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Neurology (Expert Forum)
Please advise, stenosis better, but not enough to avoid surgery?
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Please advise, stenosis better, but not enough to avoid surgery?
by dkidd, Jun 27, 2003 12:00AM
Dr., you helped me a few months ago, when my C6-7 symptoms were worse and advised it is probably surgery time. My March 03 MRI said: Scoliosis of cervical spine. Severe degenerative disc C6-7 with endplate fatty marrow changes,spondylosis,and positional cord impingement ventral cord, which is flattened. C5-6: Mild central disc protrusion with central positional cord impingement and concavity ventral cord.
I've had this for 5 years. Did phys. therapy, which helped pain, but I still have finger numbness. Hands go numb at night, tingle during the day. Because right hand can be tapped at median tunnel and fingers go numb, my neurosurgeon had me do an EMG to see if we were dealing with "double crush syndrome" & CTS. EMG was negatiave for CTS or any radiculopathy, which is weird becuase obviously I have cervical problems. Now dr. has me on a month of Celebrex and wrist splints. My hands still go numb off and on.
Pain is better &intermittent. But I still have numb fingertips off and on, forearm weakness. Loss of grip. I walk alittle funny, but I'm thinking I'm "used to these symptoms", and can live with them. However, I still don't want permenant damage. Since I got alittle better, is it enough? Or should I go ahead with surgery since the nerve symptoms seem to be the ones of concern, moreso than pain or absence of it? Please advise me, I feel like such a baby for needing this reassurance, but I don't feel like I'm "in pain", so would I need a fusion? Also, what are "endplate fatty marrow changes", and please address the cervical scoliosis.Does fusion help it?
I've had this for 5 years. Did phys. therapy, which helped pain, but I still have finger numbness. Hands go numb at night, tingle during the day. Because right hand can be tapped at median tunnel and fingers go numb, my neurosurgeon had me do an EMG to see if we were dealing with "double crush syndrome" & CTS. EMG was negatiave for CTS or any radiculopathy, which is weird becuase obviously I have cervical problems. Now dr. has me on a month of Celebrex and wrist splints. My hands still go numb off and on.
Pain is better &intermittent. But I still have numb fingertips off and on, forearm weakness. Loss of grip. I walk alittle funny, but I'm thinking I'm "used to these symptoms", and can live with them. However, I still don't want permenant damage. Since I got alittle better, is it enough? Or should I go ahead with surgery since the nerve symptoms seem to be the ones of concern, moreso than pain or absence of it? Please advise me, I feel like such a baby for needing this reassurance, but I don't feel like I'm "in pain", so would I need a fusion? Also, what are "endplate fatty marrow changes", and please address the cervical scoliosis.Does fusion help it?
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jun 30, 2003 12:00AM
It's not unusual for the EMG to be normal in the setting of known cervical disease especially if there is no weakness (only sensory nerves affected) and if the problem has gone on for over a year. As for surgery, this is a decision that you will have to make with your surgeons. Keep in mind that it's not a guarantee that the pain/symptoms will go away after surgery even if there are no complications. This depends partially on the degree of damage and how long the nerve was compressed. Not enough info on the scoliosis. But if it's mild then it doesn't need to be fixed. If it's severe, more extensive surgery than just removal of disc and a simple fusion may be needed. Finally, the endplate changes are just age-related changes that are part of the normal wear and tear of the spine. As we get older, the bone marrow just gets replaced by fat. Not a big deal.
