cervical or thoracic or something else?

[missy142]

Thoracic - done 4/10/09  - T1/2 thru T4/5 right paracentral disk bulging seen with impression the the ventral thecal sac.  T7/8 right-sided posterior disc herniation seen impressing the ventral thecal sac.
Cervical - 10/29/08
C3/4 posterior disc bulge with ventral cord abutment, central canal stenosis, left sided uncinate productive change, and left foraminal narrowing.  C5/6 central disc adjacent osseous vertebral reactive edema with posterior disc herniation, uncinate productive change, central canal stenosis, ventral cord impression and narrowing of the left foramina  C6/7, posterior central disc herniation is seen with central canal stenosis, ventral cord impression and bilateral foraminal narrowing. L5/S1 herniation 3/08 no nerve involvement apparently
2 cervical epidurals in Jan -Feb, symptoms returning. pain neck, radic., paresthesias in UE extrem.
March I experienced severe muscle weakness in my legs (overnight), Rt foot numb, next day I couldnt walk. Burning outer lateral sole of rt. foot, groin, rt buttock, LT anterior thigh have been going on about 2 months. Muscle weakness has since relented and now  able to walk @ 20 min. before I have to sit down.  My legs feel stiff, clumsy & sometimes like they're not mine.  Muscle weakness has plateau, no bowel or bladder issues. I have migraines (from cervcial stenosis?), word finding problems, paresthesias, muscle weakness with muscle aches in legs (bad), RLS symptoms. Do u think the injuries in my thoracic area could be causing the muscle weakness, paresthesias mentioned?  I realize the cervical report seems worse but when I found out about cervical i didnt have the lower ext. problems just what you would expect in the neck, pain upper back, arm hand etc., Neither orthosurgeon has ever said that my neck would be causing the LE problems even though it is impressing on ventral cord.  Thoracic MRI was to of course look for any other herniations, also for lesions.  Brain MRI this thursday. thank you!

[missy142]

I had an EMG of cervical area, proved to have bilateral radiculopathy, and bilateral carpal tunnel.  I have never had muscle weakness in the arms, just the legs.  Are you saying that the cevical herniations that are impressing on the cord, cervical stenosis and foraminal narrowing can cause leg weakness without causing UE weakness? Or is it more likely to cause UE weakness as well?   I am also concerned about MS, thoracic MRI done on open MRI which is low resolution .6T.  MRI of brain done on 3T machine showed several nonspecific punctate periventricular white matter signal hyperintensities. Diff dianosis would include chnages related to migaines.

Please one more thing, Do you think when dealing with the cord, a neurosurgeon would be better at diagnosing and possible surgery?   Please answer, thankyou so much

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history and review your imaging, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In general, processes in the cervical area can certainly affect the legs. However, in such cases, the arms would most commonly be expected to be affected as well though there are exceptions. Lesions in the thoracic region can also affect the legs, without affecting the arms. However, even if a disc is large enough to touch the thecal sac, this does not necessary imply that there is enough pressure exerted on the spinal column to cause weakness. It really depends on how big the disc herniation is and how narrow the spinal canal is. Foraminal stenosis, or narrowing of the holes where the nerves exit the spine, can also lead to weakness; the exact cause can only be determined after physical examination and other testing such as EMG.

You do certainly raise a good question and it would be important to discuss it further with your spine surgeon.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.