[Jonesy]

#22641

Hello Dr. Corenman,
I am looking for some help. I started out with shoulder pain some time back that just got worse and worse. pain started down my arms and hands and then i ended up with temporary paralasis of my arms. i went to my doctor and he said i had carpal tunnel so he sent me for an EMG. the Neuro said that i did have carpal tunnel but that she thought i also had Cervical Dystonia. my PT suggested a second opinion so i got a new doctor. She sent me to get an MRI and they found this:
The visualized part of the posterior fossa, craniocervical junction, paraspinal soft tissues
are unremarkable. The bone marrow signal intensity is within normal limits. No
significant signal abnormality is seen within the spinal cord parenchyma.

C2-3: There is a small central posterior disc protrusion without significant stenosis.

C3-4: There is a broad posterior disc protrusion causing a small ventral impression
upon the dural sac, mildly narrowing the subarachnoid space.

C4-5: There is disc space narrowing with posterior endplate spurring, and associated
posterior disc herniation. There is also prominence or buckling of the dorsal ligaments
contributing to severe stenosis of the spinal canal. There is bilateral neural foraminal
stenosis. There is abnormal hyperintensity within the spinal cord parenchyma.

C5-6: There is disc space narrowing, and there is a posterior disc herniation more
prominent to the right of midline, compressing the right anterior aspect of the spinal cord
and likely impinging upon the ventral nerve roots. There is moderate stenosis of the
right neural foramen and mild narrowing of the left neural foramen.

C6-7: There is disc degeneration with disc space narrowing and a broad posterior disc
protrusion narrowing the subarachnoid space.

IMPRESSION:
1. Severe spinal canal and neural foraminal stenosis at C4-5 with spinal cord edema.
2. Prominent right posterior disc herniation at C5-6 and other degenerative changes as
above.

My nuerosurgeon told me that if i didnt have surgery that i would be paralized from the neck down. so i had it done. i woke up from surgery and could hardly walk. my legs shook so bad i could not stand, but they sent me home anyway.it took me a month to be able to walk half way normal but the tremors and extreme wide gait on left was still there. at my next post op check up i told the doctors assistant, (who was surgery assistant) about my hands and shoulder pain coming back so he sent me for another MRI.FINDINGS:

The patient is status post anterior interbody fusion at C4-C5 and
C5-C6. The patient has undergone partial corpectomies from the previous study.
The central canal is patent at these levels of surgery, as are the lateral
recesses and neural foramina. There are some changes of myelomalacia involving
the cord at the C5 level, similar to the previous study.

There is posterior spondylosis at C3-C4 that is causing thecal sac effacement.
However, the cord is not deformed. The lateral recesses and neural foramina are
widely patent at this level. Similar findings are seen at the C6-C7 level.

C2-C3 and C7-T1 demonstrate widely patent central canals, lateral recesses, and
neural foramina. There are no perivertebral abnormalities.

IMPRESSION: The patient is status post anterior interbody fusion at the C4-C5
and C5-C6 levels. The central canal and lateral recesses are patent at these
levels. There are some persistent changes of myelomalacia involving the cord at
C5. No significant neural compressive abnormalities are present.

i went to a sleep doc and he said i now have Clonus, Hoffman’s Reflex, Hyperreflexia, babinsky, restless leg syndrome, sleep apnea, and wide gait in walking. i dont understand why all of this came on AFTER the surgery when i didnt have it before surgery.

The Neurosurgeons assistant told me that none of my symptoms have anything to do with the surgery and that there is something else wrong with me. I am so confused and scared of everything i have read about these findings. i still cant feel anything in my hands and the pain is excrusiating.

Now after going to have a leg EMG that was negative and xrays of lumbar region that were also negative now they want to send me to a new neurologist to check for Multiple Sclerosis. no one seems to know what is wrong with me.
I have been on cymbalta, and gabapentin with no help, so after all the second checking the leg EMG doc suggested Baclofen. so now i am on that too. It does seem to help the tremors but the pain is still there. can you help at all.

[Donald Corenman, MD, DC]

#22651

Your symptoms of “pain started down my arms and hands and then i ended up with temporary paralysis of my arms” sounds like a central cord syndrome. This makes sense with the MRI findings of “C4-5: There is disc space narrowing with posterior endplate spurring, and associated
posterior disc herniation. There is also prominence or buckling of the dorsal ligaments
contributing to severe stenosis of the spinal canal. There is bilateral neural foraminal
stenosis. There is abnormal hyper intensity within the spinal cord parenchyma”. You have severe compression of the spinal cord with injury to the cord. See “https://neckandback.com/conditions/cervical-central-stenosis-and-myelopathy/

You need to demand a surgical consult. No more tests should be needed other than a good physical examination. Do not let your current physicians continue you down a non-surgical path.

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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