Addy992ParticipantDecember 8, 2020 at 2:20 pmPost count: 2
Hello! I am 28 years old male. I am graphic designer who spends a lot of time on a PC. English is not my native language and I am sorry if I make any mistakes.
My problems started in early May 2020 when I had a pain in the neck that didn’t subside for days. I was very active and I thought it was some kind of muscle strain so I did some stretches that were very painful and probably irritated my neck further. A week or two later when I was doing warm ups on bench press I realized that I lost a lot of strength in my right tricep. Soon after that my pec muscle, tricep and lattisimus dorsi on the right side started twitching and I felt pain radiating down my right arm. In the following weeks most of the pain was gone but I was starting to feel tingling sensation down my arm and my index finger and thumb started to feel numb. The numbness and tingling would intensify in certain neck positions. Twitching stopped about the same time. Soon those muscles (pec, triceps and lat) atrophied and I wasn’t able to fully activate them.
I was scheduled to do MRI in september (4 months after my initial symptoms) and it showed c6-c7 extrusion and c5-c6 bulging. By the time I did MRI most of my symptoms were gone. No pain, no twitching, no numbness. Still, my muscles were very weak and atrophied and I wasn’t able to fully activate them. Also, I would still feel occasional tingling sensation going mostly from my elbow to between index and middle finger.
I did an EMNG in september and neurologist said that it showed signs of moderate to severe chronic c7 radiculopathy. He said something like third of my motor units are gone. As if I had something for a long time and I didn’t notice it. I don’t want to believe that.
On october 23rd I travelled to Turkey (my country wasn’t doing surgeries due to COVID crisis) and I had C6-c7 ACDF with standalone peek cage (arion osimplant). My NS told me that c5-c6 didn’t need surgery at the moment but I have to be careful in the future.
After the surgery tingling sensation that was dependant upon neck position has completely disappeared. But my muscles are still weak and atropied. I feel low dull pain when I press those muscles with hand and I can’t completely activate them.
I started PT a week ago and I am doing some strengthening exercises but I don’t really feel those muscles firing up.
MRI report day before my surgery (it was translated from Turkish)
Cervical lordosis has flattened.
Vertebral body heights and signal distributions of the bone structures are normal
Signal loss secondary to degeneration is seen in cervical discs. On C3-C4,C4-C5 diffuse bulging is seen.
On C5-C6 level, diffuse bulging has occluded anterior subarchnoid space and it causes indentation to spinal cord.
On C6-C7 level, diffuse bulging and right foraminal disc protrusion have narrowed right lateral recess and right neural foramina. Right C7 root compression is seen.
Diameters of spinal canal are normal.
Craniocervical junction formations are normal.
No prominent pathology is detected in soft tissues of paravertebral region.
Flattening in cervical lordosis.
Signal loss secondary to degeneration in cervical intervertebral discs,
On C3-C4, C4-C5 level, diffuse bulging
On C5-C6 level, diffuse bulging has occluded anterior subarchnoid space and it causes indentation to spinal cord
On C6-C7 level, diffuse bulging right foraminal disc protrusion, narrowing in right lateral recess and right neural foramina, right C7 root compression.
I have several questions/doubts.
Could my weakness and atrophy be caused by something else or I have to wait for nerves to regenerate? How long can that take considering my timeline? Can I have some permanent nerve damage?
What about activities, when can I go back to weightlifting?
Can you share your opinion or any thoughts you have about my case. ThanksDonald Corenman, MD, DCModeratorDecember 8, 2020 at 4:32 pmPost count: 8468
By the way, your English translation is excellent! You have a classic C7 radiculopathy (compression of the root in the C6-7 foramen). Compression of the nerve root can cause permanent injury but in my experience, the cervical nerve roots are much more forgiving of injury than the lumbar roots. You are only 6 weeks out from decompression at this point and that is a very short time period for root recovery. I will attach the recovery information for the nerve root here:
Dr. CorenmanAddy992ParticipantDecember 10, 2020 at 1:20 pmPost count: 2
Thank you very much for your answer. I’ve read the article and it’s very informative.
The last couple of months have been very hard for me and made me very anxious. I am afraid that something might be overlooked in my diagnosis. I might worry needlessly but I have to ask.
Could the weakness and atrophy I wrote about in the previous post be caused by C6 radiculopathy because I’ve read online that thumb numbness is more of a C6 root. And also I have slight weakness in wrist extension on the right side which is also connected to C6 if I read correctly.
Could that herniation on C5-C6 that wasn’t treated with the surgery be causing the weakness and atrophy (triceps, pec, lat) or it’s all about C7.
I will make an appointment with neurologist to be certain but I would appreciate your opinion.
Thanks for your patience.Donald Corenman, MD, DCModeratorDecember 12, 2020 at 9:16 amPost count: 8468
There is a possibility that you developed Parsonage-Turner syndrome and that would explain why some motor group weaknesses expands beyond the typical C7 root motors or you could have some compression and weakness of the C5-6 level. Generally, the biceps is a C6 root muscle so if you have no biceps weakness, I wouldn’t be too concerned about the C6 root. Yes, the thumb is more related to C6 but crossover of root distributions do occur.
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