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I agree completely. That makes a lot of sense.
So according the my doc, I do not have myelopathy. Yippee! Yet I’m a candidate for an ACDF procedure? The pain is there, that is one thing I know for sure. I still plan to set up second opinion visits with other surgeons.
Thank you Dr. Corenman. Although, I think I exhibit myelopathy symptoms I need to make sure I hear it from my doc’s mouth. I need to ask him to define and to let me know if I have myelopathy.
What he has been saying is “at some point we need to decompress the cord/nerves” But not necessarily specific on staying whether I have myelopathy or the signs you mentioned previously.
Yes, I think I exhibit some signs of myelopathy:
Lhermitte’s sign – mild to moderate
Hyperreflexia – my muscles/extremities twitch all day long. The pins and needles sensations that was felt from head to toe pretty and much calmed down since September. Now parasthesias is limited to feet and hands.
Imbalance & incoordination – where symptoms were more acute summer 2011; but no more
No clonus or hoffman’s sign
The exact impression of the recent C-spine MRI stated stable alignment, multilevel degenerative spondylosis. There is increase in size of left midline disc extrusion at C5-C6 resulting in left ventral cord impingement.
The initial MRI about 10 months ago stated: C3-C4, C5-C6, C6-C7 disc herniations. C5-C6 mild to moderate stenosis. Mild stenosis at C6-C7.
A few weeks ago my neck was severely inflamed and swollen. I experienced pain, stiffness, shoulder and arm pain and numbness. And I was significantly weak.
I noticed the swelling about the end of Feb, but I figured it was a symptom of my right shoulder surgery (Jan 2012). And I would say most of March is when my neck stiffness and discomfort went from mild to moderate to moderate to severe.
My symptoms calmed down by the time March ended and I was back to experiencing mild neck stiffness and pain. Then the TIAs happened within the first two weeks in April only a few days apart.
I’m so confused. And the only other symptoms that have been pretty consistent is the numbness and tingling in both hands and feet.
Maybe I am getting better and I’m not realizing it. When my symptoms presented over 10 months ago, they were acute. Now my symptoms are chronic and I’ve been on relafen 1000mg QD. Fortunately, I can function and I’m dealing with my chronic symptoms. But is it safe to wait. Perhaps my symptoms will remain chronic and not necessarily get worse.
More importantly, if an ACDF cannot prevent future TIAs. Then I feel like I am back to square one. Whats the point of going through a major surgery that will put me somewhat out of commission for about 3 months and in therapy possibly longer. Thank you Dr. Corenman for this forum.
Thank you Dr. Corenman. I have to complete the blood work before I follow up. The results were already forwarded to my neurologist. So I assume this isn’t serious as I haven’t received a phone call to return to her office sooner than later.
The spine specialist stated he didn’t see any significantly large bone spurs that would potentially impinge the vertebral artery. But I should make sure to follow up with a neurologist.
Due to the recent C-spine, he is insisting on an ACDF. Which freaks me out. But I can only agree to this if it will decrease my risk of further TIAs/strokes.
Thank you again for reading and providing your feedback.
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