MRI ANALYSIS OF CERVICAL SPINE (Copy from report of Radiologist)

Sagittal images in two sequences and axial images through the disc spaces were obtained.
Cervical spondylosis and disc degeneration were seen at C5/C6 and C6/C7.

At C4/C5, there was cervical spondylosis. There was significant central canal stenosis at C4/C5 and C5/C6 and the spinal cord was indented at these levels.

At C5/C6 and C6/C7, there was narrowing of both lateral recesses while at C4/C5 there was narrowing of left lateral recess.

The spinal cord at C4/C5 and C5/C6 had a narrowed AP diameter due to longstanding central canal stenosis.

Vertebral marrow signal was normal.

No significant tonsillar descent noted at the craniocervical junction.

CONCLUSION

1) Cervical spondylosis from C4/C5 to C6/C7.
2) Disc degeneration at C5/C6 and C6/C7.
3) Central canal stenosis at C4/C5 and C5/C6 with narrowing of spinal cord in the AP  diameter.
4) Narrowed lateral recesses bilaterally at C5/C6 and C6/C7 and narrowed left lateral  recess at C4/C5.


GENERAL SYMPTOMS EXPERIENCED BY PATIENT:

Prior to Sonotron Therapy, throughout the previous 3 years, patient complained of pain upon awakening in the morning at a level of 5 out of 10 (0 - no pain, 10 excruciating pain). Patient felt that level of pain when he used a special cervical pillow to sleep. Without it, his pain level would rise to around 7 - 8 out of 10.

To reduce his pain, ice (packed in a plastic bad) had to be applied to his neck, He would then feel his pain reduced to a score of 3 out of 10. By about 12 p.m., patient's pain would return to a level of 8 out of 10. He would then apply ice to his neck again, to lower his pain level. But by 3 - 4pm, his pain would return to the previous level of 8 out of 10.

Before going to sleep, patient would apply ice once more and sometimes would have to sleep with a soft collar plus a hypnotic drug.

Patient had tried many types of therapy before the Sonotron treatment, among which were the following.


Physiotherapy treatment

The patient received physiotherapy treatment from June 8th till July 28th, 1995.

June 8 - June 16 - daily treatments.

17 June - 28 July - 3 times a week.

Each therapy session lasted about an hour. He was treated with 3 kinds of therapeutic devices, each one took 20 minutes. The therapies were:

    Ultrasound therapy 20 minutes
    Interferential therapy 20 minutes
    Short-wave therapy 20 minutes

After each session, he felt relief from pain for only 3 hours each time.


Magnetic wave therapy

The patient was introduced to the above therapy on or around July 14, 1995. He received one of such therapies in Kuala Lumpur.

He was given this therapy, both morning and night for 4 days, each session lasting about an hour.

Two types of appliances were used to treat his neck pain. One was in the form of a bed and the other consisted of 4 rings, the diameter of which were bigger than that of his body's. Treatment by the former took 20 minutes while the latter took 30 minutes to complete.

He felt no relief at all after treatment and had to immediately visit a physiotherapist near the University Hospital in Kuala Lumpur for help.


Chiropractic therapy

On 20th July 1995, patient was treated by an American trained chiropractor in Kuala Lumpur. He was subjected to various forms of manipulation of his neck, each session lasting about half an hour. During the therapy, his neck was pulled backwards and finger pressure was applied to the back of his head. During all these procedures, patient felt very painful.

Altogether, patient attended 3 such sessions, the last two were on 22th and 25th July. After every session, patient had relief but it lasted for about 1 hour only. His session normally finished at 1:20pm. By about 4pm, his pain would return. At 6:10pm, he would feel terrible pain at his neck, even though not moving, while sitting in his plane seat on his one hour flight back to his home town.


Electrical wave therapy

Electrodes were first attached to the patient's head, neck and right arm. An electrical current was then passed into these parts of his body lasting a total of 10 minutes. The intensity was gradually increased until his head and arm were jerking involuntarily. The administrator, a doctor, controlled all these adjustments via a packet sized control box which was connected to the electrodes by means of wires.

After he finished his treatment at about 4:30pm, he felt no pain at his neck. However, by about 6:10 p.m., his pain returned, lasting a total of 1hr 40 minutes.

The patient was told to apply a special kind of eye drop to relieve his neck pain. He tried but didn't used it again because the medication hurt his eyes. He also did not go back again for a second therapy session.


RESULT AFTER 1ST SONOTRON THERAPY SESSION ON JULY 28, 1995.

Before therapy, patient reported a pain score of 5 out of 10 at his neck, without movement. After therapy, patient's pain score dropped to 3 out of 10.

Patient also reported a higher pain score of 7 - 8 out of 10 when turning his head, before the start of therapy. After the treatment, patient's pain score dropped to 2 - 3 out of 10.


RESULT AFTER 2ND SONOTRON THERAPY SESSION ON JULY 29, 1995.

Before therapy, patient reported a pain score of 0 - 1 out of 10 without moving head.

When patient flexed head to intentionally bring out pain at his neck, patient found he could produce pain score of 5 - 6 out of 10.

After treatment, patient reported a pain score of 0 - 1.


RESULT AFTER 3RD THERAPY SESSION ON JULY 30, 1995.

Before therapy, patient reported a pain score of 7 - 8 out of 10 without movement of head and 8 - 9 out of 10 when moving head. After therapy, pain score dropped to 0 - 1 out of 10 when moving head.


RESULT AFTER 4TH THERAPY SESSION ON JULY 31, 1995.

Patient woke up at 8:30am and realized he had no more pain when turning his head on his pillow. For the 1st time, he could get up with no pain. He had been having this type of pain in the mornings of the past 3 years.

He sat up for 1/2 hr and could move his head with no pain. He then observed that he also didn't get any pain when shaving, the feeling of which he always had before.

Prior to the start of the 4th therapy session, and when he intentionally tried to get pain out of his neck by forcefully doing it, he could get a pain of score of  only 1 - 2 out of 10. After treatment, he felt even better and had no pain when doing the same forceful movement.


RESULT AFTER 5TH THERAPY SESSION ON AUGUST 1, 1995.

Before the start of therapy, patient reported a score of only 1 - 2 out of 10 without moving head and 5 - 6 out of 10 with strong movement of head.

After therapy, no pain was registered without movement and pain score was registered at 1 - 2 out of 10 when moving head.


CONCLUSION

In just 5 days, patient was very significantly relieved of his chronic pain - with and without movement of his neck.

"Consider my situation as well improved. Much better than what I was before."

He was happy and bought an equipment straight away to continue the treatment by himself and to assist him in the treatment of his patients' medical problems. 

GENERAL COMMENT

1. Pain score was measured by patient, using his best judgment.

2. Pain Score 0  - No pain
Pain Score 10 - Excruciating pain

3. Operator of device was always the same person.

4. Interactive communication was always encouraged between patient and operator of device in order to gauge the degree of improvement in patient's problem as treatment  progressed. Treatment ended when patient felt comfortable enough or when pain  disappeared