lcanning

Thank you Dr. Corenman! I was not aware of the “retraction” injury possibility, I had not previously heard of. While I did not have contrast done with gadolinium in any post-op MRIs, I was given the following as part of the radiologist impressions as a part of 2 follow-up cervical MRIs done post-op, and also a CT scan that I had done when I first felt like something was becoming unstable. I put the snippets of the CT and 2 MRI’s at the bottom of this post.

One of the MRI’s seems to think there is no cord signal abnormality, one doesn’t weigh in on that aspect at all, and the CT scan seems to think everything is stable in terms of the vertebrae, but maybe contrast is needed to confirm signal issue? That said, the snippets below of those exams are a little confusing to me given how I still feel at the site where the surgery was done. If I roll over too fast in bed or my neck gets pressed on there, sometimes I get a rude awakening in terms of those shocks or a numb feeling for an instant in a leg, arm, etc.

My surgeon also did a “just in case” MRI a few days ago on 07 FEB 2018 and basically said, nothing has changed since your last MRI of your neck on 23 JAN. He also did some x-rays, including flexion position x-rays, but they were never even discussed, so I’m hoping that means there’s nothing there of note. Hence the polyneuropathy conclusion on his part and his sending me off.

With that. I am in a position now where I feel like I need to try to keep walking as much as possible rather than continue to lay dormant and afraid to walk around at all (which is what I’ve mostly been doing the past couple of weeks), but at the same time I do not want to hurt myself. To that end, neither my surgeon nor any physicians in the ER here have told me that I am in any immediate danger of serious injury from walking around the house as long as I avoid falling, etc. But it is certainly unsettling to have some of the symptoms I’ve been having the past 2-3 weeks and wondering what I should be doing, and if it is the right thing to stay out of the hospital, though I’ve taken myself to it about 6 times in the past 2 weeks out of a maybe too-healthy abundance of caution.

I am still relatively young and just want to stay on top of these symptoms before they become long term or permanent. I know time is of the essence with a lot of these issues especially if it is myelopathy, arachnoiditis, etc. I still test negative for Hoffman’s and Babinski’s and my gait is able to be totally normal as long as the swelling in my neck is contained before I try to get up. The problem I notice is that if I stand or walk long enough during the past couple of weeks, I feel what I would describe as a pressure / crushing sensation near the site of my neck surgery, and from that moment on, I seem to have about 10 seconds or less to sit down or I’m probably going to have an adverse event (fortunately, it hasn’t ever gotten to that point because I always seem to find a spot to get to by then). That said, even when sitting back down after one of those flare ups, proceeding to dragging my foot slowly across the floor can make my neck surgery site tingle. Or, lifting that same foot even an inch or two off of the floor during one of these flare ups causes pressure / tingling in the neck site as well. It’s bizarre.

While I admittedly haven’t done much rehab to strengthen the area around my neck surgery to this point, I’m not sure if rehab can offset whatever that sensation is, though I find it interesting that it never happened the first 8 weeks post-op. Is this the “retraction” injury possibility?

Every day is getting sort of scary, but every time I go to the ER here locally, I get sent home and told I have no imminent spinal emergency on my hands. That’s been my life the past 2-3 weeks, and while I would of course rather keep hearing that I am OK from every doctor, I don’t want to wait until that is no longer the case for me or them to act.

Is there anything else that could possibly be causing this in the way of “polyneuropathy”? Doesn’t seem to add up, I’m very much inclined to agree with you, Dr. And if you are correct, how would I force an ER to not kick me out? I feel like they are looking at it from an imminent paralysis situation and then ruling that out, and sending me home. I could of course be totally off base on that, but I’m starting to wonder given how many times they and now my surgeon has sent me home.

Thanks so much again for your expertise!

Sincerely,

Lucas C.

SNIPPETS FROM RECENT CT AND MRI RESULTS

From CT scan done 13 JAN 2018:

2. MILD DEGENERATIVE CHANGES OF THE CERVICAL SPINE MORE PROMINENT AT
C5-C6 AND C6-C7. NO HIGH-GRADE SPINAL CANAL STENOSIS OR NEURAL
FORAMINA NARROWING.

“THE VERTEBRAL BODY HEIGHTS ARE MAINTAINED. THE PREVERTEBRAL SOFT
TISSUES APPEAR WITHIN NORMAL LIMITS. THERE IS NO ABNORMAL SIGNAL IN
THE CERVICAL SPINAL CORD. THE VISUALIZED POSTERIOR FOSSA OF THE
BRAIN AND CLIVUS ARE UNREMARKABLE.”

From MRI done 23 JAN 2018:

Cervical vertebrae demonstrate anatomic alignment and normal bone marrow
signal intensity, without fracture or compression deformity..
Craniocervical junction and cervical spinal cord are normal in appearance.
Left hemilaminectomy defect at C5-6 and C6-7 with ill-defined T2
hyperintensity in the left posterior paraspinal soft tissues at this level.
There is trace fluid in the left C6-7 facet joint.