Donald Corenman, MD, DC
Moderator
Post count: 8427

You have symptoms of intermittent hand numbness and paresthesias, intermittent leg “stiffness” and some loss of strength and some symptoms in your neck (pain and stiffness). On physical examination, you have an increased deep tendon reflex of the left knee as your only long tract sign. Your MRI notes flattening of the cord with an increased signal at C6-7.

There are some findings that concern me. The degenerative disc at C6-7 can cause neck pain and stiffness as well as bilateral shoulder ache. Those symptoms by themselves are not too concerning. Flattening of the cord can be a significant sign but the signal change in the cord is the most worrisome finding.

Normally, signal change in the cord is from injury. The space available for the cord changes with neck positions. The spinal canal gains 20-30% in volume with flexion (bending the head forward) and narrows by the same with neck extension (bending the head backwards). If you have had a prior fall or head impact that caused forced extension, this could cause subtle cord injury. Even repeated extension without a fall can cause cord compression.

The symptoms of leg stiffness and lack of leg strength could also be from myelopathy. I think a consult with a good spine surgeon is called for. Try to avoid activities that put your neck at risk prior to this consultation (horseback riding, mountain biking, skiing, rock climbing).

Dr. Corenman