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Carpal Tunnel,Cubital Tunnel,Radial Tunnel and Cerival Disc Disease???
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Carpal Tunnel,Cubital Tunnel,Radial Tunnel and Cerival Disc Disease???


Dear Doc,
I'm a female, age 45, good health( I thought so) with some problems that seem to be never ending.. I had Carpal Tunnel surgery on both hands in Aug.& Sept. of 99. Emg showed moderate to severe, and I can say they were bad. I couldn't even hold the steering wheel without having to shake and rub them, they hurt that much. Recovering from surgery, my right forearm had so much pain I couldn't even pick up a cup of coffee. Doctor scheduled surgery for Lateral Epicrondylitis and Radial Tunnel. Before surgery I was working,(I'm a machine operator) I started getting terrible pain in my neck and right shoulder. MRI showed:  
C3-C4 Small central dics herniation.This does result in deformity of the cervical spinal cord. Also narrowing of the right C3 and C4.
C5-C6 A moderate size disc herniation. Broad based but most prominent in the right paracentral region. Mild stenosis and cord deformity.
C6-C7 Mild disc bulging without spinal stenosis or cord deformity.
I have seen a neurosurgeon, who said I need surgery.
It's complicated due to the fact the first 3 surgeries were Workers Comp. They denied the cervical disc problem.
Now I have a ulnar nerve injury(left elbow) and original Doctor(surgeon) wants to do ulnar nerve surgery.
Workers Comp. is also fighting this surgery saying it must be something in my system that is causing all these nevre entrapments. All I want to do is feel good again. And figure out what is causing all of this. Would the cervical surgery help with the nerve in my elbow? Any input on my situation would be extremely helpful. Thank you.
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Avatar_n_tn
Dear Donna:

Sorry to hear about your problems.  Repetitive injuries are very common and I am sorry that you seem to have most of them.  I have not heard of radial tunnel or cubital tunnel syndromes, so I can't really comment on these.  Cervical cord lesions can cause hand and arm problems but the EMG and neurological examination and history should have indicated if your carpel tunnel was in fact not carpel tunnel but a C5/6 lesion.  Furthermore, the ulnar entrapment or pressure lesion on the left should have also been diagnosed on EMG.  I would think you will have a very difficult time convincing the workers comp people that your cervical lesions are induced by your job and not degenerative disease as lesions in this area are so common.  They also likely have the EMG reports and your lesions may not be central (spinal) but peripheral or true carpel tunnel and ulnar entrapment.  Whether or not to have cervical surgery, is alittle difficult to say as I have not seen the films etc.  I would get another opinion because as you likely know, this type of surgery is prone to having complications and poor outcomes.
If the EMG and neurological examination suggest that your ulnar problem is peripheral and not central, then cervical surgery will have little impact on the ulnar injury.

Sincerely,

CCF Neuro MD
3 Comments
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Avatar_n_tn
Donna,

I had bilateral carpel tunnel surgery on both wrists this year(left-Jan, right-April). During my ot, the therapist told me it appeared that I had ulner nerve problems as well as trigger finger in both hands as well as carpel tunnel.  She wrote this down on my chart; however, my surgeon dismissed the therapist's findings. I believe this is due to his original diagnosis to worker's comp. Therefore, he wasn't going to treat anything else.  I have been told that my factory days are over.  I am going through voc rehab. I have swelling and pain anytime I do anything major for an extended amount of time.  Nobody seems to be able to figure out why.  I guess they aren't considering the possibility of more damage than just carpel tunnel either.  If I were you, I would fight worker's comp till the end.  I made the mistake of trusting my surgeon's opinion.  Actually, 5 different doctors have told me pretty much the same thing.  I do not have all the problems with my back that you appear to have; however, I do know that where I worked, alot of the machine operators were in bad shape.  Alot of their problems sound like your's.  So,that tells me that your problems might very well be due to your job..........KEEP FIGHTING......GOOD LUCK........GOD BLESS.
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Avatar_n_tn
Gee...sounds familiar...I'm a 43 y/o female and had ACDF surgery in Feb 2000 for herniated disks and cervical spondylosis at C-4/5/6.  After my surgery, I still had all the old aches and pains in my neck and shoulders, and now have another herniation at C-7.  I was also diagnosed post surgically (as per EMG) with have Carpal Tunnel Syndrome and Cubital Tunnel Syndrome (ulnar nerve damage) to my left arm/hand.  

I'm not sure if it is caused from a repetitive stress injury (I am a flute player) or more due to my cervical disk problems.  I don't even know what to do anymore since I don't want another surgery.  I really do believe my arm and hand problem is more due to the C7 disc herniation as that nerve also supplies the arm.  The pain and numbness/tingling in my left arm/hand seems to flare up when my neck and shoulder does.  I also have undiagnosed problem with the left hip/leg...in other words the whole left side of my body hurts.  I am sick of going to different doctors, all who deny the neck has anything to do with the arm/hand or hip problem.

Good luck in your quest!

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