Mass effect on spinal cord

[Angie880]

I am a 39 yo female, spinal fusion of C6-7 in 2001, successful. This year, I've been having problems again:  weakness and pins/needles in my arms, but especially my legs. Total numbness of my right big toe and pinky finger. I have lower back pain and my stomach is almost completely numb to touch and any sensation of heat. I'm having difficulties emptying my bowels and bladder. Colonoscopy and c-scans of my pelvis and abdomen: fine. Bloodwork:  CBC, lipids, thyroid, blood sugar, ANA, metabolic panels, B-12: normal. My gyn and gastro spec both said everything ok. My last MRI of the cervical spine showed the C5-6 disc shows "mild to moderate spondylosis with a moderate left paramedian disc plus spur. This is causing mass effect on the anterior left surface of the cord and encroaching the foramen and could certainly affect the left sixth nerve root." The C6-7 fusion is solid. My lumbar spine shows a "protruding L5-S1 disc in a central right paramedian position most suggestive of a small annular tear. This is only causing slight flattening of the anterior surface on the thecal sac and in near apposition to the right S1 nerve root". The thoracic MRI showed "moderate thoracic spondylosis with mild, predominately anterior loss in disk height and signal, with a small posterocental disk herniation with focal ventral effacement of the thecal sac at T7-8 and T10-11." What does mass effect mean? I have some neck/arm pain, but not horrible, so my neuro doesn't think the problems are from C5-6. What else could it be? PT not an option. No meds. Suggestions? I'm getting scared as time goes.

[CCF-Neuro-M.D.-CS]

Have you talked to your doctors about the MRI findings? I assume the MRIs you are talking about are after your new symptoms started?

Mass effect means that the 'disc plus spur' is bulging out of its normal position and compressing the spinal cord at that area - to what degree I cannot tell without seeing the MRIs. Compression of this area (left anterior cord) could cause weakness or clumisness of the left arm or leg, and compression of the left sixth nerve root could cause sensory loss or tingling on the lateral surface of the  left arm and/or weakness of flexing at the elbow.

If the L5-S1 disc is compressing the right S1 nerve root, this could be causing the right toe numnbess as this is part of the sensory distribution of the S1 root

An EMG if you have not had one yet, may be able to pinpoint where problems are coming from. Otherwise I cannot localize or diagnose your problem without more information

[Angie880]

Thank you for your response. I've had 2 neurosurgeons say that I'm not a candidate for spinal surgery-yeah!, as my symptoms do not correspond to the area that is herniated, i.e. no pain down the arm or shoulder and only minimal, occasional pain in my neck. Your response was the same as theirs, so that makes three!--"bowel and bladder dysfunction from a spinal cord problem usually comes togther with motor dysfunction ie weakness and increased reflexes in the legs, than sensory complaints, as these fibers run together in the spinal cord". Neither one felt I had peripheral damage either. I am going to a neurologist tomorrow, and they are going to do the EMG to determine where the problem area is.  In 2001, I had an MRI for to look for MS, as my neurologist strongly suspected that was my problem then. However, it was negative. When they found the C6-7 herniation and I had surgery, it cleared up for a time.  In 2002, I had symptoms again, and was put on neurontin. It helped so well, I got pregnant again! After the pregnancy, I was fine until the end of 2004. I've had a MAJOR change in my left eye vision within a month of eye testing and my eye doc has also recommended an MRI of the brain. My main complaint was extreme fatigue especially in the early afternoon, weakness and tingling in the legs, and the changes in bladder/bowels with loss of sensation to the stomach and groin.  Now, instead of fearing another spinal surgery, I'm worried the original diagnosis was correct and I have MS.