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Cervical Myelogram
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Cervical Myelogram

I am a 44YO healthy, previously very active mother of 4. On December 13th, 1999 I had a cervical myelogram.  During the procedure the spinal cord was punctured and dye (omnipaque) was injected into the cord.  The contrast in the cord clearly shows in the films from myelo and CT scan.  I experienced excruciating pain at that time and the pain and numbness distribution has remained.  I experience numbness/shocking sensations/lack of temp. sensation and pain.  The areas affected seem to follow the C-2 path according to Neuro.  All on left side, upper arm, shoulder, (top and back) chest, neck throat face and back of head up to about ear level.  Since two weeks post-myelo I have new "buzzing" in right lower leg and the ring and little fingers on my right hand turn blue and are painful to touch. My Neuro has prescribed Neurontin which helps with the pain but the headache, numbness and faulty temp. meassages continue.  I have had a MRI with Gadolinium to rule out C2 lesion. I understand that this is a rare thing, my Neuro has only seen the cord hit and dye injected once. Do you have any expereince with or information on this type of cord trauma?  We are in a "wait and see" mode.  The 1200 gr of Neurontin is helpful, but if I miss a dose the pain breaks through.
The Myelo was done to rule out Cord compression at C5-6 level. My exams show "brisker than brisk" reflexes. I have a mild/moderate ruptured disc at the c5-6 level.  A MRI was done on Oct 26. In November had a EMG/NCT done showing Chronic cervical radiculopathy at C6-7.   The Post Myelo CT indicates nerve entrapment from bone spur on right side and retrolethisis at the C5-6 level.  I only include that info to help with determining my situation.  Lots of "things" going on.
Any information about my condition and outlook would be greatly appreciated.
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Dear Cheryl:

We usually do not do myelograms unless the MRI and EMG are non-diagnostic.  We do them but I have never had a patient have what happened to you, happen.  The EMG study suggests that you have a nerve problem at C6-C7 and therefore some of your symptoms could be coming from this lesion.  Did the neurologist recommend rehab?  The problem at C2 could affect axonal tracts to your legs, but this would be difficult to tell given the lower lesion.  The nerve irritation caused by the dye should resolve, at least I would think so.  

I hope your problem gets resolved.

CCF Neuro MD
18 Comments
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Thank you for prompt reply. We have felt in the dark at times.
The reason I had my original MRI done was right arm parethesis down to fingers upon turning head to the right. It had been going on for serveral months.  After the MRI showed the spinal changes at C5-6 level the Dr. ordered the EMG/NCT after those findings I went to my neurosurgeon. After exam and a course of steroids with no change he ordered the cervical Myleo/CT.  All of my symptoms prior to the myleo were limited to the upper right extermities.  All the numbness, pain and temp sensation confusion is on the left side-the side the C-myelogram was done at the C2 level and a direct result of the myelogram, and believed to be totally unrelated to the right arm parathesis.  I only mentioned the original tests & problems to clarify reason for ordering myelogram.  2nd MRI with cntrast to look for a lesion at C2 as a result of the myelo was negative. This has been termed a spinal cord injury.  What we are unsure of and feel might shed light on the prognosis for recovery is was the hitting of the cord or the combined subarachnoid intramedullary injection the problem?  I realize this is a "strange bird" but now that I have clarified that the original presenting problems (1st MRI, EMG/NCT) are unrelated to all symptoms on upper left side, do you still feel the symptoms are from nerve irritation from the dye and not damage from the hitting of the cord?  Sorry for giving 2 long postings.  We live in a small town and everyone has their hands in the air.
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Dear Cheryl:

The arm problems are very likely due to the C5/C6 lesion, but since I can't examine you it is impossible to say much, but the EMG would agree with this suggestion.  Alot would depend on how much irritation happened to the spinal cord. Since I can't see the films, I don't know what to say.  My best guess, is that you should have a great deal of recovery.  The nervous can repair itself to a good extent and compensate for damage.  I guess you'll just have to wait it out and see what happens.  I would recommend rehab though.  This may help speed up the recovery.

Sincerely,

CCF Neuro MD
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I have suffered from neck problems for 20 years. More recently they have given me much pain with pain in the left shoulder and arm and up the left side of my face. MRI findings show a 40% bulging disc and cervical spondylosis at C5/C6 and C6/C7. I also have problems with my left leg...a strange sensation as though it does not belong to me. I also suffer from vertigo and double vision. Recently I had a laser partial discectomy and since that time I have been suffering from Horner's syndrome. I should point out that similar symptoms to Horner's syndrome were present before the surgery but never as marked. My vision is really troubling me and the vertigo and shoulder pain continue.
Will the Horners improve and can you explain my other symtoms (symptoms)?
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Dear Rita:

Since I am not able to see the films, do the neurological examination it is very difficult to tell you about prognosis.  The surgery might have affected the sympathetic descending tracts in which case there is little to be done.  If the surgery was recent, the exacerbation might be due to swelling or edema and therefore the horner's should improve.  The other problems are likely due to your disc problems compounded by surgery.

Sincerely,

CCF Neuro MD
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In what percentage of cases where denervation is done on C5-C6 of surgical spine is the surgery successfull?  Is there a better alternative?
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In what percentage of cases where denervation is done on C5-C6 of surgical spine is the surgery successfull?  Is there a better alternative?
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Dear Gail:

I am afraid that I really don't have an answer for you.  Alot depends on how long, where, etiology of the denervation, etc.  Without such information I can't tell you.  I would ask your neurosurgeon who knows the answers to the above and can give you some estimate.

CCF Neuro MD
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For the past two weeks, I have noticed occasional tingling at the top of my neck, right below my hair line, in the center toward the top of my spinal column. I noticed this, when I started using my computer mouse, although sometimes it happens when I haven't been sitting at the computer in days. I feel a small bump there, but I don't know if this is normal or not.
Is this something I should have checked out, or is it just that I have to stretch and exercise more during my computer sessions.
I've only had the p.c. for a couple of months, and ergonomically I'm not in the best situation. I have it sitting on my kitchen table, which puts the keyboard and mouse at a higher position than I believe it's supposed to be. Any suggestions?
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Dear Janis:

I would try and move your computer around.  If the bump doesn't go away, I would see your family physician.

CCF Neuro MD
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What is myelogram? What is the procedure foranterior cervical
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What is myelogram? What is the procedure foranterior cervical
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What is myelogram? What is the procedure foranterior cervical
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Dear James Haddon:

A myelogram is where they inject dye into your spinal canal and examine your spinal cord via CT scan.  The anterior cervical is just the view of the CT.

CCF Neuro MD
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I have just had a cervical disectomy on C6-C7(I think thats it) and I am having alot of skin pain like a severe sunburn all through my shoulder and also muscle spasms next to my incision.  This was the reason that I had surgery in the first place, muscle spasms, but they were about 3 or 4 inches lower in my back.  What is this severe pain?  Is it a sign of inflamation (inflammation) or what and what can I do to releive it?
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Dear Patti Miles:

Sorry I can't answer you as I cannot exam the wound nor do I know exactly what they did in surgery.  I would call your neurosurgeon and tell him/her.

CCF Neuro MD
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I had a MRI in Dec 99 which showed moderate disc hern at C5 and C6 & C&7 are degenerative.  Was having pain in sholders and right arm and fingers were dumb.  Tingling in the neck and pressure in the back.  Doctor recommended immediate surgery because I drive alot with my job and I was at risk of accident and possibility of crushed spinal cord.  Went for 2nd opinion and 2nd advised me as well to get surgery. After he put me through several tests he said "If I hadn't seen your films, I would think there was nothing wrong with you".  I had very little pain at 2nd interview.  I take one Alieve (over the counter) medicine per day, and I do pretty good on that alone for any pain or discomfort.

I went to Surgeon today all ready and prepared for securing a sugery date and he said now he wants to do a Myelogram first, to see if there is any damage to cord.  I still am not experiencing very much pain.  And, there is no numbing in fingers.  I have been doing pretty good, as far as pain goes.

My question is this, I am a little nervous about this Myelogram procedure, now that I know what it is and how it will be done, and I am wondering if the disc is moderate hern, should I just have the surgery to prevent any further damage?  I am 43 in very good health and I am not sure I want to have surgery later in life.  

Any advise?
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I had a MRI in Dec 99 which showed moderate disc hern at C5 and C6 & C&7 are degenerative.  Was having pain in sholders and right arm and fingers were dumb.  Tingling in the neck and pressure in the back.  Doctor recommended immediate surgery because I drive alot with my job and I was at risk of accident and possibility of crushed spinal cord.  Went for 2nd opinion and 2nd advised me as well to get surgery. After he put me through several tests he said "If I hadn't seen your films, I would think there was nothing wrong with you".  I had very little pain at 2nd opinion.  I take one Alieve (over the counter) medicine per day, and I do pretty good on that alone for any pain or discomfort.

I went to Surgeon today all ready and prepared for securing a sugery date and he said now he wants to do a Myelogram first, to see if there is any damage to cord.  I still am not experiencing very much pain.  And, there is no numbing in fingers.  I have been doing pretty good, as far as pain goes.

My question is this, I am a little nervous about this Myelogram procedure, now that I know what it is and how it will be done, and I am wondering if the disc is moderate hern, should I just have the surgery to prevent any further damage?  I am 43 in very good health and I am not sure I want to have surgery later in life.  

Any advise?
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