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Hi Dr, hoping you can help with my question.
In December 2016, I injured my neck which resulted in large bugles at c5/6 and c6/7 level with left nerves severely impinged. Underwent posterior discetomy to relieve nerves immediately and at the the time I had pins and needs in left elbow and thumb, index finger. Pins and needles were gone immediately post surgery.
In July 2017, I have some how injured further and experienced pain in my upper back neck area for 2 weeks which then reduced back to a manageable level. I then started getting sensations in both legs. Primarily started in both shins as a cold/wet feeling, however to dates it shifts week to week, sometimes in my calves, and sometimes above knees. Also sensitive to clothes and can feel like a burning feeling. I had whole spine MRI done in July, thoriac and lumbar were fine. However cervical slightly worse then 2016. Latest Results below and wondering if this can be causing my symptoms? Scheduled to see nuerologist shortly but after your opinion if possible.
C5/c6 – there is a large broad based disc bulge indenting the cord. Mild facet arthropathy seen. There is mild to moderate foraminal narrowing and nerve root impingement on the left. Mild canal stenosis. No focal cord oedema seen.
C6/7 – a broad based disc bulge is seen indenting the cord. Minor facet joint arthropathy. No nerve impingement or cancel stenosis. No cord compression.
Conclusion: suspicion of mild impingement of editing c4 root. Moderate impingement of c6 left root. No cord compression or canal stenosis seen at any level in cervical spine.
I find it a bit weird that in the details it mentions canal stenosis but conclusion none seen at any level? Looking through your site canal stenosis can cause these symptoms in my legs, but I wonder if “indenting the cord” can also? Symptoms seem to be brought on by sitting, and clear up by walking around. Any feedback would be appreciated.
You can have effacement of the cord with a spur but no stenosis as the canal is wide enough. Effacement is anterior cord draping without compression. Most of the time, this causes no cord symptoms (myelopathy- https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/).
Your symptoms could be from cord compression (“a cold/wet feeling, however to dates it shifts week to week, sometimes in my calves, and sometimes above knees. Also sensitive to clothes and can feel like a burning feeling”) but also could be from peripheral neuropathy (see https://neckandback.com/conditions/peripheral-neuropathy/). This could be discerned by a careful physical examination or maybe by a neurological consult and an EMG/NCV test (see https://neckandback.com/treatments/emgncv-electromyograms-and-nerve-conduction-studies/).
You did not report current arm symptoms so any foraminal stenosis in the neck would be asymptomatic.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.Thank you for taking the time replying to me Dr Corenman.
I have no arm symptoms at all. Purely both legs however has not affected the feet. Shins, calves and upper thighs above the knees only. I do notice certain chairs, or sitting can bring it on more intense which makes me think it is based on movement and something touching somewhere that it doesn’t like. In regards to the cord indentation, could you elaborate on this a bit for me? For example, can sitting with head motion forward put extra pressure and cause compression from the disc bulges? It is usually always like for like too, where I suffer a stinging or burning pain in one leg, it’s equally in the same spot on the other.
Thank you for mentioning peripheral-neuropathy, would movement of my body that as mentioned above that triggers it fuether still entertain this condition?
Cheers
Thought I should provide some better background that may assist you answering my questions. I am a 30yr old male. Back in July during the 2 week painful period prior to leg sensations, I forgot to mention that I did experience the cold/wet feeling in my shoulder blades, this was only brief and occured while sitting down, leaning forward. Quickly vanished when getting up and walking around. I only experienced it in this location for around 3 days, possibly once a day before it proceeded to my legs and never returned to my shoulder blades. This triggered me to see my Nuerosurgeon who ordered the full spine MRI. He did perform a physical examination by the means of tapping on my knees and said there was slight delay. He also said, while it is possible my neck can cause this issue, he said many other things can also and referred me to the nuerologist.
While waiting for my appointment, I have experienced the cold feeling in my lower back, but only when bending over putting clothes in the washing machine. So I’ve only really experienced it twice in the 3 month period in this location as i rarely do the washing due to the issues im experiencing. But again, the primary location is my legs and it comes on it’s own without any much trigger besides sitting, but will still be present walking around unless going for a decent walk, it will clear up.
Medicines I’ve tried to no releif
1. Lyrica 75mg
2. Mobic (anti inflammortory) 7mg and 15mg to no relief. I did think i had slight relief on the 7mg so my GP upped it to 15mg but it did not do anything so I’ve stopped taking as I figured I may of just had a good day or 2 on the 7mg.I’m scheduled to see the nuerologist next week, is there anything I’ve mentioned to you that would be most valuable to him? I guess it’s easy to blame my bulging discs on the issue and the fact that I disturbed it and all these symtoms presented, but at the same time I’m hoping the Doctor doesn’t get side tracked and will consider all options.
Further to this, it’s been occuring for 3 months while waiting for my appointment and I do worry about permanent damage, however it is hard to get into these doctors. Should I be doing more? Should my GP be doing more? the GP has only checked my blood counts at my request and wrote the referral.
I think that is everything I wanted to ask, sorry !
Again, thank you for reading my questions and providing some feedback.
Cord draping is made worse with neck flexion (hanging your head down) but what factor that works against this is the “delay” in reflex in your legs. Cord disorders would cause significant increased reflexes-hyperactive reflexes. A neurological consultation with EMG/NCV is your next step.
Based upon your intermittent symptoms, I am not too worried about permanent injury.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
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