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Old 09-03-2008, 06:48 PM   #1
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madonna33j HB User
Brown Sequard New Symptoms and MRI

Hi Everyone,

I am 10 years out from a spinal cord injury. I am fused at c5-c6. My spinal cord was cut during that surgery and I was paralyzed for a short time. I've spent years in physical therapy to relearn to walk and use my hand again.
I've lost hot/cold/pain on the left side...(although I have hypersensitivity there also) and loss of muscle strength on the right.

In March of this year I started having pain in my left leg. When I crouched down, I started to have horrible pain, when I tried to stand up. It progressively got worse. The only way I can describe it, is that when I stood up it felt like I was tearing my leg muscles apart. I also have pain on the bottom of my left foot that I could swear I have something terrible wrong with it.

Over the past two months, the intense pain in my leg has gotton better...much better. I know have a strong burning (more than my everyday for the last 10 years burn pain) on the outside of my left leg, running down the length of my thigh, calf and under my foot. The pain on the bottom of my foot has gotton worse.

I went to the dr. and got an mri. I'll include the results below. The Dr. scared me and said that I needed to deal with the fact my disc, above the fusion site, is flattening my spinal cord. He said if it ever comes out, due to an accident or something, I could be paralyzed again. He said the chances were small that would happen, but yet I had to know the risks of it. He said we should start therapy.

I said okay, look I am having all these pains, so let's do MRIs on my foot and lumbar spine. Let's rule out the leg pain isn't sciatica and the foot pain isn't a neuroma. (since all my sensations are off..it's hard to tell Dr.s exactly what sensations I am feeling.) He said fine.
They came back normal, except for inflamation in the tendon in my foot.

I saw the dr. today. He is sending me to a podiatrist and that's it! I asked about therapy...and he said I didn't need it. ??? huh? He said, are you losing bladder control? I said no, so he said you don't need therapy.
I left there feeling like I was in the twilight zone. Is this the same guy who just told me last month that if I leave the disc alone, it could cause permanent nerve damage? What did I miss?

Can someone PLEASE look at my MRI results and if you have any knowledge on it, please fill me in. I obviously have to find another Dr. But for right now, I'd sincerely appreciate the knowledge for myself.

Also, if you have brown-sequard syndrome......do you have any pain similar?
Can the pain get worse over time? Is this nerve pain stemming from the herniated disc or something from the prior injury? I know no one can probably tell me that one!

Thanks!

Osseous Structures: Again noted are post-surgical changes consistent with prior dicectomy and fusion at C5-C6. There is complese osseous fusuon through the disc space. There are mulilevel degenerative endplate changes. There is minimal grade 1 anterolisthesis at C3-4. There is persistent congenital canal setnosis. The AP diameter of the spinal canal at the level of C4 is just under 1.0cm

Intradural Contents: Again noted is abnormal signal in the right side of the spinal cord at the level of C5-C6 measureing up to 8mm in length and 4X2mm on axial T2 image 12 of series 6. It is unchanged compared witht he prior examination. No new foci of abnormal signal are identified within the spinal cord and there are no abnormal intradural masses or fluid collections.

Visualized Thoracic Spine: No disc herniation or significant disc bulges or protrusions are identified in the visualized thracic spine.

Disc Levels:

C2-3: There is no stenosis, impingement or significant change since the prior exam

c3-4: A disc bulge indents the thecal sac without touching the spinal cord. Right greater than left uncovertebral joint and left facet hypertrophy contribute to bilateral neural foraminal narrowing.

C4-5: A disc buldge flattens the ventral spinal cord. There is prominent right uncovertebral joint hypertrophy extending into the right lateral recess, greater than seen on the previous exam. This could account for the right C5 radiculopathy. There is stable left neural foraminal stenosis secondary to facet and uncovertebral joint hypertrophy.

C5-6: There has been prior discectomy and fusion. There is no residual or recurent disc herniation. Uncovertebral joint hypertrophy, increased since the prior exam. There is resultant left neural foramen stenosis without impingement.

C7-T1: There is no signifcant disc bulge, soft disc heriations, stenosis or impingement.

Here are the Impressions:

1. Stable abnormal signal in the right side of the spinal cord at C5-6 likely represents focal myelomalacia.

2. Degenerative disc disease continues to exacerbate congenital canal stenosis, most pronounced at C4-5 where there is impingement of the ventral spinal cord.

3. Progression of degenerative chane since the prior eexamination, specifically there has been progression of the unconvertebral joint and facet hypertrophy increasing the degree of neural foraminal stenosis at multiple levels.

4. No acute asseous abnormalities.
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Old 09-13-2008, 10:35 AM   #2
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Re: Brown Sequard New Symptoms and MRI

i went back to the dr. He said he wasn't worried about it. So, I left stunned. One month prior he had me in tears saying the disc had to be moved from the spinal cord.
Now he says we don't even need physical therapy. A completely about face!

I've posted on two websites, without any help or the slightest direction. Of course I will go for a second opinion. It is helpful though, to get advice from those who have it, so you learn from their experience.
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Old 09-14-2008, 07:32 PM   #3
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Re: Brown Sequard New Symptoms and MRI

Hi Madonna33j,

I'm sorry that you haven't had an answer yet, and I do not have the exact same symptoms that you do, although I can relate to some of them. It sounds like you've been through a lot, and I am so sorry about that. I cannot understand why your doctor would tell you that you need to deal with the fact that your disc is flattening your spinal cord?? When my disc was flattening my spinal cord my neurosurgeon said that I needed surgery again, which was my 2nd surgery.

First of all PLEASE get a 2nd, and even 3rd or more opinions. Is this the same doctor that did your first surgery?

I have done quite a bit of research today regarding your situation just to help you understand a little better hopefully. I've concentrated on your disc that is flattening your spinal cord. From all the research the spinal cord itself is actually divided up in several sections, and the anterior horn of the spinal cord is the ventral (meaning the front) grey matter section of the spinal cord. The anterior horn contains your motor neurons.

Which part of your spinal cord was damaged? There are apparently millions of nerve fibers in the spinal cord itself, and there are 4 main groups of spinal nerves: Cervical nerves, Thoracic nerves, Lumbar nerves, and Sacral nerves. Each one of these can effect different parts of your body.

As far as the C5-6 Uncovertebral joint hypertrophy, I would search that on the internet by just typing in "uncovertebral joint'. Neural Foramina Stenosis is the narrowing of the foraminal canal where the spine nerves exit through. The Cervical Spinal Stenosis can cause pain, weakness, and numbness in arms, legs, and can also cause gait and balance disturbances.

I would try to find someone that maybe has more experience in spinal cord damage, but don't give up, and keep searching! That's what we all do, and we are all here for you! Even if we don't have the exact same symptoms I'm sure that a lot of us can relate to some of your symptoms.

Please keep us updated. Take care, and I will keep you in my prayers.

Annette
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C5/C6 ACDF 08-22-06
C6/C7 ACDF 05-22-07

 
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