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Neurology (Expert Forum)
Myelopathy before and after Cervical Corpectomy C5-C7 w/fusion- I am very scared
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Myelopathy before and after Cervical Corpectomy C5-C7 w/fusion- I am very scared
by Goodkarma5, Apr 15, 2006 12:00AM
Thank you for any help. I feel I am losing it and am desperate for answers. I don't know what to do. I am 41 years old and was diagnosed with Compressive Cervical Myelopathy c5-c7 July 05. I should have been diagnosed at least two years ago as my Rheumotologist missed an MRI he ordered for the c-spine and I was told I was fine except for having Fibromyalgia ( which he doesn't really believe in). So I sufferd for another couple years, lost 20 lbs, weight only 90lbs from the downhill struggles. Pain, weakness, numbness, tingling schocks..you name it...everywhere. When I did get my diagnosis, I showed Myleopathy and surgery was my only option. So I had surgery Dec.1st - an Anterior Cervical Corpectomy w/fusion(c5-c7). Supposedly successful. Puzzles me that they say its successful because I am worse now than before the sugery and really scared.
My surgeon never even asked me to move my neck, only looked at xrays and dismissed my claims saying "you will never be normal and painfree and to get used to it." Mind you, I am not a complainer and always took pride in my work ( have been off since Aug05. I was worried about how I could return to work. My Neurologist has been more helpful and says that they hoped because of my age I would do better, but Myelopathy doesn't reverse itself and after a year I will know what is permanant damage. I am in the midst of a bunch of testing and return to him in a few weeks. I can't wait. I even went and got my own MRI results because I am so sure something bad is happening and I don't know if I could be in serious trouble. I have such bad numbness tingling and burning I am too disoriented to walk around. My legs are weaker than ever. The shocks go right into my head arms, face, legs, My left shoulder is burning so bad almost all the time. I feel like my position is off and I can't seem to think straight.
Here are my MRI results. could you help me dicipher it?
Findings - There is no evidence of Chiari Malformation. The spinal cord is of normal caliber. There are no abnormal signal intensities seen within the cord. Ther is mild to moderate sized disc protrusion at the C4-c5 level which is somewhat increased since the prior study (July 05).There has been interval fusion from the c5-c7 level. The c5 disc is remarkable.
While there are some paramagnetic effects from the surgery there does appear to be some posterior spurring at both the c5-6 and c6-7 levels. There is also bulging of the c6 disc, there is some effacement of the anterior thecal sac at both of these levels but no evidence of cord compression. There does appear to be an element of neural forminal stenosis at the c5-c6 and c6-7 levels on the left. Vertabral alignment is anatomical.
Impression: Mile to moderate sized central disc protrusion at the c4-5 level slightly more prominent that on the prior study./Staus post anterior fusion from the c5-c7 level with some posterior spurring noted at the c5-6 and c6-7 levels with some effacement of the anterior thecal sac along with an element of neural foraminal stenosis on the left at both c5-6 and c6-7 levels.
I am sorry this is so long. I just don't know if I need to get to the emregency room. I deal with this alot but I have gotten a great deal worse over the last week. Something is terribly wrong. If someone tells me this is the nature of Myelopathy, then ok, at least I can deal with knowing I wont end up paralyzed. I can just know what to expect. Also could degenative disc disease be that progressive? IS my surgey successful? I know they had to decompress my spine and that was the main reason for surgery. Still I feel like I have no control over my body anymore.
Thank you to whoever will write back. I think I am so used to dealing with the abnormal that I might not realize the seriosuness of what is happening now. Most people would be at the hospital long ago, but I seem to have lost faith that there is help.
Thank you so much. This means so much.
My surgeon never even asked me to move my neck, only looked at xrays and dismissed my claims saying "you will never be normal and painfree and to get used to it." Mind you, I am not a complainer and always took pride in my work ( have been off since Aug05. I was worried about how I could return to work. My Neurologist has been more helpful and says that they hoped because of my age I would do better, but Myelopathy doesn't reverse itself and after a year I will know what is permanant damage. I am in the midst of a bunch of testing and return to him in a few weeks. I can't wait. I even went and got my own MRI results because I am so sure something bad is happening and I don't know if I could be in serious trouble. I have such bad numbness tingling and burning I am too disoriented to walk around. My legs are weaker than ever. The shocks go right into my head arms, face, legs, My left shoulder is burning so bad almost all the time. I feel like my position is off and I can't seem to think straight.
Here are my MRI results. could you help me dicipher it?
Findings - There is no evidence of Chiari Malformation. The spinal cord is of normal caliber. There are no abnormal signal intensities seen within the cord. Ther is mild to moderate sized disc protrusion at the C4-c5 level which is somewhat increased since the prior study (July 05).There has been interval fusion from the c5-c7 level. The c5 disc is remarkable.
While there are some paramagnetic effects from the surgery there does appear to be some posterior spurring at both the c5-6 and c6-7 levels. There is also bulging of the c6 disc, there is some effacement of the anterior thecal sac at both of these levels but no evidence of cord compression. There does appear to be an element of neural forminal stenosis at the c5-c6 and c6-7 levels on the left. Vertabral alignment is anatomical.
Impression: Mile to moderate sized central disc protrusion at the c4-5 level slightly more prominent that on the prior study./Staus post anterior fusion from the c5-c7 level with some posterior spurring noted at the c5-6 and c6-7 levels with some effacement of the anterior thecal sac along with an element of neural foraminal stenosis on the left at both c5-6 and c6-7 levels.
I am sorry this is so long. I just don't know if I need to get to the emregency room. I deal with this alot but I have gotten a great deal worse over the last week. Something is terribly wrong. If someone tells me this is the nature of Myelopathy, then ok, at least I can deal with knowing I wont end up paralyzed. I can just know what to expect. Also could degenative disc disease be that progressive? IS my surgey successful? I know they had to decompress my spine and that was the main reason for surgery. Still I feel like I have no control over my body anymore.
Thank you to whoever will write back. I think I am so used to dealing with the abnormal that I might not realize the seriosuness of what is happening now. Most people would be at the hospital long ago, but I seem to have lost faith that there is help.
Thank you so much. This means so much.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 22, 2006 12:00AM
Without seeing the actual films, I cannot confirm the accuracy of teh report, and any interpretation of the report may be limited in this way
In general, posterior spurring means that there is 'spurs' of bone projecting from the vertebral body, a common finding in degenerative disc disease. They can cause pinching of a nerve root by narrowing the hole or 'foramina' that the nerve roots exit the spinal cord through. Pinching of the C5/6/7 nerve roots can cause sensory symptoms or loss in teh shoulder, or down the arm, and potentially some muscle weakness in teh shoulder or arm.
Effacement of the thecal sac means that a disc is narrowing the fluid space around thespinal cord but not compressing the spinal cord. Nothing strikes me as urgent about this MRI report. If there is still suspicion of spinal cord symptoms, a flexion-extension xray of the neck may show that there is significant narrowing of teh spinal canal, as while the MRI is done in a fixed position, there may be less space for the spinal cord in a flexed or extended position.
Unfortunately, this surgery does not gaurantee success, and is primaily done to prevent further neurological injury when evidence exists that neurological injury is occurring. If any of your symptoms were not due to spinal cord compression, then the surgery would not be expected to do anything for them. But this may mean that treatment targeted towards other sources of pain may help such as muscular or ligament pain.
Good luck
In general, posterior spurring means that there is 'spurs' of bone projecting from the vertebral body, a common finding in degenerative disc disease. They can cause pinching of a nerve root by narrowing the hole or 'foramina' that the nerve roots exit the spinal cord through. Pinching of the C5/6/7 nerve roots can cause sensory symptoms or loss in teh shoulder, or down the arm, and potentially some muscle weakness in teh shoulder or arm.
Effacement of the thecal sac means that a disc is narrowing the fluid space around thespinal cord but not compressing the spinal cord. Nothing strikes me as urgent about this MRI report. If there is still suspicion of spinal cord symptoms, a flexion-extension xray of the neck may show that there is significant narrowing of teh spinal canal, as while the MRI is done in a fixed position, there may be less space for the spinal cord in a flexed or extended position.
Unfortunately, this surgery does not gaurantee success, and is primaily done to prevent further neurological injury when evidence exists that neurological injury is occurring. If any of your symptoms were not due to spinal cord compression, then the surgery would not be expected to do anything for them. But this may mean that treatment targeted towards other sources of pain may help such as muscular or ligament pain.
Good luck
Good Luck
Nicky
Do you have Leukemia? Is bruising like that part of your symptoms? I would be scared too. We wouldn't be human if we weren't.
Thank you for responding. I hope you feel better soon. I halso hope you have the nice weather we are having today. Its going to be 70 in Mich.
I can't drive today, but will play with my pups and ferrets - thats my best meds. My husband is on a fishing trip so I will have some girl time.
Bless your heart for responding. I hope one of the Dr.s can tell me something about the MRI results. Sometimes knowing is the best thing for the mind. I hope you find answers too. Happy Easter!!
The only reason I am telling you this is because the failure rate of this type of surgery is more than they tell you. It is a very hard surgery to fight back from. I recommend you to go see a massage therapist, chiropator, and an acupuncturist. These professions give me more relief and it keeps you off the hard pain killers. ARe you taking Neurontin? Neurologist love that stuff and it is an awful drug. I have a friend they gave that to in a pump in pretty high doses and they fried his brain. I also took it and it really did nothing for me but give me bad reactions.
My heart really goes out to you for everything you are going through. The shocks do go away after a while.