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  • Avatarmnjody
    Participant
    Post count: 19

    Hi!

    About three weeks ago, my right hand started feeling numb, then I started to get severe pain in my elbow (wakes me up at night), half way up the back of my upper and lower arm. I now have trouble picking up things – like a pot on the stove, a full bottle of water, I find myself using my left hand to help my right out. I never had issues with my right side before, it’s always been my left side. I had an MRI in December, which is below. Could these issues be stemming from the neck?

    MRI from 12/2020:

    1. Postoperative findings of the cervical and upper thoracic spine from C5
    through T2 levels. Central bulging annulus at C5-6 and to a lesser extent at
    C6-7 contributing to moderate canal narrowing at C5-6 with mass effect along the
    ventral aspect of the cord at this level. Repeat CT may be helpful for further
    characterization if clinically indicated.
    2. Multilevel neural foraminal narrowing is also present, greatest on the left
    at C4-5 and C6-7.
    EXAM: MR CERVICAL SPINE WITHOUT IV CONTRAST
    COMPARISON: Radiographs 12/14/2020, previous MRI 12/31/2019, CT 12/29/2019.
    FINDINGS:
    Skull base-C2: No focal abnormality.
    C2-3: No canal or neural foraminal narrowing.
    C3-4: Left-sided uncovertebral hypertrophy contributing to mild to moderate
    left neural foraminal narrowing. No significant canal narrowing or right neural
    foraminal narrowing.
    C4-5: Regional hardware-related artifact limiting detailed evaluation. No
    significant canal narrowing identified on sagittal imaging. Bilateral facet and
    uncovertebral hypertrophy contributing to neural foraminal narrowing, moderate
    to severe on the left, mild to moderate on the right.
    C5-6: Operative level. Postoperative findings with central bulging annulus with
    flattening along the ventral aspect of the cord best demonstrated on image 23
    series 6/7, image 7 series 3/5. Overall moderate canal narrowing with retention
    of small amount of CSF posterior to the cord at this level.
    Uncovertebral hypertrophy contributing to mild left neural foraminal narrowing.
    No significant right neural foraminal narrowing.
    C6-7: Operative level. Postoperative findings with central bulging annulus
    without significant mass effect on the cord, partial effacement of the thecal
    sac compatible with mild to moderate canal narrowing. Bilateral uncovertebral
    hypertrophy, left greater than right contributing to moderate to severe left
    neural foraminal narrowing, mild right neural foraminal narrowing.
    C7-T1: Operative level: No significant canal or right neural foraminal
    narrowing. Mild left-sided uncovertebral hypertrophy contributing to mild left
    neural foraminal narrowing.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    First, what side of the hand is involved? Is it the thumb side or the little finger side? Is there any pain or numbness radiating from the neck to the hand or do the symptoms originate from the elbow?

    What surgical procedure(s) do you undergo and when did you undergo them that indicate “post-operative changes”? What were your original symptoms and what was your outcome after surgery?

    Symptoms can be generated from the elbow, the wrist or the nerve roots in the neck. See
    https://www.neckandback.com/conditions/carpal-tunnel-syndrome/
    https://www.neckandback.com/conditions/cubital-tunnel-syndrome/
    https://www.neckandback.com/conditions/symptoms-of-cervical-nerve-injuries/

    Your symptoms could be related to any of the above. Further information you supply can hone the origin down.

    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.
    Avatarmnjody
    Participant
    Post count: 19

    In December 2019 I had ACDF C6-T2 and then added on c5-6 4 days after the first surgery. All symptoms prior to that were left sided. I still have left sided issues including numbness and tingling, into my thumb and pointer finger. I also get headaches very often. My new pain is right sided, very strong pains, runs down the back of my arm through my elbow into the mid forearm. My outer arm is numb and thumb and pointer fingers are numb but no pain to them.

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7982

    “thumb and pointer fingers are numb”. Thats either a C6 radiculopathy or a carpel tunnel syndrome (see previous hyperlinks). You have had a C5-T2 fusion (ACDF) so the C5-6 level (the origin of the C6 nerve root) should be stable-unless it’s a pseudoarthrosis (non-fusion). The level obove (C4-5) would affect the C5 nerve root which does not radiate down below the elbow.

    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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