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  • rv80
    Post count: 1


    I’m a 32 year old man and in August 2011 I had a laminectomy surgery of C5 and C6 because of severe spinal cord compression because of congenital spinal stenosis. This left me with a huge myelopathy lesion on the spinal cord at those levels.

    After surgery my walking gait improved and most sensation has returned in my fingertips. But when laying in bed my left arm keeps on tingling a lot. On some moments my walking gait is more worse than others as well. And some numbness occurs when it’s really cold outside.

    My concern lies in the following:

    The other levels of my neck are still really narrow because of the congenital narrow spinal canal. C4 is around 8mm and so is C7. However on the MRI when I’m laying horizontal there is spinal fluid to be seen all around the cord. It’s almost nothing, but it is present. When bending the neck a bit backwards (not flexion, but a bit) the spinal cord becomes compressed on those levels with almost no spinal fluid left visible around the cord.

    I’ve had two neurosurgeons look at this and both of them don’t seem concerned with my spinal cord being visibly compressed when my neck is a bit backwards. They say that because there is spinal fluid visible around the cord in the normal / laying position MRI I’m fine for lots of years to come. But I am concerned about it including the only 8mm of canal space on those levels. I’m really young and don’t want to lose more function and would rather have those two levels fixed before developing serious problems.

    I kind of have no idea what to do in this situation.

    Thanks for your time!

    Donald Corenman, MD, DC
    Post count: 8465

    Your symptoms are the typical sequella to a mild spinal cord injury.

    If there is CSF around the cord on the MRI, this means that there is still some “room” for the cord. This is balanced by the congenital narrowing of the canal as 8mm for the canal is very narrow.

    The spinal canal changes in diameter with flexion and extension- narrowing by as much as 30% with extension (bending backwards). A fall onto the front of your head could potentially cause a central cord injury (see website) by narrowing the canal and pinching the cord.

    Without an examination, a complete history and review of all your images, I cannot tell you how significant your problem is. Let us assume that there is critical stenosis present. You would have two choices in my opinion; stop activities that put your neck at risk and live with the small risk of injury or have a laminoplasty performed (see website). This procedure opens the canal and limits the risk of injury.

    Dr. Corenman

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