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Need to be able to walk/stand so I can work again

  I am a 45 yr old male who had an ACDF of the C5-C6 and laminectomy of the C5-C7 back in april of 2012. This did resolve most of the issues I had with hand and arm numbness at first though those are coming back now. Its been less than a year since those surgeries. I digress though as Im here about other issues. I have what is either vascular claudication or neurologic claudication. I have serious difficulty walking beyond 100 yards or stnding more than 10 minutes without taking a break and sitting. Even sitting causes lower back pain and issues throughoout the buttocks and legs. my feet have had a numbish feeling for over a year, When I walk, these days with a rolling walker, the pain begins in the lower back area and spreads through the buttocks and into the thighs and even lower if I push myself.I have had temporry issues with bladder and bowel incontinence. I have mild to moderate saddle anesthesia. Ive seen a vascular doctor and he doesnt believe there is enough of a vascular issue to cause these issues. Yet so far there are no imaging findings to support CES or anything similar. I do have mild to moderate central canal stenosis in the lumbar region, degenerative disc disease all superimposed on a congenitally small spinal canal. The level of stenosis is either dependant on which radiologist you ask or maybe my exact position at the time of the MRI.( as in whether its mild or moderate). My question is could the mild stenosis, along with the small spinal canal and possible mild-moderate lumbar instability cause cord compression thats being missed in typical supine MRis? I have had flexion and extension Xrays that showed mild instability.
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Avatar universal
Thank you Dr Kaul for your reply, I do understand that the mild stenosis with mild instability would likely not cause compression, but adding the congenitally small spinal canal could that then possibly cause some? My other question was about MRIs and how effective typical supine MRIs are or arent in cases of instability. the supine position, especially when combined with raising the knees with a bolster DOES put the spine into a more open position, possibly temporarily eliminating mild compression. Isnt that part of the reason why leaning over a shopping cart is so helpful in neurogenic claudication?
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1711789 tn?1361308007
MEDICAL PROFESSIONAL
Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. Possible cause of arm symptoms that may need to be considered include further degeneration, nerve impingement at a lower level, neuropathy/ myopathy, micronutrient deficiency etc.  
            The claudication may need further evaluation to identify its type though this sounds more like a neurogenic cause; while the backache could occur secondary to postural issues, neuro-muscular causes such as muscle sprain, nerve impingement, injuries to muscles/ ligaments etc inflammations, fractures/ dislocations, referred pain from other regions, micronutrient deficiencies etc.
             With mild spinal stenosis and mild-moderate instability, compression of neurological structures is unlikely and unlikely to be missed on the MRI and one may need to look at other potential causes such as neural compression at lower levels, myopathies etc. I would suggest consulting an internist for a detailed evaluation initially and depending on the cause diagnosed/ suspected, it can be managed accordingly or specialist acre may be sought.
Hope this is helpful.

Take care!
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