shrikant_touchMemberJune 11, 2012 at 6:07 pmPost count: 6
on 12 may 2012 My father age 69 suffered from shooting neck pain started from rightside of the lower neck area and within seconds spread across both the hands ,legs and shoulders .(he felt like paralysis attack) He was brought to hospital and admitted for next 12 days Since that day he has lost his bowel /bladder control (is on catheter and taking anema for clearing bowel) His MRI report is as below 1. loss of cervical lordosis is noted. 2.mild anterior and posterior osteophytosis is noted at c3 to C6 vertebral bodies. 3.Neural foramina and facet joints are normal. 4. Sagittal daimeter of bony spina canal as follows C2 16mm ,C3 14mm, C4 13mm C5 15mm ,C6 14mm C7 15mm 5.Central prostrusion at C3-C4 and C6-C7 are noted causing thecal sac compression. 6.Central extrusion at C4-C5 are noted causing mild cord compression. 7. the thecal sac shows normal signal characterstics. 8.central linear cord hyper intensity on T2WI is noted at C3 to C6 levels. 9.paraspinal soft tissues are normal.
He is taking rest at home with naturopathy /homeopathy meds /massage and is showing some relief from pain but his bowel /bladder problem not solved yet is
Please tell us whether surgery is required for this.Donald Corenman, MD, DCModeratorJune 11, 2012 at 10:53 pmPost count: 8468
Your father has symptoms that could be from spinal cord injury. The sharp electrical like pains that radiate down the arms and spine could be L’hermitte’s sign- lightening type pain that occurs from cord compression.
Bowel and bladder failure has a long differential but cord injury is one of them. Can he walk and if so, is his gait normal?
The signs of spinal cord injury are hyperreflexia, Hoffman’s sign, clonus, problems with balance in lower extremities and problems with fine motor control in upper extremities (zipping a zipper, picking up a coin, handwriting changes, putting a key in a lock). A good and thorough physical examination can reveal these signs and help with diagnosis.
The MRI notes a signal change in the cord from C3 to C6. This could be from cervical stenosis and myelopathy (see website) or from a process within the cord itself. A careful radiologist can determine what the source of the signal change is.
If this is injury from cord compression, he will need surgery but further information regarding the signal change needs to be completed before a decision can be made. Get a consult with a spine surgeon.
Dr. Corenmanshrikant_touchMemberJune 12, 2012 at 2:02 pmPost count: 6
Thank for the reply
Please find above link for the MR Images taken on the day of injury (12/05/2012).
> as on today (12 june 2012) my father can walk normally ,can stand straight ,having no problem in zipping a zipper/inserting key in a key hole or writing (his signatures are also alright).
>on 26.may.2012 USG done for
1. Hepato-Billary Systems
2. Genito-Urinary System
shows no demonstrable abonormality except excessive bowel gases.
> on 4th June evening catheter was removed to check bladder functioning , atleast three or four times he urinated well on his own but next day morning he was again put on catheter due to retention.
> 7th June 2012,due to fever, he underwent pathological tests for
1. Complete Heamogram
2. Maleria Antigen
3. Urine Examination
4. Widal test
and is daignosed with typhoid ( S pythi “o” and S pythi “H” positive in 1:80 dilution) ) and taking antibiotics for the same .
> Ever since discharge from hospital he is regularly taking naturopathy for clearing bowel ,massaging etc feeling relaxed except bowel/bladder problem.
> in the year 2004 ,he was bedridden for almost 3 months due to severe pain on lumber disks L4 and L5 (I donot have much details).
and recovered without surgery with the help of a Chiropractor cum physiotherepist within 3 days.
>Dr please tell us how long can we wait before undergoing surgery ?
ShrikantDonald Corenman, MD, DCModeratorJune 12, 2012 at 9:33 pmPost count: 8468
The images indicate that your father has severe central stenosis and cord injury. Does he have any of the spinal cord injury signs that I previously indicated (long tract signs like Hoffman’s sign)?
Bowel and bladder dysfunction can originate from the cord but there are physical examination findings that go along with this dysfunction. If the problems stem from the cord injury, he does need surgery. Recovery is an unanswered question as even with cord decompression surgery, there is no guarantee that the cord will fully recover.
Dr. Corenmanshrikant_touchMemberJune 14, 2012 at 12:18 pmPost count: 6
We got consulted with two spine surgons ,one of them examined my father and suggested meds(oral) for B12 defficiency for 15 days and asked us to wait.
While another surgon suggests immidiate surgery (microscopic posterior decompression)to avoid further damage
my father does not show any tingling sign / sensation triggered by a mechanical stimulus (hoffman’s).
shrikantDonald Corenman, MD, DCModeratorJune 14, 2012 at 12:54 pmPost count: 8468
B12 deficiency is unlikely. There are blood tests however that can reveal this. I do not have the luxury of examining your father but if he has long tract signs (as I indicated earlier) with the current symptoms you have indicated and the MRI findings that I reviewed, I tend to agree with the surgeon who thinks that decompression of the cord would be helpful.
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