I would like to ask for your help and opinion. These are my MRI results:
I will give the important hightlights.
Thoracic - done 4/10/09
T1/2 thru T4/5 right paracentral disk bulging seen with impression the the ventral thecal sac.
T7/8 right-sided posterior disc herniation seen impressing the ventral thecal sac.
Cervical - done 10/29/08
C3/4 posterior disc bulge with ventral cord abutment, central canal stenosis, left sided uncenate productive change, and left foraminal narrowing.
C5/6 disc adjacent osseous vertebral reactive edema with posterior disc herniation, uncinate productive change, central canal stenosis, ventral cord impression and narrowing of the left foramina
C6/7, posterior disc herniation is seen with central canal stenosis, ventral cord impression and bilateral foraminal narrowing.
As far as the cervical injuries go I received 2 epidurals in the last couple of months with pretty good results but the symptoms are returning. pain, radiculopathy, paresthesias
In the beginning of march I experienced severe muscle weakness in my legs with paresthesias in my outer lateral sole of right foot, groin, right buttock, left anterior thigh. the muscle weakness relented and now I am able to walk about 20 minutes before I have to sit down. My legs feel stiff, clumsy and sometimes like they are not mine.
Like I said thought they are somewhat better but muscle strength has plateau. No bowel or bladder issues so far.
I am having a brain MRI done thursday for possible pathologies. I have migraines (probably from the cervcial stenosis), word finding problems, paresthesias, muscle weakness with muscle aches in legs, seem to now have what would seem to be like RLS.
I know this is alot, I have an orthosurgeon, now a new one who I think is better and am to see a neurologist next week.
Finally my question. Do you think the injuries in my thoracic area could be causing the muscle weakness, paresthesias in the lower extremities and groin, buttock? I realize the cervical report seems worse however when I found out about those injuries i didnt have the lower problems just what you would expect in the neck, upper back, arm hand etc., BUT NOT LEGS.
thank you so much any opinion or input would be appreciated.
Sorry for the delay in responding --- I was out of town for the Easter holiday.
I think your leg problems are more related to the disc degenerative changes in your neck as the nerves exiting from the spinal cord at higher levels will supply the lumbar region.
The reason you might have had delayed symptoms refers to the length of time your cervical spinal nerve roots have been compressed and the extent of involvement of the spinal cord.
As the length of time increases, the severity of the symptoms increases as well
The thoracic changes seen on your MRI show some impression of the thecal sac (nerve root endings contained in a sac outside of the central spinal cord.) but no direct spinal cord involvement as seen in the cervical spine.
I believe your brain MRI is scheduled for tomorrow. I don't think they will find any significant abnormalities. My educated guess is the majority of your symptoms are related to your cervical spine.
Keep me posted -----
first of all thankyou for your prompt response and good infomation and I hope you had enjoyable easter weekend!
I just wanted your opinion as to why do you think both of my ortho surgeons did not suggest that the cervical area was the culprit regarding my bilater lower extremity motor weaknes and paresthesias? Those surgeons, they just look and the films and I dont believe they look at the radiologist reports. I know they should be able to see these things themselves, after all they're surgeons but it makes sense if the cord is being pressed on that these symptoms would occur. It makes me lose my confidence. I am happy I had the thoracic MRI though at least I know what is going on there for future reference. My cervical area has been receiving tx from chiro, heat, tens, massage, at home traction since 10/08. Also have had 2 epidurals. IS it really possible the ortho's dont see the cord inolvement and it just looks like the herniation is touching the thecal sac?
Do they need to read the radiologist report?
I can walk about 20 minutes before my legs become spastic, clumsy and weak, by the way my deep tendon reflexes are normal.
I am very frightened with all of this, i'll tell you.
My first surgeon wanted to operated on my L5/S1 herniation that isnt pressing on anything! He is so eager to cut!
I am going to my new ortho who has also seen my cervical films and ordered the thorasic. Perhaps I should insist he look at the cervical radiologist report from october whether I offend him or not. Time is wasting. Do you think the thoracic herniation could cause any problems? I have some pain over the right flank area from time to time.
Is there any chance of permanent damage to me (like my walking would remain limited permanently)? I am so sorry for all the questions and request for speculation from you. I realize its impossible for you to predict everything, but your imput is appreciated once again. After this I will give you an update ater I see my surgeon on monday and that will be after i have my brain MRI also.
thanks!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! bless you
I can't speculate why the ortho surgeons are not identifying your lower extremity issues with the cervical spine. I do believe a neurosurgeon would come to that conclusion as they are more versed in neurological changes and the impact of involvement of the spinal cord. Hopefully this new ortho is a little more responsive. I imagine that the prior surgeon did not feel it was related because your symptoms were not so severe as to be life-threatening. There is a difference between cervical radiculopathy versus cervical myelopathy and the dividing line is sometimes a bit blurred.
I don't think you are in any danger of permanent damage or other problems with your current activity level. Just be cautious and try and avoid any potential risks for further injury such as a fall.
Let me know what the new doctor says ---
P.S. I did have a very nice Easter. Met friends and family in San Juan Capistrano for a champagne brunch and it was a beautiful day!
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