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Old 08-26-2010, 06:44 AM   #1
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Thecal Compression Help & Advice

Hello everyone
I would really appreciate some help and advice with my recent MRI Neck scan.

I have been informed today that I have Thecal compression @ 2 levels in my cervical spine at C3 & C4 with possible inclusion of Thorasic region however area of scan was limited. Severe muscle spasm was also found.

I am being referred to a specialist at present.

History

I am a pensioned Police officer having been retired on ill health grounds due to several issues. One being hemiplegic Migraine with possible TIA's. A moderate hole in my heart has been found.

I have suffered from severe muscular pain in my neck for over 20 years causing severe headaches that docs put down to stress. I suffered IBS as a result of consuming vast amounts of Ibuprofen which I have now stopped.

I suffer from severe Sacro Illiac pain and sciatica on a daily basis with constant pulled muscles in my spine casing my lungs to feel like they will collapse.
I have reported numbness in my face, nose, both arms as well as severe pins and needles in my arms too as well as occasional difficulty urinating. Doctors think that the pins and needles may be mini strokes but I was convinced it was from my neck and after years of trying I now have my MRI Results.
For your info when I was in my teens I was attacked by a large group of youths who punched and kicked me around the head causing severe swellingand bruising however I did not attend a hospital. (not sure if this may have been the cause of neck injury).

I also suffer from severe head fog, poor short term memory and flu like symptoms but without the cold.

My questions are

Is thecal compression anything to be concerned about?
Do my symptoms sound linked in any way?
Is it possible that the whole of my spine may be affected?
I am now self employed as a landscaper and I often undergo heavy manual work with Chainsaws, lifting etc etc, could this condition affect my job?

Sorry for my ramblings but I am feeling very concerned about what the future may hold.

I hope you can help.

Regards

Marc

Last edited by studio500; 08-26-2010 at 06:51 AM.

 
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Old 08-26-2010, 10:46 AM   #2
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Re: Thecal Compression Help & Advice

Hi Marc,
In short, thecal sac compression is something to be concerned about, yes. In the cervical area, there is a narrow area that the spinal cord and nerves pass through and any compression in that area can be cause for concern. The C3 and C4 areas cover from your neck down to just below the clavical area so the muscle spasms and some of the pins and needles might have something to do with thecal compression but a doctor would be better to discuss that with. Make sure that you make him aware of the occassional difficulty with urination, since that can be an even more serious complication if it is related.
Your best bet is to wait to discuss your symptoms with your consult. He can tell you what is related to your neck and what is not.
Best of luck to you,
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Old 08-26-2010, 03:48 PM   #3
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Re: Thecal Compression Help & Advice

The symptoms could indeed correlate with the findings. If you search for a spinal dermatome chart or picture you'll see where typically we feel problems at various spinal levels. Make sure you are seeing an Orthopedic Spine Surgeon or a Neurosurgeon who only does spines. Consider getting two opinions as it may help you understand your options and give you confidence that some treatment is needed.
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Old 08-26-2010, 04:34 PM   #4
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Re: Thecal Compression Help & Advice

Let's talk anatomy here first.

Your spine in the neck is much smaller than the spine in the lumbar area and so there is not as much room if something goes wrong. Your spinal cord goes down through the center of the vertebrae. At each vertebra, a pair of spinal nerves peels off the cord and exits through an opening called a foramina. Pressure on spinal nerves from arthritis or a herniated disk causes pain and as it advances, causes numbness, tingling, muscle dysfunction and eventually, if totally compressed to the point of loss of blood flow to the nerve, paralysis.

The spinal cord if compressed, does not hurt but produces symptoms below the level of the compression. Symptoms include things like numbness and tingling in the toes, difficulty walking, muscles that just don't work right such as thigh muscles that don't want to move your legs forward, and bowel and bladder dysfunction(both can't hold it or can't go). And depending on where the compression is in the neck, can cause muscle dysfunction in the arms as well such as dropping things, trouble writing, tingling and numbness or just a slow loss of sensation that can be so subtle you don't even recognize it. You get generalized weakness in the arms as well.

BUT...and here is the but...the spinal cord is covered by something called the "thecal sac". The thecal sac holds in the spinal fluid around the cord just like you have fluid covering and circulating in your brain. It's the same stuff...cerebro-spinal fluid. If something is compressing the thecal sac, it is not necessarily compressing the spinal cord. Thecal sac compression is not bad but when and if it advances to the point of compressing the spinal cord itself, then you have a problem.

But even then, cord compression is not that bad. You can take compression down to half thickness and be okay if it happens slowly. I know...that's how far mine was compressed and one doc said to operate and another said to leave it alone. The surgery to relive spinal cord compression has a 3% chance of leaving you paralyzed.

It sounds as if you have spinal nerve compression and thecal sac compression. If the spinal nerves are compressed to moderate to severe levels then they will frequently advise surgery to relieve it before the nerve is permanently compromised. Thecal sac compression is not operated on. Spinal cord compression is usually operated on when it causes major symptoms below the level of compression.

BTW, how do you know you have sarco-iliac problems...have you had x-rays? There are specific disorders that affect the SI joints and they are more prevalent in men than women. Has anyone ever done an MRI on the SI joints to find out if they have plain old arthritis(OA)? If erosive arthritis is present that would make it one of the many sero-negative spondyloarthropathies.....arthritic disorders that specifically affect the spine and SI joints. You should find out. They have a lot of meds to treat them.

You have a problem but it's not the thecal sac compression. That could be a problem down the road but not right now. But it sure sounds like you have a lot of other problems just a serious.

Find out what more is wrong and then educate yourself on the anatomy so you know what needs to be watched and what is okay to leave alone right now. No one should rush into spine surgery.

Lesson over.

hugs........Jenny(fused from C3 to T1)

 
Old 08-29-2010, 05:00 AM   #5
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Re: Thecal Compression Help & Advice

Thank you so very much to every who has replied.

I have tears in my eyes as I write this response, not out of despair but out of relief that at last after so many years of pain I am one step closer to answers. More so to receive answers and explanations from your good selves.

I shall respond idividually if I may to each reply as it will be easier for me to focus but I am so thankful to each of you for taking the time out to offer your advice and opinions.

Marc

 
Old 08-29-2010, 05:07 AM   #6
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Re: Thecal Compression Help & Advice

Hello BH

My urination difficulties come and go and right now I have a burning sensation in my bladder that has been there for almost a week which coincides with my current high level of back pain all along my spine.

My urination flow varies too so much so that several years ago I had my prostate checked and the Dr stated that it may be due to a prostate infection however flow has continued to vary for years since then.

I will do as you say and make him aware of this as I did not know they could be linked untill now thanks to you.

 
Old 08-29-2010, 05:11 AM   #7
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Re: Thecal Compression Help & Advice

Thank you SpineAZ I will search for those charts next and digest the information.
I'm not sure who I am seeing yet or what his/her specialist area is. I should know in a week or two once my appointment arrives.

Marc

 
Old 08-29-2010, 05:40 AM   #8
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Re: Thecal Compression Help & Advice

Thanks for the lesson Jenny and the hugs both are most welcome

I am trying to learn as much as possible about the spinal structures etc as I will feel better equipped on my appointment.

As I said previously I have suffered shoulder and neck pain for many years but it is now becoming so very much worse. Yet my doctors in the past have had varying responses to me usually putting it down to stress and giving me meds despite me telling them that the only stress I have is from the pain, as I'm a pretty laid back person. Others have even told me to stop wasting their time in not so many words.

My neck pain however is changing. My whole neck, shoulders and head muscles would go into spasm giving me severe pain, So much so I could have riped my head off or let a bus run over it! Anything to stop the pain as breathing also became difficult. Now though I get massive jarring when I turn my head. Kinda like when you turn your neck too fast and it feels like a metal bar down down your neck, only this is happening accross the whole left to right and right to left neck movement range.
Cold air also kills me with pain.

My middle back muscles keep pulling constantly and the pain always radiates in a circle pulling in my chest too.

As for my sacro no I haven't had any other MRI or Xray here or on my back, just the short neck MRI.

About 7 years ago I was changing a tyre on my car when I felt such a snap in my sacro area that I thought I had broken my back! I had to crawl inside and was unable to walk for over a week. After this my legs would often buckle from underneath me and stairs were impossible.

I had physio where they lay you on one side and push your hip sharply over and this helped a little.

My lower back has now become very flat ie there is no longer an arch between my back and buttocks.

My lower back causes me extreme pain every morning but sometimes subsides with movement. However I can't jump down a step etc as my back feels like it will snap and my legs will buckle Gauranteed.

Despite this I have forged ahead as a landscape gardener for the last two years. It has been hard as on many days I have no strength or I am in severe pain.
Lifting a chainsaw above shoulder height almost kills me now and I feel frustrated as it looks like my second career is almost over too.

I'm losing weight rapidly as I've lost my appetite and my muscle mass seems to be fading too.

I'm sorry to go on so much but some things I say may be relevant. I'm just glad that the severe pins and needles in my arms isn't from a minor stroke despite being told so from one so called specialist who was scratching her head as to why no other stroke symptoms were present. I told her I thought it was being caused by my neck but she dismissed it.

Marc

 
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