Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: DeQuervain's & numb fingers post C4-5 fusion
Forum: The Neurology and Neurosurgery Forum
Topic Area: Strain Injury
Posted by CCF neuro MD MM on November 29, 1998 at 19:48:01:
In Reply to: DeQuervain's & numb fingers post C4-5 fusion posted by jk on November 29, 1998 at 16:30:00:



I am 6 wks post-op revision surgery of C4-5 fusion with plating. In Mar/Apr '98 I had 2 injections in R wrist for DeQuervain's. At the time, I suspected my neck was causing the wrist symptoms. In July, '98 I had first C4-5 acdf. Until about 1 wk ago, my wrist had not bothered me since the 2nd inj. I also have transient numbness in my ring and pinky fingers on the R. History of R lat epicondylitis and radial tunnel release in June, '97.

Having physical therapy 3x wk for the past 2 wks., consisting of heat, mild stretching exercises for shoulder and trapezius, chin tucks and shoulder rolls.

Are these wrist/finger symptoms likely caused by nerve compression in the cervical region? Would a new MRI be advisable? jk



The only symptoms you actually describe are numbness in the ring and pinky
fingers, this area is supplied by the ulnar nerve, and compromise of the
nerve causes numbness in exactly the area you mention.
The ulnar nerve can be damaged anywhwere from its origon in the neck,
(lower cervical T1 level) to the level of the palm of the hand.
Surgery at the level you mention would not compromise the ulnar nerve so the
problem may be more peripheral ( unless you have a separate disc problem
lower in the cervixcal spine ).
You have had sufficient priblems in the wrist area to cause damage down
there also. I would think the ideal test would be to do an EMG
examination to localize the problem along the course of the ulnar nerve
The MRI will only assess the neck, and depending on this result proceed
to MRI if there are indications that the problem is in the neck.

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