[CaliFornia]

#29828

I did do a nerve test. And below are the results. I am having issues with my left side as well, and I’ve omitted that part from my question. Lastly, a hand/elbow surgeon determined last week that I do not have significant ulnar nerve or carpel tunnel issues in either hands.

SUMMARY
The motor conduction test was normal in all 4 of the tested nerves: L MEDIAN – APB, R MEDIAN – APB, L ULNAR – ADM, R ULNAR – ADM.

The sensory conduction test was performed on 4 nerve(s). The results were normal in 2 nerve(s): R MEDIAN – Digit II, R ULNAR – Digit V. Results outside the specified normal range were found in 2 nerve(s), as follows:

 In the L MEDIAN – Digit II study
o the peak latency was increased for Wrist stimulation
 In the L ULNAR – Digit V study
o the peak latency was increased for Wrist stimulation
o the peak-to-peak amplitude was reduced for Wrist stimulation

The needle EMG examination was performed in 7 muscles. It was normal in 3 muscle(s): R. DELTOID, R. TRICEPS, R. FIRST D INTEROSS. The study was abnormal in 4 muscle(s), with the following distribution:

 Abnormal spontaneous/insertional activity was found in R. BICEPS, R. BRACHIORADIALIS, R. PRON TERES, R. CERV PSP (L).

 Abnormal interference pattern was found in R. BICEPS, R. PRON TERES.

Impression: ABNORMAL STUDY
There is electrodiagnostic evidence for:
1) Acute on Chronic Right C6 radiculopathy.
2) Mild Left median nerve neuropathy at the wrist (CTS).
3) Mild Left ulnar nerve neuropathy at the wrist.

[CaliFornia]

#29829

Lastly, if my left hand grip strength is a 5, my right hand grip is 4.5. I am not having issues with lifting my right arm or noticeable weakness in my right biceps. The only weakness seems to be my right hand grip, index and little finger.

[CaliFornia]

#29830

Apologies for the multiple posts, an additional fact:

I am not having weakness in my right biceps or bending my arm at the elbow. In fact, I just lifted a 15-20lb weight with underhand grip to test my bicep strength.

[Donald Corenman, MD, DC]

#29832

Grip is normally lost due to either compression of the C8 nerve (C7-T1 level) or ulnar nerve compression at the elbow (or wrist). Weak grip with no loss of biceps strength would be surprising to be a C6 root although the EMG findings do support a C6 nerve root compression (” Abnormal spontaneous/insertional activity was found in R. BICEPS, R. BRACHIORADIALIS, R. PRON TERES, R. CERV PSP”).

If you have weakness but no pain in your arm or hand, a selective nerve root block cannot help to diagnose your current cause of weakness. I think a meticulous physical examination and a thorough reevaluation of your films and records would be the next step.

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.

[CaliFornia]

#29856

Thank you, Doctor.

In your YouTube video, you mention that a risk of posterior foraminotomy is instability.

Can you comment whether such risk of in instability is increased if the foraminotomy is done to both sides at the same level? And if so, what are the consequences of cervical spine instability?

[Donald Corenman, MD, DC]

#29860

Foraminotomy causing instability is increased with a bilateral approach at the same level. The foraminotomy is performed by removing 50% of the facet. Obviously, bilateral at the same level would remove the equivalent of 100% of one facet (it is not really as bad as that but does have some similar repercussions).

Spine instability causes a sense of unreliability with certain motions of the neck. In addition, sharp or impact motions can cause sharp pain and a feeling of “shifting” of the neck.

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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