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I correctes myself after i m learning more a bout what is normal speed of velocity in some ranges.
In the upper (arms its range from 50 to 65 m/s velocity)
So this my wrong (and i m learning and corrected myself)
“L PERSONAL EDB .FIB HEAD ANKLE 46 m/s
Pop fossa fib head 44 m/s
R tibial-AH POP FOP FOSSA ANKLE 43 M/S
L-TIBIAL -AH POP FOssa ankle 42 m/s”
—-so this sentence i write in last post (in this topic) was wrong because from legs more than 40 m/s its normal range.
So NCT test show problem in SNC BUT NO. IN MNC (and this could contact to compress by posterior (i read in one good website this information,that compress by anterior effect on the motor nerves control and posterior effected on the the sensory .
I read this :
I read this :Normal impulses in peripheral nerves of the legs travel at 40–45 m/s, and 50–65 m/s in peripheral nerves of the arms. Largely generalized, normal conduction velocities for any given nerve will be in the range of 50–60 m/s.
So if i see this number
But in sensory nerves in median R and L
Was see velocity L median 44 and R 46
Peak lat ms L M 4.01 and R 3.91 .
This SNC TEST.
Also the nerologic conclusion the results writing also have some problems in sensory in legs (but thia information i not steel clear-maybe over days i will understand)

And i read that pressure from posterior effected on the sensory nerves .
And on anterior its effect on the motor nerves control.
What i see is little pressure (in very little area on the spinal CSF from posterior i posted in early topic
And this can be confirmed with the test of SNC .
I also feel symptoms with (what i left legs heavy )+some numbness in legs
Difficult to walking fast (max arrived to 120 steps in minute (i checked this morning and hold this speed just for 1 minute and hard me to hold this walking fast more than this minute(its arrived to calculate to 5.7-6 kmp (in past i remember when i do walking fast its arrived to 7 7.4 kmp and i do this for 20 minutes .
Other physical examination was normal
Heel to heel normal
Walking in dark room normal
Babinski negative
Clonse ankle negative
(Little finger escape just from time to time just in left side .(when i m extension the hand )

But i m feel progress of my sensation in my legs and feet (even i m not stumbled when i walked (something its happened even if it’s very little.
When i m dressed my pants its more slowly.
They feel of heavy legs start before 2 mount (when i remember and this was in continue in 2 weeks and after its hold
But now i feel the heavy of legs also with (little pain in the legs little needles in knees (in right legs)
(I read the sign of myelopathy in c s he have steps of one (and this hold for few times (maybe mounts or more and boom its Go to next level ).
I have chronic neck pain in the back of the neck .(this was developed and not very feel before 4 or 3 years its arthritis i think i developed FROM degenerative disc diesase)
Aching in back of the neck.
Noise when i moves the neck(this was also sign in past)
Thanks for your attention
*I m contact your office to get the service L C D (I and wait for your office respond to my q a bout this service)!
Thanks

Thank you for your reply Dr Corenamn.

I am waiting to see the Pain Management Consultant, but here in the UK the wait is generally long.

My MRI scan done in November 2019 showed acute effusion in both cervical and lumbar previously operated segments. Also that there is extensive degenerative spine disease along the whole spine.

Could you pleases explain what ‘acute effusion in both cervical and lumbar previously operated segments’ means?

My next appointment is in September 2022 and will be another telephone appointment, so it won’t be possible to have a thorough physical examination.
I suspect that the neurosurgeons will leave me until I need to have surgery urgently, as there is such a long list and backlog due to Covid stopping elective surgeries.

Thank you for your reply Dr Corenman.
I have now had a telephone appointment with another of the registrars of the consultant that I am under. I deal with a different one at each appointment, so neveer know how much of my file they have read and there isn’t time to go through everything during the appointment, which is 15 minutes long, because we are talking about the whole of my spine.

This latest neurosurgeon said again, several times, that doing surgery on my spine would be “extensively complicated and invasive”. He also said that “any surgical intervention on my spine would be associated with significant morbidity and would not guarantee reversal of symptoms and could make them worse. In fact, there is no surgical target for the back pain.” He said it would be a last resort and is sending me to Pain Management to try spinal injections. I was referred for this in August 2019, but by the time my name got to the top of the list, I had one appointment but the Covid shutdown happened, so I never moved on to have the Medial Branch Block injections he wanted to do to check which levels were pain generators before doing Radiofrequency Ablation there. I am still waiting to receive a reply to a letter I have sent asking to move forward with my treatment.

I now have numbness in the little finger and half the ring finger on my left hand, that doesn’t go away. Sometimes it is worse than others, but it never completely goes away. The neurosurgeon said he wasn’t worried about this because the EMG/nerve tests I had done a year ago didn’t show any evidence of left ulnar neuropathy. I hope he is right. My Mri report done in November 2019 states there is right exit foraminal narrowing at C4/5 and C5/6 and minimal left exit foraminal narrowing at C6/7.Flexion and extension cervical x-rays done in November 2019 showed a grade 1 anterolisthesis of C2 on C3 which reduces slightly on extension.

The MRI report from November 2019 mentions there are small disc osteophytes (?) in the mid and lower thoracic spine as noted previously in 2018. These are at T12/L1, T8/9, T9/10 and at T2/3.
It also says there is straightening of the lumbar spine and minimal retrolisthesis at L2/3. It also says there are disc-osteophytes noted at L2/3, L3/4 and L5/S1 levels.
I asked him if the straightening of my lumbar spine was going to be a problem because I suppose the spine isn’t loaded correctly now. He said yes it would and that it would be part of the reason I was in pain.

He also mentions that my MRI scan done in November 2019 showed acute effusion in both cervical and lumbar previously operated sigments. Also that there is extensive degenerative spine disease along the whole spine.
They will have another telephone appointment with me in 12 months time.

Dr Corenman, I would be extremely grateful if you could comment on this, especially the points that I have put in bold. I know that there is a lot here, sorry.

Good morning Dr. Corenman,

I’m still dealing with bizarre issues and its become to the point where I don’t know what to do next. I’ve had Botox injections in traps a month ago and some of spams improved and within 2 weeks its back to pre injection status(Botox should give 6 months?). Also during the past 2 weeks I’ve been utilizing a NMES, IFC and Tens combination unit for a minimum of 4 hours a day and still my back of neck is hard like a rock. I’m also in my 9th week of physical therapy and no improvement. The therapist’s all tell me my traps and scalene muscles are all extremely tight.

All I’m told is there’s some residual foraminal stenosis, even after decompressive ACDF’s, laminectomies, facetectomies, foraminotomies and I was fused in a kyphosis at C7/T1. Can C7/T1 kyphosis cause severe spams in traps? thanks

Hello Dr. Corenman,

I spoke to my neurosurgeon and he mentioned what can be done is to add instrumentation from C5, so that there will be instrumentation from C5 to T3. He would add bone graft to help make things more solid. What he explained is, after laminectomies (C3-C7), medial facetectomies (C5-C7) and foraminotomies (C5-C7), it can weaken spine and cause instability. The ACDF’s (C3-C7) and partial Corpectomy (C7-T1) are solid and nothing needs to done from an anterior spine perspective.

What’s your thoughts on this, I want to make sure I ask around before committing? Are all instability issues usually seen on scan’s i.e. flexion\ extension or are some based on clinician’s judgement? Thanks again