Spinal Cord Compression

[sisfoley]

For about 6 months  I have been having tingling in both right and left hands.  About six months ago I had several episodes of pain in the breat bone area.  I have also had several spirts of bladder control problems with the feel of urgency to void.  None of the symptoms last long in duration but, would  return about once a month.  In 2000 I had an xray that showed straightening of the spine and narrowing of the c5-6 disc interspace with spurring.  Spurs from the c5 vertebra and c6 show uncinate processes causing encroachment on both of the neural foramina.  The impression stated:   degenerative disc and joint disease c5-6 with neural foraminal enchroachment and signs of muscle spasms.  As my conditioned worsened, I saw a neurosurgen that ordered an MRI 2/22/02.  The findings were disc space narrowing at c5-6 with moderate size diffuse disc protrusion compressing on the right side and diplacing it with stensois.  Impression stated: diffuse disc protrusion a c5-6 with cord compression and stenosis with degenerative arthritis of the neck.  After an exam the doctor said I have hyperflexia (on exam my reflexes were overly strong on the right side) with myelopathy  He ordered physical therapy to see If I had any improvement.  After about 2 weeks the physical therapy was stopped.  I had not made any improvement and seemed to have worsened to some degree.  I am now  having shoulder pain and drop things on ocassion.  The doctor said this was a serious condition and that I should not delay surgery.  My questions are:

How serious is this condition and do you feel I should consider surgery at this point?.  I am 53 and the physical therapist said my neck looked like a 80 year old.

What generally happens if I would delay surgery?  My neurosurgeon told me the surgery would help stop the progression of the cord compression, but he was not sure about the pain.  

I know I have written A lot.  I trust my doctor, but I am scared to go forward or stay the same.  Any advice would be appreciated.

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

Sorry to hear about your symptoms. Please keep in mind that I have not examined you nor have I personally reviewed your films. However, when a patient actually has spinal cord compression from a herniated disc with associated weakness, sensory and reflex changes, we usually do recommend surgery, sometimes on an urgent basis depending on the degree of compression. With time, the region of the spinal cord that's being pushed on by the disc can soften and start to degenerate causing irreversible damage. What this means for you is that the symptoms such as weakness can end up being permanent. Your neurosurgeon is right about the pain. Even though the pressure on the cord can be relieved by removal of the disc, sometimes the pain does not go away entirely. I can understand how you may be a bit reluctant to undergo spine surgery, but in your case it may be the only option to prevent further damage to your spinal cord. Finally, if you're still concerned about the need for surgery, you could always go for a second neurosurgical opinion. GOod luck.

[pikamom]

Don't wait too long! I had an acute herniated disc at L5-S1 and had emergency surgery, did well for 5 years and then it ruptured again on the other side. I postponed that surgery for four months and by the time I relented, I had footdrop. Unfortunately, I've had problems with nerve pain and numbness in my feet ever since. I have problems with balance and walk with a cane.

[shrley]

I have been burning on my lower back and numbnes and tingling in my legs for months. Some days are worse than others anyway I HAVE OTHER SYMPTOMS. BLURRED VISION, STAGGERING, SLURRED SPEECH, DIZZIENESS. There are other things but I'll tell another time. I went to my family dr. with theses problems and he sent me to a neurelogist. The nr. had a mri done on my brain on the 12 of mar. 2002.Also we had a mri on my cervical spine the 22 of March. I WANT GET THE RESULTS until the 29. The nr. seems to think it might be ms. My father had the same symptoms but worse he was in a wheelchair also they didn't call it ms. It was long name with 13 letters in it. I am 39 years old married with 4 children. (African American) my father has been dead for 24 years. He suffer with the disease for 10 years before he died. I just want a name for what it is that I HAVE.

[Maxi]

I know this is very hard to comprehend, and make a decision regarding surgery.  I felt I had to post this comment to you as I have been where you are presently.  After approx. 1yr of increasing symptoms to where you are now, I still postponed surgery another 6 months.  I finally had Ant.Cerv. Discectomy with fusion C5-6.
The compression was very severe at this level and the cord had a diameter of only 4.5mm.  Although the decompression was successful, I was left with a incomplete spinal cord injury.  My MRI today, (4 yrs later) still shows the cord permanently indented.  I now have been diagnosed with Central Cord Syndrome, which has left me with all the defeceits you mentioned plus bowel, bladder problems.
Believe me, if I could turn the clock back, I would and follow my neurosurgeons advice.  If only we had hindsight!

[sisfoley]

Thanks for your response.  I would like to correspond more with you.  This site has been very helpful.  Please email me at ***@****

[Suemom]

Last year I had surgery on my neck.  I had spinal stenosis and they replaced my neckbone with a titanium mesh from C3 to C7.  Before the surgery I could hardly walk up stairs.  I had a hard enough time walking at all.  I had pain in my arms, some numbness in my right hand, and my right leg felt like it was asleep all the time.  After the surgery, and here I am a year later, I'm doing pretty well.  The right leg still feels asleep, but I can walk up stairs without holding on or pulling myself up. The pain in my arms is gone.  I still have some of the symptoms I did before surgery, but a definite improvement since then.  I would recommend surgery to anyone having symptoms severe enough.  I wish I would have gone in sooner to have the surgery.  Don't hold off.  And good luck!

[RedLady]

I recently (January, 2002) underwent spinal surgery to both my cervical spine and lumbar spine (ten days later) and spent 26 days in the hospital.  I have been suffering terribly off and on for five years. I experienced loss of sensation in both feet, loss of coordination, I dropped everything I picked up at least once, and I was constantly falling down and injuring my self, sometimes seriously, and towards the end, I had a loss of bladder control. I even have a spinal infusion pump for pain, after trying everything we could on the market for pain.  I awoke one night screaming with pain in the left buttock area and ended up in the ER.  After trying without success to relieve the pain I was admitted and underwent cervical and lumbar mylograms.  To my surprise, the staff neurosurgeon after a only a cursory examination, ordered another study of my neck.  He told me that my spinal cord was severely deformed from compression due to osteophytes, herniated disks, and myelopathy and if I were to fall or get jarred or hit, I could be paralyzed from the neck down.  Boy, did I wait too long for surgery. I even had three neurologists in five years! I now have fusion from C4 to C7 and from L3 to S1 with instrumentation.  I set off the security alarm at KMart the other day from all of the titanium in my body.  I am still in pain though not nearly as severe and am experiencing horrible tingling and coldness in both feet and a sensation of walking through sand or pebbles all of the time 24/7.  SO, please do not put off surgery if your neurosurgeon suggests it at this point.  I had no idea what danger I was in!

[photolady]

Reading all this is pretty scary!  Since mid-january, I have had pain, numbness tingling and weakness in my right leg and foot. Things got so bad I had to use a cane for support, which I hated. Finally went to an orthopedist, who did an Xray and MRI. I have a stress fracture in L4 (I think), a slipped vertebra at L5, and the disc between L5 and S1 is herniated with nerve root compression. Actually, the MRI showed 5 bad discs, but only one is pressing on the nerve. Had phys therapy (no help), oral prednisone (2 rounds) which was great when I was taking it, but all symptoms returned once I got below 20mg/day.  Now doing a series of epidural injections (depo-medrol), two down and one to go, which have helped a lot with the pain and weakness, but I still can't sit for very long and still have numbness and tingling in my foot and leg. The orthopedist has already said I may end up having surgery, which would involve removing the herniated disc and fusion to stabilize the two vertebra, and I am really afraid of it all. The recovery period is long and difficult, and it would really have an impact on my ability to earn money.  I am a nature photographer and have to be fit and out there, not an invalid.  But after reading all your comments, now I'm afraid NOT to have surgery, if the doc says I need it.  What I want to know is how likely is it that these injections might really work, and I wouldn't need surgery.  And how likely is it that if I don't have surgery, all the problems will return, maybe worse.

[patchrouli]

Hi, I;m new to  this site, this is my first comment. In 1998 I had a mutiple Lamainectomy and Fusion at L-5 s-1, and I had a othopediatic and a spine surgeon do it, they put a rod in my spine to stabilize it, they told me that if I didn;t go ahead and get the surgury I could be disabed, paralized waist down for the rest of my life, they told my my spine would just break it was to unpredictable to tell when. Now at the time I was 38 years so I knew I had a few young years of life ahead of me well, after the operation it was down hill from there, they told me , it will take a year to heal, with in that year I was getting worse and worse and much worse today, it seems a nerve was severed to what extend now one knows, To put it midly I live on pain meds. and I still can barely ambulate.  
  If I were you I would make sure you have a Neurosurgeon do the Surgury, My biggest mistake, if I could have sue,ed  I would have won, I did win the auto accident suite though, well anyway, all I;m saying is think twice get a couple opinions, and feel better ,one mistake and a lifetime of pain, depresion, seizures etc...                                may your higher power be with you                                     patchrouli

[elaine88keys]

I am currently scheduled for c5 diskectomy with iliac graft fusion in Toronto with a Neurosurgeon and Ortho-surgeon on May 15,2002.

My c5-6 disk herniated from a fall in April 2000 and caused my right arm to pain intolerably, my neck to pain and hands (including thumb and fingers).  I have never experienced a pain quite like it and I lay in bed for two weeks until I could arise to deal with the pain.  Currently I suffer from L'hermittia symptoms and now a lower back disk is giving my problems.  I drink my coffee with pins and needles, I exercise in pain but I am so used to it, it seems normal.  The biggest concern is my current heavy leg feeling which is apparently an indicator the compression is getting worse.

I am extremely proactive with this pain and have tried many optional therapies.  However, even my Chiropractor is opting that I have the surgery.  

My dilemna is that I also have a bulging disk at c4 and when the pain presented itself it was right sided though the herniation was deemed to have been on the left.  I awaiting neck and pain in the left shoulder and it presented itself.  I also went for cortisteroid needles which helped but I got folliculities all over my neck and back and chest and it took two months to clear up with an antibiotic.  No one would correlate it to the needles however, there is all kinds of information on the net showing that for some this can happen.

I have researched the Anterior Cervical Diskectomy with Fusion surgery to the best of my ability and currently have found an Article with the Canadian Medical Assoc. that states that it should be explained to patients that "symptomatic adjacent segment disease may affect more than 1/4 of all patients within ten years after an anterior cervical arthrodesis.. that single level arthrodesis involving fifth and sixth cervical vertebra and pre-existing radiographic evidence of degeneration at adjacent levels appear to be the greatest risk factors for new disease...Therefore we believe that all degenerated segements causing radiculopathy or myelopathy should be included in an anteriou cervical athrodesis.  Although our findings suggest that symptomatic adjacent-segment disease is the result of progressive spondylosis, patients should be informed of the substantial possibilty that new disease will develop at an adjacent level over the long term."

I have, prior to finding this article, heard of the need to go back to the disk above or below and do another diskectomy.  I therefore asked my Dr's for another MRI vs. my year old MRI and they agreed.  I asked them that if the C4-5 evidences compression or the bulge stills exists, and since the diskectomy of one disk comprimises the stability of the others, that I am conveying that I would rather have them do a double fusion.  I don't want to have to do this surgery more than once if at all possible.  They are awaiting the MRI.  

My concern is the need to have a second surgery, and yet is having a double fusion tantamount to more risk.  Any information, input and recovery information anyone could give me would be greatly appreciated.  

At 42 having been a person that treadmills an hour 5x a week, teaches piano for a living and really enjoys the good in life and yet can handle life's downfalls, I have to know I am making the right request.  My daughter is only 9 and my son 15.  My husband says I should be decisive one way or the other and it is stressing out relationship.  I am really in need of hearing from other's who have undergone this surgery.  Thanks.

[Maxi]

I have had multiple succeeding Cspine surgeries over 4 years.
I too am from Ont. Canada.  If you wish to correspond, please reply with an address.

[Elliee]

Hi Everyone, I am from the UK, I am so frightened for my father that I wondered if anybody could help me.  My dad has told me that he has received his results back from an MRI scan and he has to have an operation to remove vertabrae from his spine.  Spinal cord compression?  He gets a lot of pain in his neck and after seeing a consultant about pain in his foot, the consultant was concerned that his feet are always twitching and all his muscles are tense.  He sent him for further tests which have resulted him in having this problem.

My dad is blocking this out, and I feel I am smothering him to find out more.  He is losing his balance a bit and putting a brave face on it.  I want to book some time off work to be with him when he goes to hospital, I am not sure how big the operation might be.  My mum and dad are divorced and although he has a girlfriend I am frightened of stepping on toes.  I know this message sounds a bit vague but how can I help him I love him to bits and want to support him as much as I can.

Elaine

[terrybelle]

I am 37 years old and have been living with severe neck pain off and on for about 7 1/2 years and never knowing the cause of it, (I suspect it was from lifting something heavy). I was told by an orthopedic surgeon that I would have to live with the pain and that he would not operate on me, that was told to me from 1997 thru 1999 and then I gave up. I have twins and I was a stay at home mom for four years because I could not work with this neck pain it was coming and going and I could not go any substantial amount of time without severe pain. In April of 2002 my symptoms got worse so I went to see my regular physician because I was having severe pain in my neck and between my shoulder blades and pain and weakness in my right arm. I needed pain medication and low and behold she gave me percocettes! Thank God! I had been at my job for a year at this time and I loved it so much I was afraid that I would have to quit because of the pain. I had been in somewhat of a remission for a couple of years (I could take aspirin or tylenol for the pain). I thought my prayers had been answered. I was living with the bulges in my c-spine. So here I am now one month after my anterior cervical diskectomy and fusion surgery. I found a neurosurgeon in my area and he diagnosed me through MRI and saw right away what the problem was, I had spinal compression from bulging discs in 2 levels of my cervical spine c5-6 and c6-7. He scheduled me for surgery 2 weeks after he diagnosed me. I was relieved that he was able to give me an answer because I went to a pain specialist and he told me "There is nothing wrong with you, you just have myofacial pain" that means muscle pain. This so called Dr. looked at my MRI without getting the report from the radiologist. He sent me to physical therapy for 4 to 8 weeks. I could not help but feel he was wrong so under the direction of my regular physician I got a second opinion. It was a good thing that I did because when the neurosurgeon operated on my neck he said it was worse than he thought it was.  When he saw inside my neck he said there were tendons that were starting to wrap around my spinal cord and he had to trim them away. He said that he had suspected this but because of my age he did not think that this was the case with me because he had only seen this happen to people over 50 years of age. It was a good thing that I said yes to the surgery because my Dr. said that if I would have waited I could have been paralyzed or I could have died from the tendons wrapping around my spinal cord. Thank goodness I found this Dr. he has given me another chance to live my life without limits and pain!  I am not totally recovered yet but my prognosis is very good. I will be going back to work in 2 weeks! I have little pain now and the weakness in my right arm is going away. The Dr. says that any pain, weakness or stiffness will go away within 1 month for a total of 2 months recovery time.  This is the first time in 7 1/2 years I can really believe that I am going to be normal again. I am so happy that I cry because I know by the way I feel that I am getting better every day. The most important thing that I want to tell anyone out there is get 2,3 or 4 second opinions if you have to and if you have spinal cord problems see a neurosurgeon because in most cases an orthopedic Dr. is only going to do you wrong one way or another. I did a lot of research before my surgery such as looking up related web sites on the internet and reading about this surgery and talking to former patients of my nuerosurgeon to see what their outcome had been. I Hope this letter helps someone.  Thank you.

[zgen]

Hello, I am new to the forum and I was reading the post and found that one person mentioned that they were also having symptoms of pain in the chest/breastbone area.   I to have started having this NEW symptom for about 3 weeks now.  It started on the left side and now on both.   I have also started getting pain in my shoulders that is pretty constant as well as both shoulders.

THE ABOVE NEW SYMPTOMS STARTED ABOUT 3 WEEKS AGO, COULD THESE BE NEW SYMPTOMS BE RELATED TO MY CERVICAL SPINE?  


Last MRI 8/28/01 showed:

C3-4  Mild broad base disc bulge with overall mild central spinal stenosis.

C4-5  Mild broad base disc bulge with a superimposed central disc protrusion.  Overall mild central spinal stenosis is present.  No frank neural formainal narrowing is seen.

C5-6  There is a large posterior osteophyte centrally present, causing moderate effacement of the ventral thecal sac. It appears partially fused with C7 vertebra and there is mild flattening of the cord at this level.   Overall mild to moderate central spinal stenosis is present.  A mild disc bulge is also seen at this level somewhat right sided in appearance with mild narrowing of the right neural foramen.

C7-T1  There is a small disc bulge with overall mild central spinal stenosis.

Thank you to all who answer.

[zgen]

Hello, I am new to the forum and I was reading the post and found that one person mentioned that they were also having symptoms of pain in the chest/breastbone area.   I to have started having this NEW symptom for about 3 weeks now.  It started on the left side and now on both.   I have also started getting pain in my shoulders that is pretty constant as well as both shoulders.

THE ABOVE NEW SYMPTOMS STARTED ABOUT 3 WEEKS AGO, COULD THESE BE NEW SYMPTOMS BE RELATED TO MY CERVICAL SPINE?  


Last MRI 8/28/01 showed:

C3-4  Mild broad base disc bulge with overall mild central spinal stenosis.

C4-5  Mild broad base disc bulge with a superimposed central disc protrusion.  Overall mild central spinal stenosis is present.  No frank neural formainal narrowing is seen.

C5-6  There is a large posterior osteophyte centrally present, causing moderate effacement of the ventral thecal sac. It appears partially fused with C7 vertebra and there is mild flattening of the cord at this level.   Overall mild to moderate central spinal stenosis is present.  A mild disc bulge is also seen at this level somewhat right sided in appearance with mild narrowing of the right neural foramen.

C7-T1  There is a small disc bulge with overall mild central spinal stenosis.

PS..  Can anyone explain to me what the MRI basically says?  

Thank you to all who answer.