Can genioplasty cause neck, spine, and shoulder pain?

Hello,

Welcome back to icliniq.com.

I read your query and understand your concern.

I am sorry to hear about your pain and would like to help as much as I can. I have seen your MRI in detail (attachments removed to protect the patient's identity). There are osteophytes at multiple levels, as well as two slipped discs, which produce indentation upon the thecal sac. There is compression upon the left-sided C6 nerve root by the herniated disc at this level. There are also some Schmorl's nodes at the cervical and thoracic spines, which are part of degenerative changes in the spine. So, you can share this information with the concerned orthopedician or physiotherapist, and I believe they can guide you further.

I hope you had a pleasant experience with icliniq.com.

I will always be available for you in case you have any queries.

Thank you.

Hello,

Welcome back to icliniq.com.

Of course, you can ask further questions. Please proceed.

Thank you.

Hello,

Welcome back to icliniq.com.

I have scrutinized the specific images of your concern. I find that indeed there are lucent lines across the mentioned regions (facet, spinous process, etc) in those images, which may raise the question of fractures. However, looking at the STIR (short tau inversion recovery) images, I find that there is no corresponding evidence of bone edema or inflammation. This means that even if these lines represent fractures, they would be old fractures and should not be producing any intense pain now. But perhaps that is not the case. And if there are indeed old fractures, they would be producing lump-like calli or calcification by now. To conclusively determine whether these lines actually represent fractures, you can discuss with your orthopedic doctor and get a CT (computed tomography) scan with thin-slice bone window images. In the meantime, I would suggest you follow the posture or physiotherapy advice you may have already received.

Follow-up with CT spine with bone window.

Thank you.

Hello,

Welcome back to icliniq.com.

Well, cervical spine injuries have been rarely linked with jaw injuries (or surgeries), so that can be a possibility, albeit quite remote. If we take that possibility and add it to the faint lines seen on the MRI, we can build a picture that these lines represent old, unhealed fractures. So the possibility cannot be fully ruled out, and your suspicion may be the correct diagnosis.

Please follow-up with reports of CT spine.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

It is great to see that you got the CT scan done for now. We can make conclusions about the previous concerns. There is a tiny lucent defect at the spinolaminar junction at the D1 level, representing partial spina bifida rather than a laminar fracture. There is also a very faint lucent line across left-sided facets at the C4 level. It may represent an old fracture but almost healed. You had also spotted another line at the C3 level on the MRI, but that is not found on the CT. So, in summary, the fractures that you had been worried about are actually already healed or do not exist. I feel this information will give you some relief. Thoracic outlet syndrome is a reasonable consideration by your doctor. I have examined your MRIs again, but actually, the thoracic outlet was not fully included in the spine MRIs. So, in that case, your doctor may advise you to MRI the brachial plexus or thoracic outlet.

I am happy to have been of help and would be glad to advise further if and when required.

Till then, best wishes.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

The left-sided C6 nerve root compression is seen at the following places.

1. T2 oblique sagittal : 11/14
2. T2 sag : 5/15
3. T2 axial : 33/56.

I hope this information will help you get appropriate treatment from the concerned specialist.

Thank you.

Hello,

Welcome back to icliniq.com.

I can understand your concern.

About the MRI (magnetic resonance imaging), the nerve compression can be seen in images 5,6 of the T2 sag. It is a foraminal zone compression there. However, if the concerned doctors have considered this "not so significant", I will not disagree. I think the consideration of thoracic outlet syndrome still merits further evaluation.

I hope this information will help you.

Thank you.

Hello,

Welcome back to icliniq.com,

I can understand your concern.

The dorsal root ganglion is normally located just outside the thecal sac, in the foraminal or extraforaminal zone. So, in the image nos. 38-40 On the left side, we can see that there is a posterior osteophyte that is touching the anterior root or dorsal root ganglion, and that can be a possible point of compression too.

Hence, though the surgeons may consider that these are not so significant for surgery, physical therapy can indeed offer some benefit.

I hope this information will help you.

Thank you.