First Timer - Hi All! - Spinal Cord Disorders Message Board

Jill1004 · 04-09-2006, 08:37 PM

Hi Everyone. A quickie overview. I'm 40 and am s/p a 2 level ACDF with instrumentation (and cadavar bone) on 11/18/05 at the C5-6/C6-7 levels. The surgery was a complete success and in my eyes... my OS is an absolute wonder! The pre-op issues that plagued me are gone... the numbness and tingling, severe weakness and pain in my left arm. Gone. I probably should mention that my issues are related to a car accident in 5/05 when I was rear-ended at a stoplight. Prior to surgery my OS questioned doing the C4-5 level as well which showed minor issues, but after much deliberation he/we decided to just do the two levels and save me from the anterior and posterior approach, and the longer surgery/post op recovery, telling me that a subsequent surgery would be probable at some point in the future. I was fine with this decision. After my surgery and "getting in there" he was most confident with his work and said that doing only 2 levels was the right approach. My post-op x-rays show fusion and again, the symptoms from before are gone.

Over the last couple of months, however, I have begun to have new symptoms and issues. I have posterior neck pain that radiates up into my head and daily headaches, of varying degree. I have also begun to intermittent low back pain, and numbness and tingling in my right thigh/leg that has gotten progressively worse over the last few weeks and now radiates into my foot. This pain/numbness/tingling is far more prominent when in the sitting position, such as sitting here at my computer (my job) or when driving. My upper thigh, hip gets numb to the point where I could poke it with a pin and not feel it. I have pain similar to sciatic that radiates into the outside/back of my thigh, knee and calf. My foot , while not numb like my thigh, has a very dulled feeling to it. I also have an electrical type tingling sensation in both sides of butt and randomly throughout my left upper leg and "other" more personal areas. All very bizarre.

A lumber MRI in the supine position proved completely normal. My OS then ordered another cervical MRI. In September prior to the surgery, the C4-5 level showed a small central disc bulge/low profile profusion with no spinal or foraminal stenosis.

The most recent MRI (3/06) revealed that at the C4-5 there was now broad-based disc protrusion at the left paramedian aspect extending into the left neural foramina causing left foraminal stenosis. This is minimally effacing the left anteroir aspect of the thecal sac, but not the spinal cord.

My surgeon talked about my leg issues being referred pain from the cervical spine, but I am having a difficult time finding much information online to support this. Dermatome maps don't match my issues, and typically the pain/numbness in my right leg would be associated with an issue at the L4 or L5 level, right?

I guess I am just wondering if any of you good people have had an issue like this. I am undergoing facet block injections on Tuesday (4/12). I'm not certain exactly what we are hoping for, but I want the leg issues to go away. I have two teenage sons, one who will be going off to college 3-1/2 hours away in August and playing basketball. I HAVE to be able to ride in the car, as I refuse to miss out on stuff (more than I have already) because of pain/numbness while driving/sitting in a car.

Any heads up... words of advice... wisdom.. or just your plain ole' 2 cents would be most welcome at this point. If you have questions for me... fire away!! Thanks so much in advance for your time.

Jill~

joplin7042 · 04-09-2006, 08:38 PM

Welcome To The Health Boards!

mb100 · 04-09-2006, 11:00 PM

Hi Jill,

Sounds like a problem in the lumbar, dont it. But it could be cervical like the doc says. Cervical Myelopathy is when your cervical spinal cord is being compressed, by a herniated disc usually. It can cause symptoms anywhere south of the compression site. Some of the usual suspects are, bladder problems, or sometimes the other side, rough gait, dragging one foot, pain and or numbness in legs/feet, or pretty much anywhere for that matter. And weakness/fatige. Heavy feeling limbs.

I'm assuming the MRI 3-6 was in the supine position too. I've had several and I wonder what an upright would look like, the disc with a load on it.

You have spinal tracts runnin top to bottom in your spinal cord. If they're damaged up north, you'll feel it down south, most likely. Although some show no symptoms at all. Google spinal tracts for more info on that, as well as myelopathy. That will keep you busy for awhile.

The fact that your symptoms increase when sitting sounds like the problem is lower down, but not nessesarily. It could be the C4/5 herniation.

I find that when I drive in alot of traffic my symptoms go through the roof. Turning my head alot at any time does this, or holding it in a turned position for too long.

By the way, I had acdf C4/7 4-04 w/plate for myelopathy. I have residual/permanent problems in lower back/R. leg. Now a new herniation at C-3/4 slightly compressing the cord that they dont think needs any work at this time. I dont like the sound of that, especially after reading your story!

I know there would be a good reason but, why would he fuse C-4/5 posterior instead of just doing acdf C-4 through 7?

Did you sustain any injuries to the low back in the accident? Or was it just whiplash.

Where are they doing the facet block injections? Are they for the leg problems?

Was there any event that brought on the new symptoms?

Any new symptoms in the arms or shoulders?

I know, sounds like alot of random thoughts.

But this will start the dialog, Folks are sure to jump in. Read around alittle on this site and click on the names that have something similar to you. read their threads and posts and get back to us!!! Best of luck.

Take it slow.....Mike

Jill1004 · 04-10-2006, 12:16 PM

Hi Mike ~ Thanks for your reply. I have never been so confused about what is going on with my body! All rather frustrating to me. I appreciate your Google tips and will look into the things you mentioned. You certainly seem to know what you are talking about... and from personal experience I'm sorry to say. That's the wonderful thing about these boards - people who have gone through it all and know first hand. Medical professionals, therapists, friends and loved ones can be incredibly supportive and caring, but unless they have laid on the table and had parts removed, new parts put in, and lived through the emotional and physical experiences themselves... they just don't know.

To answer your questions:

If my OS had done the C4-5 level at the same time that he did C5-6/C6-7, doing three levels would have required both anterior and posterior approaches and instrumentation on both sides of the spine. Two levels only required the anterior approach with instrumentation. My C4-5 prior to surgery only showed a small central posterior disc bulge, but he explained that that would be stressed once the two levels below were fused.

No injuries to my low back from the accident that I was aware of. Just the sudden onset of horrible neck pain that had me leaving the scene via ambulance. At the time of impact I was stopped at the light and my head was turned to the left, as I was going to make a right on red. The neck pain was intense and was that of a deep hot burn.

The facet block is in my neck. I'm not certain what this is even supposed to accomplish. I was under the assumption that it was for pain, but I just spoke with the hospital radiology nurse who will be with me tomorrow and she said it is more of a diagnostic tool. I had ESI's prior to my surgery (injected through the side of my neck under my ear) which proved to be the most horrific pain I have experienced in my life (and I've had two babies.. naturally with no pain meds!!

) I was told the facet blocks would be through the posterior aspect of my neck and would not be anything like the ESI's, but now the radiology nurse explains that they are in fact almost identical and that the facet blocks ALSO go through the side of the neck. I'm a wreck right now remembering what I went through in the fall and will this in fact be what I experience tomorrow. Ugh.

My new symptoms seemed to be brought on by a 3 hour car ride and sleeping in a hotel room one night. I experienced horrible back and leg pain. Prior to the trip I was experiencing only minor leg pain when driving/sitting for longer periods. Now whenever I sit for just a few minutes my thigh goes numb and the pain goes down my entire leg.

No new symptoms in the arm. Some very random tingling in my hand, but nothing persistent. I still have intermittent pins and needles in my upper back and toward the left shoulder area. That was still pretty bad after the surgery, but has gotten somewhat better in the last few months. I do have random bouts of tingling in various parts of my neck - not just posteriorly, but all the way around. My pinky on my left hand has a "dulled" sensation, which is to be expected and only further complicates things in that I had an ulnar nerve transposition on that side in July. It was when all my cervical issues didn't subside after that surgery that they did a cervical MRI and found my neck to be an absolute mess.

Again... I appreciate your thoughts, advice and words of encouragement. I am a nervous wreck about these injections tomorrow. A happy thought... by this time tomorrow the injections will be done!!! Have a great day!!!

mb100 · 04-10-2006, 01:09 PM

Hi Jill,

I was, and still am confused only because I've never heard of it being done that way. I'm sure there's a reason for it. I have those 4 vertabra fused, all anterior w/plate. I do know muti level fusions have a higher risk of failure.

Anyway, try to relax they will be over tommorrow. Maybe they will give you a sedative beforehand. Not that that will help today. Duh! I dont know much about the injections having never had one so I cant really speak to that. I have heard alot of others that said they worked well.

Lots of folks on here have had multiple surgeries or problems with an adjacent disc after acdf, and alot of different conservative treatments have been tried on them with varying degrees of success. Keep reading.

I chuckled when I read what you said about how well meaning friends and family cant know. I've seen that deer in the headlights look many times when trying to explain something. We do indeed have a common bond!

I hope the injections work for you, best of luck!

Take it slow
Mike