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Old 11-29-2010, 03:57 PM   #1
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mary goodrich HB User
CT results -need help

I had fusion of C5-C7 done recently. I've had spasms in the right shoulder area ever since surgery. Didn't think much of it until after something else happened a few months post-op. My right hand began having difficulties with weakness and fine motor abilities. I have trouble opening bottles and turning the key in locks as well as writing and all kinds of daily things that I've always been able to do. At times, it is better than others, but mostly I have difficulties all the time now. Had an EMG a month ago. It mostly points to right C6 radiculopathy. It also talked about the right Ulnar nerve at the elbow, but didn't emphasis a major issue there. Had a CT Scan done with a myleogram. This is where I need help. It says:

- Effacement of the ventral thecal sac at the C5-C6 but especially C6-C7 level with perhaps some contact with the ventral cord. (Earlier it states, "Lateral view demonstrates effacement of ventral thecal sac at the C5-C6 but especially C6-C7 level consistent with extradural compression with perhaps some contact with the ventral cord identified.")

It also says, "The nerve root sleeves appear to fill normally with attention to the right side with no definite nerve root sleeve impingement."

My neurosurgeon says this doesn't indicate that I need to have a surgery to fix something. He ordered physical therapy, as my right shoulder area spasms and hurts a lot. He said something about the hole being a little smaller on the right side where the nerve root is in my neck. He doesn't want to think about surgery to fix this, but if that was something that needed to be looked at, he said it would be from the back rather than the front. He also said that the CT Scan doesn't at all support difficulty with the hand related to the neck.

I'm confused. What do the results above mean? Should I get a second opinion? I definitely don't want another surgery, but I'm also afraid that something must be fixed for my hand to work right again. I can't live this way. I couldn't even make a turkey for Thanksgiving because of this. Please give me an idea about what the CT Scan is saying, because I think it really does point to something possibly touching the nerve. Is that what it means when it says, "...perhaps some contact with the ventral cord"?

Last edited by mary goodrich; 11-29-2010 at 04:55 PM. Reason: more info

 
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Old 01-15-2011, 07:26 PM   #2
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Re: CT results -need help

I think it might be a good idea to obtain a second opinion, though I suspect you might be referred for another CT. I'm not a medical professional, but given your symptoms and the potential findings in the CT coupled with the EMG results, I think an MRI may give a better view of the affected area.

Basically your CT is indicating that there appears to be some compression of the spinal column near C6 (specifically in the "front" [ventral] region, the part facing the chest.) The ventral nerves and nerve roots are almost exclusively confined to motor (movement) nerves, but if there is a condition causing compression of the ventral spinal column, it's possible that some sensory (pain) nerve fibers are also affected. Certain reflex loops can be affected, giving the impression of pain even though the usual sensory nerves may not be affected directly.

The "effacement" refers to thinning of the protective layers surrounding the spinal cord, and would be consistent with a smaller than normal foramen (opening) in the vertebrae. Many people have this condition without experiencing any discomfort or lack of motor control, but others can have tingling, numbness, pain, and some loss of movement.

I think it might be helpful to seek the opinion of a neurosurgeon at a major teaching hospital, if you can find one that is not too far away. A skilled neurosurgeon working with a skilled radiologist should be able to give you a well-reasoned review of any imaging studies or other tests.

Quote:
Originally Posted by mary goodrich View Post
I had fusion of C5-C7 done recently. I've had spasms in the right shoulder area ever since surgery. Didn't think much of it until after something else happened a few months post-op. My right hand began having difficulties with weakness and fine motor abilities. I have trouble opening bottles and turning the key in locks as well as writing and all kinds of daily things that I've always been able to do. At times, it is better than others, but mostly I have difficulties all the time now. Had an EMG a month ago. It mostly points to right C6 radiculopathy. It also talked about the right Ulnar nerve at the elbow, but didn't emphasis a major issue there. Had a CT Scan done with a myleogram. This is where I need help. It says:

- Effacement of the ventral thecal sac at the C5-C6 but especially C6-C7 level with perhaps some contact with the ventral cord. (Earlier it states, "Lateral view demonstrates effacement of ventral thecal sac at the C5-C6 but especially C6-C7 level consistent with extradural compression with perhaps some contact with the ventral cord identified.")

It also says, "The nerve root sleeves appear to fill normally with attention to the right side with no definite nerve root sleeve impingement."

My neurosurgeon says this doesn't indicate that I need to have a surgery to fix something. He ordered physical therapy, as my right shoulder area spasms and hurts a lot. He said something about the hole being a little smaller on the right side where the nerve root is in my neck. He doesn't want to think about surgery to fix this, but if that was something that needed to be looked at, he said it would be from the back rather than the front. He also said that the CT Scan doesn't at all support difficulty with the hand related to the neck.

I'm confused. What do the results above mean? Should I get a second opinion? I definitely don't want another surgery, but I'm also afraid that something must be fixed for my hand to work right again. I can't live this way. I couldn't even make a turkey for Thanksgiving because of this. Please give me an idea about what the CT Scan is saying, because I think it really does point to something possibly touching the nerve. Is that what it means when it says, "...perhaps some contact with the ventral cord"?

 
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mary goodrich (01-15-2011)
Old 01-15-2011, 09:43 PM   #3
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Re: CT results -need help

Quote:
Originally Posted by jverive View Post
I think it might be a good idea to obtain a second opinion, though I suspect you might be referred for another CT. I'm not a medical professional, but given your symptoms and the potential findings in the CT coupled with the EMG results, I think an MRI may give a better view of the affected area.

Basically your CT is indicating that there appears to be some compression of the spinal column near C6 (specifically in the "front" [ventral] region, the part facing the chest.) The ventral nerves and nerve roots are almost exclusively confined to motor (movement) nerves, but if there is a condition causing compression of the ventral spinal column, it's possible that some sensory (pain) nerve fibers are also affected. Certain reflex loops can be affected, giving the impression of pain even though the usual sensory nerves may not be affected directly.

The "effacement" refers to thinning of the protective layers surrounding the spinal cord, and would be consistent with a smaller than normal foramen (opening) in the vertebrae. Many people have this condition without experiencing any discomfort or lack of motor control, but others can have tingling, numbness, pain, and some loss of movement.

I think it might be helpful to seek the opinion of a neurosurgeon at a major teaching hospital, if you can find one that is not too far away. A skilled neurosurgeon working with a skilled radiologist should be able to give you a well-reasoned review of any imaging studies or other tests.
Thank you for your help. You gave me some info I didn't know. I tried to get a 2nd opinion, but that doctor said it was too recent of a surgery to consider anything yet. So I had several physical therapy sessions recently. By the end of those sessions, my hand regained 100% of it's strength!! I was pleased. However, I still have a lot of spasms and pain in the upper shoulder/neck area. They taught me how to do certain exercises, and when I am faithful with them, it definitely helps. They tell me I have several months of exercises to do before it is totally resolved. I'm very hopeful now that I won't need surgery to fix anything. Thanks again!!

 
Old 01-16-2011, 08:07 AM   #4
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jverive HB Userjverive HB Userjverive HB Userjverive HB Userjverive HB Userjverive HB Userjverive HB User
Thumbs up Re: CT results -need help

Your progress is great news; keep up the good work! It really is amazing how much physical therapy can help, and to me it demonstrates the body's remarkable ability to heal itself and/or compensate for losses due to disease or trauma.

If anything changes, please let us know. I'm sure others will be encouraged by your results. It may indeed take months of exercises to reduce the pain and spasms, and you may very well have some residual pain, spasms, etc. Even if you recover completely, some of your symptoms may flare up from time to time. This is extremely common with neurological conditions. If flare-ups become a real problem, or if physical therapy doesn't provide all the relief you need, your neurologist or pain doctor ought to be able to find a medication to minimize your discomfort. Surgical intervention may be necessary later on, but just make sure you understand the risks and benefits. Best of luck, and keep us informed if anything changes.

Quote:
Originally Posted by mary goodrich View Post
Thank you for your help. You gave me some info I didn't know. I tried to get a 2nd opinion, but that doctor said it was too recent of a surgery to consider anything yet. So I had several physical therapy sessions recently. By the end of those sessions, my hand regained 100% of it's strength!! I was pleased. However, I still have a lot of spasms and pain in the upper shoulder/neck area. They taught me how to do certain exercises, and when I am faithful with them, it definitely helps. They tell me I have several months of exercises to do before it is totally resolved. I'm very hopeful now that I won't need surgery to fix anything. Thanks again!!

 
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CynthiaLLL (02-17-2011)
Old 02-02-2011, 12:06 AM   #5
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Re: CT results -need help

When was the fusion done? Your neurosurgeon probably wants to ensure fusion is complete.

< edited >

Last edited by hb-mod; 02-02-2011 at 01:28 AM. Reason: Please do not post unapproved website links- Posting Policy. (Some "Approved" websites in "Resources" tab- bottom screen)

 
Old 02-17-2011, 12:12 AM   #6
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Re: CT results -need help

I would definately get a second opinion from a Board Certified Neurologist. You can make a toll free call and request one in your area. You need someone to answer ALL your questions.

 
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c6 radiculopathy, cervical fusion, hand weakness, myleogram, neuropathy



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