Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Radiculopathy questions I am a 37 year old male and am "currently" serving in the USAF. I suffered a femoral neck fracture in Feb 1992. Initially I was misdiagnosed as having a sprain. A week later I was correctly diagnosed with a "right valgus impacted femoral neck fracture." I was admitted and my hip was successfully pinned in the valgus position. In 1994 I began experiencing more than the usual discomfort. I consulted various physicians and was told my pain was due to atrophy. I was sent again to physical therapy (which never helped). Since 1995 my condition has deteriorated exponentially. Last year I was diagnosed with: 1. Limb Length discrepancy of the right leg, measuring 1.5 cm, stemming from a femoral neck fracture and resulting pinning Because of continuing pain and numbness in my lower limbs My doctor sent me to a neurologist. My neurologist ordered an MRI that showed I have mild rotary scoliosis and then performed a EMG nerve conduction study on my back and lower extremities. I was diagnosed with S-1 radiculopathy. Around Feb.1998 I began experiencing severe neck pain and numbness in my upper extremities. My doctor expressed concern and ordered an MRI of my neck this time. The MRI showed: I was sent for another EMG nerve conduction study. A neurologist performed the EMG nerve conduction study on my neck and upper extremities. I was diagnosed with C5-6 radiculopathy. My doctor suggested seeing a neurosurgeon. I explained my reservations about cervical spine surgery and that I wanted to explore other non-invasive treatment's first. My doctor eventually recommended a Medical Discharge from the military What exactly is radiculopathy? What should I be doing (or not be doing)? My neurologist said I shouldn't lift over 30 lbs. The air force will evaluate my medical condition and rate my "disability " accordingly. They will offer me a percentage and I must either agree with the amount or appeal. I really have no guidance to gauge an acceptable offer. I was just wondering if you could guesstimate a % I should accept. I believe I already have arthritis. What other future complications can I expect from the radiculopathies?
= We can definitely answer the question regarding the radiculopathy but without a chance to review the films and examine you we cannot give advice regarding the percentage you accept, that takes our involvement to a level which would not be appropriate for this sort of service. I would suggest that you see an independent physician who is experienced in dealing with the military and have him review your records and films to obtain guidance on this matter. Radiculopathy refers to damage or irritation of a nerve root which is causing symptoms in the distribution of the nerves which arise from that root. These symptoms are both motor and sensory, the sensory symptoms involve refered pain in the territory, ( called a dermatome)supplied by that root, this usually extends down a limb in a characteristic pattern if the neck or lumbo-sacral regions are involoved. The motor symptoms involve weakness of the muscles supplied by that nerve root and again a typical pattern of weakness is seen. Examination of a person with radiculopathy will reveal absence of the reflexes associated with the roots involved. As regards complications the process is usually not a progressive one ,unles the nerve compression is progressive, although you can expect any weakness in the muscles involved to continue. I would agree that you should avoid lifting heavy weights as any activity which strains the spine is likely to worsen the problem, this applies both to your work and exercise activities. You should continue to exercise however, ideally under the giudance of a physical therapist who can tailor an exercise program to your specific needs. | |
