injuries
Stenosis
Arm Pain
Neck Pain
Failed course of Steroid Injections
Chemical Radiculitis
Spondylolisthesis
Headache
Transitional segment
Many more conditions….
How does Flexion-Distraction Work?

For Disc related conditions:

Increases the intervertebral disc height to remove annular tension on the annular fibers and nerve by making more room and improving circulation.
Allows the nucleus pulposus, the center of the disc, to assume its central position within the annular fibers and relieves irritation of the spinal nerve.
Restores vertebral joints to their physiological relationships of motion.
Improves posture and locomotion while relieving pain, improving body functions, and creating a state of well-being.
For Non-Disc related conditions:

Patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac restrictions and misalignment, certain types of spinal stenosis), Flexion/Distraction provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain:

The posterior disc space increases in height.
F/D decreases disc protrusion and reduces stenosis.
Flexion stretches the ligamentum flavum to reduce stenosis.
Flexion opens the vertebral canal by 2 mm (16%) or 3.5 to 6mm more than extension.
Flexion increases metabolite transport into the disc.
Flexion opens the apophyseal joints and reduces posterior disc stress
The nucleus pulposus does not move on flexion. Intradiscal pressure drops under distraction to below 100mm Hg. On extension the nucleus or annulus is seen to protrude posterior into the vertebral canal.
Intervertebral foraminal openings enlarge giving patency to the nerve.

Reference: Cox JM, Feller JA, Cox-Cid JA: Topics in clinical Chiropractic 1996; 3(3):45-59


If you have more info, please feel free to post additional details.

Dr. Timothy Durnin
drs.chiroweb.com