Re: HELLO, i need some help
did they actually do your EMG FROM that c spine area on down or just at a lower end(just from the upper arm or from the elbow) of the arm itself? that alone could make the diifference in just how this all actually got interpretted. the thing is while we do not have an actual c8 vertebrae,we do have a c 8 nerve,and that IS also the ulnar nerve where it starts and comes down right from the spinal cord level.
depending on just what that osteo is actually affecting would dictate whether or not this is where that actual compression or involvement is at. i do have to say tho that when you have the symptoms you are in just that pinkie and only part of that ring finger,well that is a classic ulnar/c8 involvement symptom,with that ulnar actually being compressed at some point or you would not have had the more constant numbness you had/have. your symptoms just fit totally with that c 8 dermatome( a dermatome is the area any given nerve actually innervates). just where IS all of the atrophy at,further up the arm or down into that hand? that wouldalso dictate just where or how far up the nerve that compression is at.
thankfully,you are being referred to the right type of specialist for this,an actual neurosurgeon. they would look at your situation in a totally different way/angle than an ortho would for the source of affectation. it really IS important for me to know,and your neuro too just where that EMG was started from,the c spine or futher down the arm. the thing here is,if it was NOT done FROM the c spine(you would have had those needles stuck into the upper neck area not just the arm)the ortho should not have just 'assumed' the cubital til that c-7 t 1 area of the c spine had been thoroughly checked out first before ANY actual surgical procedure was even done on you. i really hope he did not just assume this was cubital and went ahead with an actual surgery on you. he should have checked things out totally and completely before submitting you to an actual surgical procedure,thats just his job to do for you,his patient.
i personally,based upon just what you have posted here and my self also having very severe c8 damage,really do think your problem IS stemming more from the osteo with other possible contributors there too that do not always show really well upon MRI either. you just have very 'classic' c 8 nerve compression symptoms going on,despite that release surgery the ortho did on you. it sounds like things are actually worse than better since he did that surgery,am i right there? you just should NOT be having any atrophy at all if that nerve involvement was actually what the otrtho told you it was. atrophy,in this sense would be caused by innervation loss to the muscle,not just from a disuse standpoint.
the bigger picture here is if that c8/ulnar is actually being somehow compressed or impinged at the c spine level it just really does need intervention soon if you are ging to have any real hope of getting that muscle and possible nerve back again. the way nerves are compressed and the overall length of time this has been left to go unreleased is what will dictate pretty much whether or not you will be able to get that muscle eventually rehabbed back again. like i mentioned above, i lost alot of my c 8 and also my median nerves that were damaged at the c spine/cord level becasue of a surgery i had to have done in my cord right at the c 8 nerve level. amazingly,over the past five years or so,i have actually regained some nerve flow in areas where there was none when my physiatrist did my first EMG about two months post op. we just recently did another last year that showed i had actually gotten alot back again but i did lose alot of fine motor function in my left hand just from the cord damage which i was already informed before my surgery that was just going to happen becasue of my situation. in my case,it was unavoidable.
alot of what you will or wont possibly get back again is very highly dependant upon the overall damage to that nerve and how it will respond once it is finally relesed by the neurosurgeon(AND some physical therepy too,which would be needed in your particular case). you ARE seeing the right type of doc with the NS here,trust me on that one. depending upon just what the ortho did or did not follow thru with pre op,well,he could have done a completely not needed type of surgery on you there. but that would depend upon just what he used to determine his dx of your situation too. but if you did not have that EMG done from that c spine level and he went ahead with this particular surgery,he simply did not thoroughly do his job before putting you thru a surgery in the wrong place,you know what i mean? just from what you have described here it would seem pretty clear that your compression was not at the cubital but at the c8 c spine level the whole time possibly?
just an FYI here for you on the hand "loss' thing you were told about? any real 'loss' in your case would most likely be limited to only the areas where that ulnar innervated in your hand,you know what i mean? you would NOT actually lose the whole hand mobility,just the areas where that ulnar actually innervates. what is being affected right now is pretty much the overall extent(just EXACTLY where is that atrophy showing itself right now?). and this would be the worst possible case scenerio given the symptoms you now have. so that whole hand thing,i seroiusly doubt would ever actually occur. i have extensive damage to a couple(ulnar and median mostly) in my arm down thru my hand and amazingly i still have pretty good hand function despite losing eight fine motor muscles and the loss of my thumb(but it was very pathetic at the very beginning). my whole hand at first was actually starting to claw about one month post op,but they placed a lumbrical brace over the area where the fingers go to the base of the hand and it did help to keep this whole thing from occuring. PT would be required for you too once you can get that nerve released properly. but time is also kind of your freind here too after that as in my case,i actually got alot more nerve flow back over the past few years that my doc and myself thought was just completely gone for good.
i do wish you lots of luck with this and the NS visit. hopefully he can fix that problem that at this point really does sound c spine related. you 'can' get back some pretty amazing nerve flow once that area is no longer being affected and time kicks in with the nerve repair and therepy. so all hope is not lost with this,K? please keep me posted on just what you find out with the NS. i really do want to know just how extensive that involvement actually is and what he can do to fix this for you. just hang in there,K? **
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.