JazzmanParticipantFebruary 12, 2018 at 10:22 pmPost count: 3
Hello Dr Corenman
I am a 58 y/o woman with a history of 4 cervical surgeries, 3 anterior and the last posterior. I have had multiple fusions as well as a 2 level corpectomy with all the necessary hardware, titanium cage, plate, rods and screws. My first surgery was close to 30 yrs ago and the last three all within the last 7 yrs with the last 2 , 2 yrs apart( last one 3 yrs ago).
I have noticed leg weakness for at least the last year and a half which I just ignored, but it was causing me to slowly refrain from most activities( I have been totally disabled for the last 8 yrs due to the permanent damage that past cord compression has left me with) because of the severely limited time I could stand at any given time. I have lived with a certain aspect of this for all of the last 8 years but it definitely was intensifying over the course of this last year at least. In hindsight I now know that my hands were affected as well. I have had a significant essential tremor in both hands with the right far worse, for some years.
I noticed back in October that things were getting much worse. I have been having that familiar “ buzzing” and burning feeling in my feet and lower legs( mainly just the “vibrating”/ “buzzing” in the lower legs). Things were progressing all this time until about the end of the first week of January when everything changed overnight. I found that suddenly my neck had an intense feeling of pressure and stiffness like I’ve never known, when I would stand and walk. My walking has become very unstable with that heavy weak feeling in my legs. My legs became so weak suddenly that they were trembling when I would stand. My arms and hands are very weak. When it first changed overnight I had “ hot spots” here and there on my feet and legs as well as the outside of both upper arms ( it felt like my skin had been scalded and was very sensitive). If I stay down I’m not so bad but being on my feet seems to cause everything to worsen. I’m convinced that certan neck positions are aggravating this but don’t know what they are. I had some slight paresthesia in my upper lip area as well as out to my cheeks on both sides when it worsened suddenly but not noticing it now. Seems like it’s affecting my ears some, a little pressure and an intensity of sounds that is irritating.
I saw my neurosurgeon 2 weeks ago for the fastest appointment I’ve ever had with him. I wasn’t in good shape that day at all. He saw me “ walk” into the exam room and came in with a very concerned look on his face. All he did then was ask me what was going on ( he hadn’t seen me in over 2 yrs since my last post op appt). He then barely checked my leg strength and my arm strength ( which was shockingly weak) and stood up and announced that he needs an MRI of the head and neck and a Kyle gram due to my history. I’m still waiting for the tests. Could this all be just myelopathy ? And should I be concerned about my doctors very unusual serious demeanor and the very brief exam ? I am worried this time because of the length of time the symptoms have been present. I have developed edema around my cord before one surgery and was in tough shape but this is worse. I’m barely able to function now, have so much trouble being on my feet and extremely weak clumsy hands. I’m staying off my feet for the most part because that seems to make everything worse. Am I right to be very concerned this time ? Really trying to avoid a fall for sure.JazzmanParticipantFebruary 12, 2018 at 10:28 pmPost count: 3
In the last paragraph that should say myelogram and not “ Kyle gram” as it does, auto speller I guess. I didn’t notice it until after I submitted it.JazzmanParticipantFebruary 17, 2018 at 10:11 pmPost count: 3
Need to clarify/update my post from the other day. I did not mean to imply that my essential tremors were caused from my cervical problems because I know they are not. I meant to imply that they get significantly worse during times of cord compression, sometimes have trouble signing my name. The weakness in my hands and arms together with the now worse tremors make ordinary activities challenging at best.
When I referenced ear issues I should have clarified that I have no ear pain or reduced hearing. The intensity of sounds that I find irritating are not sounds outside of myself but rather my own voice( I’ll avoid the possible husband jokes here). I do have pressure and what I would call a constant not ringing but a very slightly perceptive “ noise” and when I talk it is amplified in my own head. I did not tell my NS about this because I thought I told him enough. I saw my primary care dr a few days ago for an already scheduled appointment and mentioned it to her so that she could check my ears. She found nothing out of the ordinary.
Symptoms are all still the same with some days a little better than others. I did experience left arm pain all day yesterday with pins and needles in that hand and some slight numb feeling in the thumb and index finger. No arm pain today at all. My tests aren’t scheduled until week after next. I know myelopathy can be a very “diffuse” problem but some of these on and off symptoms are driving me nuts. I am from a medical background and not one given to worrying about myself, on the contrary, I usually ignore things until I absolutely can’t any longer.
Still want to know if you could attribute all this to cervical myelopathy. I understand why my NS wanted a CT of the head but I’m sure I don’t have a brain tumor. So much of this is all too familiar but with some new twists. I don’t have a good feeling about this time. Oh yes, have had some loss of bowel control this which I’ve had much worse in an episode of cord compression before. Would you think that a CT myelogram would be the best way to diagnose this ? I hope so since this is what I’m having. Thank you in advance for your replyDr. CorenmanModeratorFebruary 18, 2018 at 7:14 amPost count: 5825
Yes- all your symptoms could be a result of myelopathy. Because of all your prior cord insults, you could also be developing syringomyelia which would be seen on am MRI but is somewhat harder to spot on a CT myelogram. The CT myelogram might be a good test however due to all your implanted hardware which can cause image distortion on an MRI scan. Another problem is that your physical examination will have residuals from all of your prior cord insults and might not be reliable to look for worsening of your disorder. All-in-all, I would agree on a CT myelogram and a new MRI also.
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