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in reply to: Ulnar Nerve Compression #29943
Can a posterior foraminotomy be performed bilaterally at the same level with a single incision or does it require two separate incisions for each side?
in reply to: Ulnar Nerve Compression #29864I have decided to perform a foraminotomy at my right C5-C6 level. The stenosis on the right side is severe, and I want to maximize the likelihood of regaining strength I lost in my right hand.
I also have mild stenosis at my left C5-C6 level. And I was thinking of using the operation as opportunity to address stenosis on both sides. If I was not doing foraminotomy on my right side, I would not opt for foraminotomy for the left side as I don’t think the left side is severe enough to warrant surgery.
Is it common to perform foraminotomy on one side and use conservative methods (steroid injection, for instance) to treat stenosis on the left side? How have you handled similar situations where one side has severe stenosis and the other mild?
in reply to: Ulnar Nerve Compression #29856Thank 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?
in reply to: Ulnar Nerve Compression #29830Apologies 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.
in reply to: Ulnar Nerve Compression #29829Lastly, 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.
in reply to: Ulnar Nerve Compression #29828I 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 stimulationThe 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. -
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