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Thank you Dr. Corenman you have provided me with a lot of clarity.
I have been reading the info on your site, “Walking Disorders – How Nerve and Joint Injuries Change Gait”:
“The foot lift is performed by the tibialis anterior and the upward hip is brought about by the gluteus medium contraction on the opposite side.”
I am wondering if it is possible that my left leg weakness is caused by the right side compression of L4 and possibly L5? (I first noticed the weakness after several training sessions of one legged squats with TRX.)
I have had the left leg weakness for almost four years; it is worse when I’m fatigued – that’s when I drag my toes and can literally trip over my own feet.
Neurologist’s Motor Exam 7/25/17: “She had weakness throughout the left leg graded at 5- except for the hip flexor where I would grade her at 4/5.”
To me, that looks pretty much unchanged from the first motor exam on 11/17/15: “She had weakness in her hip flexor on the left side graded at 4+ and the hamstring graded at 5-“.
Thanks again Dr. Corenman, I feel like I’m finally beginning to understand my options.
I have never had neck or back surgery. In 2015 neck and lumbar flex/extension X-rays were taken and no motion of C5-6 was mentioned only the spondylolisthesis of L4-5.
The first neurosurgeon I saw diagnosed severe cervical stenosis and said I was at risk of paralysis. He referred me to his partner for neck surgery; his partner ordered the x-rays and said I did not need neck surgery I needed L4-5 surgery. I was told that the cervical stenosis appeared severe until the dye was added (during myelogram) and then it appeared “moderate” (they had to tilt the table to get the dye past L2-3 and into the cervical spine.)
Could the L4-5 spondylolisthesis cause my left side weakness, clonus, clumsiness, etc., in addition to my right side sciatica? These symptoms have slowly worsened over the past three years.
I also have “near total collapse” of my L2-3 disc space with sclerotic endplate changes – would this be a factor (I have been told it is not.)
I am in St. Louis, Mo. Do you think I could get a definitive diagnosis at your clinic?
Thank you Dr. Corenman.
Thank you, Dr. Corenman,
My neurosurgeon showed me the MRI images showing spinal fluid surrounding the cord (although the white spinal fluid on the image looked pretty thin to me). His office notes state: “She does have spinal canal stenosis at C5-6, but with questionable impingement. In fact, on her recent myelogram CT study, there does not appear to be actual cord impingement.” He also stated he thinks there is a reasonable chance that the myelopathy is unrelated to the cervical stenosis. What else could be the cause?
CERVICAL SPINE CT WITH CONTRAST 7/12/17: “C4-C5: There is solid bony fusion across the left facets and the disc space without midline AP canal diameter narrowing. There is severe left and moderate to severe right foraminal narrowing due to residual uncovertebral and facet arthropathy. C5-C6: There is markedly sclerotic very hypertrophic endplate and uncovertebral changes. There is severe bilateral foraminal narrowing, slight retrolisthesis of C5 on C6 and severe disc space narrowing. There is moderate AP canal stenosis. There is some cord flattening/deformity. There is light retrolisthesis of C5 on C6. C6-C7: There is severe disc space narrowing and severe left ucovertebral arthropathy. There is severe left foraminal narrowing, mild right foraminal narrowing but no midline AP canal stenosis.”
You have my heartfelt thanks for your input; over the past three years I have had multiple MRI’s, two myelograms, x-rays and two EMG/NCS studies (EMG/NCS studies were essentially normal) but no definitive diagnosis.
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