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  • RC456
    Member
    Post count: 2

    Dr. Corenman,

    Thank you for creating this site. I am a young male in my late 20’s who was very active (fishing, golfing, weightlifting, basketball) until I hurt my lumbar spine back in August of 2012. MRI of Lumbar spine demonstrated L2-L5 bulging discs with no neuroforaminal or spinal canal stenosis. I went to a chiropractor for 4 weeks for that injury because I started developing right sided paresthesias in addition to the lumbar pain. I underwent adjustments and decompressive therapy with the DRX-9000. Well, after a few weeks at the chiro. I started having parasthesias in my mid back where I was being adjusted 3 times a week for 4 weeks, and no improvement in symptoms. MRI of my thoracic spine was done and revealed T7-T9 small disc protrusions with mild flattening of thecal sac and cord indentation but no cord compression or cord signal abnormality.

    My multiple thoracic HNP was diagnosed in October of 2012. Since then I have just been swimming and doing stretching with light weight exercises for core and back. The parathesias in my mid back have disappeared but for the past few months I have had muscle fasciculations that occur all over my body. They occur throughout the entire day in all muscle groups, prob. once every hour but it doesn’t disturb my sleep or anything. In addition, for the past few months I have had urine seeping out of my urethral opening for about 5 minutes after I urinate. I don’t know if this has been happening forever, or because I have been more vigilant for bowel or bladder dysfunction but it worries me. So I went to have another MRI back in January on 2013 when these symptoms started to appear. It stated no changes from last MRI- No acute cord compression. I have no muscle weakness and minimal back pain. Overall, just abnormal sensations down both LE at times- not constant with minimal pain, and the muscle fasciculations with the urine problem.

    Therefore, would you consider these symptoms to be a sign of cord compression? Even though my MRI states that I do not have compression. I am young male and am in the field of anesthesia and have loans to pay off and need to support my family. Will this condition progress overtime and cause permanent nerve damage? Overall, nothing has gotten worse in a few months, but I just wanted to get another opinion. Thank you so much for your time.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    Symptoms of thoracic cord compression include imbalance, loss of fine motor control in the lower extremities and bowel/bladder dysfunction. By your description, I do not think you have most of these symptoms.

    In addition, cord compression leads to long tract signs. These are signs found upon physical examination that include hyperreflexia, clonus, dysesthesias and problems with gait seen with stress maneuvers. A spine expert should be quite familiar with these signs and should be able to identify them. If these signs are absent, there is more evidence that you do not have myelopathy (dysfunction of the cord due to compression).

    Muscle fasciculations that occur “all over” your body are not related to the spinal cord. There are many different conditions that can cause these fasciculations and a metabolic work-up might be helpful.

    Good luck.

    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.
    RC456
    Member
    Post count: 2

    Doctor Corenman,

    Thank you for the reply. I truly appreciate the information. Upon physical examination, I did not have any long tract signs a few months ago when I visited my neurosurgeon. But I believe I have dysesthesias in my lower extremities. I get abnormal sensations that are difficult to describe. At times they are pins and needles and others it is almost a burning and numb feeling. However, sometimes these symptoms disappear. Is this a concern with compression or could this be from indentation of the cord. I am just confused about my clinical presentation because I really have no pain but have neurological symptoms.

    Currently, I am taking MSM, Chondroitin, and Glucosamine. In addition, I am taking Wobenzym N which is a natural homeopathic supplement with papain, Bromelain and other enzymes. Through research from some of my medical articles I have access to from school I read about enzymatic degradation of the disc. Would you recommend these supplements? Thank you again. Have a good week.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    There are many different conditions that can cause strange symptoms in your legs other than cord compression. Metabolic, infectious, degenerative and autoimmune disorders can all cause these symptoms. WIthout long tract signs on examination, the source of “weird” leg symptoms should be looked into by a neurologist.

    The substances you are taking will not affect the disc, spine or cord. Wobenzym is an offshoot of chymopapain, a substance that was used to inject into the disk to dissolve the nucleus and extract it. Needless to say, this technique fell out of favor due to the occasional paralysis that occurred with use.

    These enzymes are proteins that are broken down in the gut and absorbed as simple amino acids. This breakdown makes these enzymes useless when they are absorbed.

    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.
    barca
    Member
    Post count: 5

    RC456,
    I have the exact same issues as you…WORD FOR WORD.

    I have extruded discs at T7-8 and protrusions at T6-7 and T11-12.

    I have fasciculations primarily from abdomen down but also get them from time to time in shoulders and arms. I also have bizarre tremors and dysesthesias. I feel like sometimes an incorrect assumption is being made that cord compression cannot affect the entire nervous system.

    I have had multiple blood tests and seen just about every speciality of doctor (including 2 neurologists) and have zero answers as to the cause of continuing degenerative discs and muscle issues.

    Dr. Corenman is there specific metabolic, infectious, degenerative and autoimmune disorders we should be asking about…what or where would someone start to look in relation to a disease process progressively degenerating discs?

    thanks,

    Donald Corenman, MD, DC
    Moderator
    Post count: 8409

    Fasciculations can be related to cord compression but if there is thoracic cord compression and fasciculations occur in the upper extremities, this is not related to thoracic cord compression. Faciculations occur “down river” from the compression and will not occur “up river”.

    I wrote two chapters about the most common non-spinal disorders that can occur to cause these symptoms. It would be difficult to cover all of these conditions here but any good neurologist or rheumatologist should be able to help deduce what the potential disorders are.

    Now, degenerative disc disease is caused by genetics, trauma, occupation and advocation.

    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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