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#21963

Dear Dr. Corenman,

I am a 72 year old retired male physician. I live overseas. Below is my medical complaint and history.

Complaint: Electric shock-like sensation radiating down into the left upper extremity

Onset : sudden

Course: intermittent related to mobility of neck especially at neck flexion or extension of arms on bending down.

Duration: on and off during the last year and a half

Past history:

A history of acute hyper extension injury and another blow to the forehead after falling down.

Past medical history : numbness & tingling and warm sensation of foot since five years until now and mild numbness & tingling and warm sensation of left hand. (mild lumber stenosis and lumber spondylosis )

Controlled hypertension with concore 5 mg one tablet daily, Reflux oesophagitis (diaphragmatic hernia fourth grade. xyloric 100 daily for chronic Gout.

Gaptin 300 daily for numbnes.

Family history:

father died with heart attack after chronic obstructive lung disease and heart failure .
mother died postoperatively of irreducible surgical umbilical Hernia

Investigations:

Digital X -Ray: Shows advanced cervical spondylotic changes are seen evidenced by:

Antero-marginal osteophytosis

Narrowed C5-C6 and C6-C7 disc spaces

No muscle weakness

MRI shows:

Congenital cervical central canal stenosis with superimposed posterior disc protrusions at C3-C4,C4-C5,C5-C6 and C6-C7 that result in cord compression,worse at C3-C4,C4-C5

* Intramedullary abnormal signal is noted along the compressed cord segments opposite C3/4 and C4/C5 discs.

A local surgeon recommends surgical interference (posterior approach)

Before I arrange for travel to the U.S., I would like to know first your recommended treatment plan or what my options are. Also, I would like to know the estimated length of stay and prognosis, if possible.

Lastly, what would be the estimated costs for the recommended treatment plan or options?

Upon request, I can send you some recent tests and imaging reports.

Thank you for your consideration.

[Donald Corenman, MD, DC]

#21986

Based upon your symptoms and MRI, you could be developing myelopathy. The electrical shocks you experience could be a form of L’Hermitte’s syndrome (cord injury from cervical motion due to stenosis). I worry about your cord signal changes (“Intramedullary abnormal signal is noted along the compressed cord segments opposite C3/4 and C4/C5 discs”).

Check the section https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/ to determine if you have symptoms of myelopathy other than the electrical shocks. You also might have had a mild central cord syndrome with your “history of acute hyper extension injury”. See https://neckandback.com/conditions/spinal-cord-injuries-neck/ and look at central cord syndrome.

You sound like you need surgery. Going anterior vs. posterior depends upon your neck alignment now, your pathology (how many levels and how much compression) and your physical examination. Either ACDFs or posterior laminectomy or laminoplasty are a two to three day stay in a hospital. The ACDFs require a cervical collar for about a week, give or take and the posterior decompression would be a collar for three weeks. Nine weeks if a posterior fusion is added.

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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