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Neurology (Expert Forum)
cervical stenosis causes numbness in legs? Surgery question
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cervical stenosis causes numbness in legs? Surgery question
by dkidd, Mar 25, 2003 12:00AM
Diagnosis from MRI: "C6-7 severe disc disease with endplate fatty marrow changes and spondylosis. Positional cord impingement ventral cord, which is flattened. Neural foramen mildly narrowed. C5-6, mild midline dic protrustion with positional cord impingement."
I am very grateful for response I got 2 weeks ago, but still have questions. Physical therapy, namely traction, has helped somewhat. Hand numbness & loss of sensation persists. Is it my imagination or can this effect my walking? I seem to be taking smaller steps, and not feeling as coordinated. Physical therapist said that would ONLY be in the case of lumbar problems, which I do not have.
I'm almost done with therapy. If my shoulder/neck pain is better (which it is slightly) yet I'm still weak in the arm and hand, with numbness and tingling, and slight leg sensations, will this still be indication for surgery? Basically, to look at me, I appear fine--not screaming in agony by no means. By my MRI report, would the surgery be a one level, or two?
Should I wait until it gets worse? I feel like I'm not in "enough pain" to warrant surgery. I've had this for 5 years, but only in the last several months had the numbness and weakness. I'm very conflicted, and know my neurosurgeon will "leave it up to me". Sorry to be asking again for reassurance and advice.
I am very grateful for response I got 2 weeks ago, but still have questions. Physical therapy, namely traction, has helped somewhat. Hand numbness & loss of sensation persists. Is it my imagination or can this effect my walking? I seem to be taking smaller steps, and not feeling as coordinated. Physical therapist said that would ONLY be in the case of lumbar problems, which I do not have.
I'm almost done with therapy. If my shoulder/neck pain is better (which it is slightly) yet I'm still weak in the arm and hand, with numbness and tingling, and slight leg sensations, will this still be indication for surgery? Basically, to look at me, I appear fine--not screaming in agony by no means. By my MRI report, would the surgery be a one level, or two?
Should I wait until it gets worse? I feel like I'm not in "enough pain" to warrant surgery. I've had this for 5 years, but only in the last several months had the numbness and weakness. I'm very conflicted, and know my neurosurgeon will "leave it up to me". Sorry to be asking again for reassurance and advice.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Mar 25, 2003 12:00AM
Please keep in mind that I cannot give an accurate medical opinion without personally reviewing your MRI and examining you. What I can say is that you certainly can have spasticity or increased tone in your legs with severe cervical spinal CORD disease. This means the disc can't just be compressing the nerves coming out from the spinal cord and travels through the foramina (bony canal), but it has to be actually pushing on the spinal cord which runs from your brain to your lower back. The spinal cord carries motor information down the back from your brain and then nerves exit the spinal cord to supply the muscles in your limbs. If the information gets cut off due to the spinal cord being pushed on by something, this tends to affect everything below the area where it's cut off which in the case of cervical spinal cord disease would include the legs. Now again, without seeing your films, i cannot say whether or not this is your case.
Whether or not to have the surgery depends on a lot of factors such as age (younger with better chance at recovery), coexisting diseases such as diabetes or heart disease which can increase the complication rate, and current condition. Usually if there's documented weakness and pain, and the patient doesn't get significantly better with conservative therapy, I tend to favor surgical options. An EMG can also be helpful in characterizing degree of nerve damage and can sway me towards or away from surgery depending on what I find. If you feel that you're not in "enough pain," then it may be ok to postpone surgery. However, the weakness and sensory changes you have now run the risk of becoming permanent if they aren't already. Talk to your neurosurgeon and look to them for guidance. If you aren't getting much feedback, consider a second opinion from a nother neurosurgeon and see what they recommend. SUrgery is not a thing to be taken lightly and I do understand your concerns. Guidance from your attending physicians should be helpful. Good luck.
Whether or not to have the surgery depends on a lot of factors such as age (younger with better chance at recovery), coexisting diseases such as diabetes or heart disease which can increase the complication rate, and current condition. Usually if there's documented weakness and pain, and the patient doesn't get significantly better with conservative therapy, I tend to favor surgical options. An EMG can also be helpful in characterizing degree of nerve damage and can sway me towards or away from surgery depending on what I find. If you feel that you're not in "enough pain," then it may be ok to postpone surgery. However, the weakness and sensory changes you have now run the risk of becoming permanent if they aren't already. Talk to your neurosurgeon and look to them for guidance. If you aren't getting much feedback, consider a second opinion from a nother neurosurgeon and see what they recommend. SUrgery is not a thing to be taken lightly and I do understand your concerns. Guidance from your attending physicians should be helpful. Good luck.
especially bad at C3/4. I have had symptoms in the arms and
hands in the past, but those have stopped. My biggest concern
is with buring, numbness and tingling in my feet. Neurologists
have told me that there is not likely a connection with the
cervical stenosis, but it is strange to me that the symptoms
started at about the time the stenosis was diagnosed.
Can anyone tell me of a similar symptomology?
Thanks for your help.
Perry
I'd love to know how your numbness and hand/arm sensations "stopped". If mine could stop, maybe I wouldn't require a fusion! All I'm reading and hearing is that once the cord compression causes myelopathy, you can't reverse it without surgery, and that surgery can only reverse it if it hasn't gone on too long. This is pretty much also what the dr. responded to me, above.
Did your symptoms fade on their own, through a therapy, or what? Was it numbness and weakness?
some numbness and tingling in the fingers of my left hand (ring
and small finger) and pain in the left arm. Have had weakness
in both arms on occasion, but all that has pretty well gone away.
As mentioned before, the burning, tingling and discomfort in my
feet are my main concern. Please don't let my experience keep
you from surgery if that is what you need. I am also contemplating surgery because of the awful way my MRI looks.
However, it's doubly hard to go in for surgery when the classic
symptoms of cervical myelopathy have abated and been replaced by
something most people are calling peripheral neuropathy.
Let me know what you decide.
Perry
I am a 32 year old male who has had a lower fusion with instramentation on my lowerback back in 1997. The vertabra area was on L-5 vertabray.
In my surgury back in 1997 the used steal screws and a metal cage to help aid with my fusion.
After my surgury I had no numbness in my legs untill this year when I re-injured my back doing some prying at work.
I went to see my doctor about this matter and he did a MRI on my lower back.
The MRI came out to be negative.
I am still having numbness in my legs on the outsides of my thighs and on the top of my knee's. Every once and in a while I would have a sharp pain on my left outside of my thigh.
The pain never goes past my knee.
What I am wanting to know is there any other test that I can have done to check to see if I have a problems with a pinched nerve or bulging disk in my back.
My doctor will not do any more test on me other than the MRi that he did a few weeks ago.
I have good insurance, but trying to get a referal is sometimes hard to do.
I just want the numbness to go away, but so far it has not.
It seems like it gets worse the more worn out I get from work.
Also do you think that with me haveing steal in my back that this can be casuing me the numbness and slight pain.