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Old 07-28-2009, 06:53 PM   #1
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Radiculopothy in both arms , could it be from the T spine insted of C spine

i am one yr post-op and my c5-6 acdf didnt help or make any change in pain or muscle weakness , im wondering if its possible that my isues with my arms and hands could be caused from the T1-2 insted of C spine ? All doctors ive seen refuse to even consider taking an MRI of T spine or a nerve conduction test, what do i have to say to these doctors to get what i think i need?

 
Old 07-29-2009, 09:08 AM   #2
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

everything that actually innervates the arms down to the hands is within that c 5-6 down to the t 1 vertebrae, with ALOT of actual crossover at the c 7 thru the T1 nerves. they have both motor and sensory nerve root connections to each other there. but more important, just what WERE your pre op symptoms like and what are you feeling exactly now? do you have a copy of your c spine MRI in your possession? if you do, could you please just post that summary at the very end of that report here? if you do not have one,you really DO need to obtain one. from what you are describing here it would appear that they did NOT actually hit the "right" area that was simply creating your symptoms in the first place possibly? the one area that will usually also show up when you just have that c spine done is also about the first four to five T spine vertebrae too. so any real findings, if remarkable, would also be included there too. but like i mentioned above, once you hit that t 1, there just is no innervation from there on that would be affecting down that arm at all. you are out of whats called the brachial plexus after t 1.

i really do think you need a second opinion and possibly that EMG depending upon if you are having a constant numbness anywhere. but seeing that summary of your pre op MRI would REALLY be very helpful as far as seeing something that they may NOT have fixed that was actually causing you the more prominant symptoms. and knowing what those symptoms were(as detailed as possible down to what fingers were involved then and now) combined with that summary would help even more. Marcia
__________________
3-22-01,herniated C-6-7
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.

 
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Old 07-29-2009, 10:39 AM   #3
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

i had the acdf on c5-6 because of a herniation and large [ right sided ] osteophyt , doctors all along have said that the osteophyt and herniation would only cause isues with the right side only , but i have continually before and after surgery have had pain and weakness in both arms , shoulders, wrists ,as well as pain in my thumbs and pinky fingers. i was told that surgery was purformed mainly to stop the damage and progression ,but it didnt work im still headed for a wheelchair that i wont be able to operate because of my arms and hands . thank you

Last edited by cindybells; 07-29-2009 at 08:52 PM. Reason: left a word out

 
Old 07-30-2009, 08:48 AM   #4
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

wow,now that really sounds pretty screwed up given what your symptoms actually were and still are. there would HAVE to be some other findings further down than c 5-6 to be giving you the level of symptoms. do you actually have that MRI report you could post the summary of for me? it really would show just what was there. this just does not sound right at all to me. something would have had to be going on down further. were you simply 'told' the findings from your report by your doc or have you seen your own report? trust me here when i say the many many specialists do NOT always tell a patient about every actual hard finding that pops up in any given rad report. they just tell you what they "feel" is pertinent to what they think and may not even know that a particular finding is something more than is stated either. it depends on the level of specialist and their overall knowledge and experience. they are NOT all created equal, believe me.

but posting that MRI report really would help alot. also obtaining a brand new MRI for comparrison would just show any newer changes and or progression of definitive findings. something is just sooo not right with this situation and the MRI would hopefully show just what they more than likely missed. this just should not even be happening if they had actually fixed the right things? Marcia
__________________
3-22-01,herniated C-6-7
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.

 
Old 07-30-2009, 04:06 PM   #5
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

To Feelbad ... I will write old pre-surgery MRI report..not able to down load things ,so here it goes ...---------------------------------------------------------------------------------------------------------------------------- history; neck and bilateral arm pain... ----------------------------------- findings: there is a mild straightening of the normal curvature but cervical vertebral body height alignment and marrow signal characteristics are normal. the cord is free of intrinsic morphologic change or edema...------------------ The C2-3, C3-4 and C4-5 levels are unremarkable...------------------------ At C5-6 the disc is desiccated with a slight bulge. There is a superimposed large right posterolateral disc protrusion . This effaces much of the lateral recess and proximal foramen compressing the transiting right C6 nerve root. Left foramen is widely patent.---------------------------------------------- At C6-7 there is a very small midline disc extrusion in midline located in the subligamentous space. The canal and foramen are widely patent. ------------ C7-t1 level is unremarkable. ---------------------------------------------- IMPRESSION: C5-6 large right posterolateral disc protrusion abuts the cord and affaces much of the lateral recess and foramen where it appears to compress the transiting right C6 nerve root. Tiny midline C6-7 subligamentous disc extrusion without canal or foraminal compromise.

 
Old 07-30-2009, 07:44 PM   #6
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

To Marcia [ feelbad ] are you able to work in yur condition or are you on disability ? i cant work ...and thank you for yur suggestions

 
Old 07-31-2009, 01:40 AM   #7
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

Hi I am on my blackberry so I can't write much-will come back Fri on my computer. I would be more inclined it is still cervical or something like Thoracic outlet syndrome. Just because they "fixed" it doesn't mean it can't develop bone spur complexes or new compressive issues above. I will come back Fri.-I have had major cervical probs and surgeries. You should ask for an interscalene block. Research till we chat. NP

 
Old 08-03-2009, 08:21 AM   #8
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

sorry it tok me so long to just get back to you cindy. i was also looking for more direct info on what the findings at c 7 were really saying since in one sentence the rad uses a term that right after that he mentions something that kind of contradicts what was stated right before that kind of thing? this is why it is always good to read thru the reports and see what wording is actually used word for word. from what i can actually make of this, considering the way it is worded is that at the c 7 there does appear to be some extrusion of the inner disc area, but it does not mention a protrusion like the outter ring being torn or a fissure there either, so it sounds like it IS all still contained within that disc itself? the thing you need to keep in mind about the disc itself is that they DO contain pain fibers right within that disc. so anything that is actually even occuring within that actual disc itself, can and does produce pain, even tho it may not be actually herniated it still can produce pain. and if any actual tear occurs within that outter ring, when those inner contents(the nucleous) get introduced into an area its not supposed to be in, the surrounding nerve roots and other reactive soft tissue areas, it acts as an irritant to a degree which just makes the nerves very inflammed and angry too. but that,just from how that report is worded,at least at the time of the MRI,it has not yet occured there.

the one thing i would VERY highly recommend you obtain as soon as you can, would be a repeat MRI with a contrasting agent if possible. there is very obviously alot more going on in the lower end of your c spine area and possibly even at t 1 where they don't seem to even note any of those normal T spine vertebrae that just DO naturally show up whenever they do the c spine. there just HAS to be more going on here that may have not showed itself as badly upon that first MRI. this would also show just how much your surgeon actually took care of in there too. that c 5-6 just would not be responsible tho for the symptoms you are having, espescially the pinkie? that IS more the c 8 nerve. but like i mentioned before, there IS simply alot of play and some overlapping that goes on with the c 7-8 and T one areas too. since these nerves actually have both motor and sensory components within them, alot of how your symptoms are would lead back more to specific areas of the nerves. you can have like a sensory issue going on with numbness at one area when a particular nerve is being affected that can actually also cause a motor function type of issue in a whole other area too kind of thing? thasts the "overlapping" thing i mentioned?

but getting that MRI is just a really badly needed thing for you right now just to really hopefully get a much better look at the lower end and what was or was not actually done at the c 5- 6 too. the c 6 does run down to the hand but the c 5 does not. if i remember correctly it does invlove that thumb and the forefinger? i would have to double check that but that does sound right from my little memeory that is getting worse here too,lol. i would just speak with your regular primary doc at this point just to actually get that referral for the MRI. it would more than likely be a much quicker way to just get this done vs waiting for another appt with your surgeon? when any surgeon just even does a surgery on us, they do not always like anyone "doubting" their work, so getting that MRI from him would probably be much more of a hassle. but that would also depend upon how your surgeon is. but to continue having all the pre op symptoms actually still there post op, well, something is not right there at all. i just do not think from everything going on here that he addressed the appropriate generators of your real symptoms. so getting that comparritve MRI is just really really crucial for you right now just to see how things are. with most spinal problems, they simply progress over time so something may show up much more clearly now vs when the last MRI was done. but this is number one on the top of your priority list here at this point. depending upon the overall findings of the MRI would dictate what your next steps should be with this.

i am and have been on disability since the end of 2004. i will never be able to work again becasue of the major overall damage from the spinal cord nightmare. had to give up ALOT after that surgery.

just have a chat with your primary right now so he really knows how bad and unchanged this all is. it should not be any real problem to simply refer you for another MRI to see things in there now. good luck cindy and please keep us posted, Marcia
__________________
3-22-01,herniated C-6-7
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.

 
Old 08-04-2009, 08:31 AM   #9
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

I spoke with my GP last friday [again] and was able to convince him to atleast let me have an MRI of my neck [only] he refuses to approve MRI of any other part of spine , I was able to get the appt for MRI yesterday [monday] i now live in a very small town so getting an appt it seems is very easy and quik, I did ask the rad technition if he included any part of the T spine and he said that usually the first 1 or 2 of T spine does show up [I HOPE SO], I cant wait to hear what findings are and if he actually took ANY of the T spine . Thank You Marcia I will write back with results as so as I get them. As far as SSI i have been fighting since 2005 and still not approved [THANK GOD I HAVE GROWN CHILDREN TO HELP ME]

 
Old 08-13-2009, 05:50 PM   #10
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Re: Radiculopothy in both arms , could it be from the T spine insted of C spine

Hi cindybells. I haven't weighed in on your problem as I knew Marcia was on it and she knows everything about necks. But I thought I'd add a little something. The nerve between C7 and T1 is known as C8. It serves the little finger and the far outside of your arm. This was the last of my 3 herniated disks to go in my neck and the one that alerted me to the trouble in my neck(didn't know I had other herniated disks). But this doesn't affect the the thumb or other fingers (with the exception of the side of the ring finger...maybe) and you seem to have weakness and pain all over your arm and hand. Even your original MRI shows no reason for the pain with regards to your neck.

But that doesn't mean there is nothing wrong. It just means it isn't your spine. It could be your brain. Another poster here is being looked at for the possibility of MS. I've had 4 strokes in the base of my brain(lacunar strokes) that mimicked my neck problems but were strokes....and with PT I recovered the use I lost as a result. It could be as Marcia pointed out, a thoracic outlet syndrome problem where a nerve gets pinched by a rib in the shoulder area and causes what you describe. I had a major problem with arthritis in my shoulder that caused similar symptoms. Just because you had a problem in your neck doesn't mean there is another problem there. It might be something very different. Might be worth it to see a shoulder specialist(ortho). If it was there before surgery and still there after(but the right sided pain is gone) then it seems to me that something else is wrong as well and you need to find out what.

This is not unusual. I had surgery on both shoulders the year before my neck surgery as all my pain was being attributed to my shoulder arthritis. Some of the pain went away after surgery. Most of the rest turned out to be from the neck. Some turned out to be from rheumatoid arthritis that no one knew had attacked my spine. That is now gone thanks to a new med.

Mysteries need solving and sticking to one answer may not be YOUR answer. Maybe time to dig a little further for the source of the pain and weakness.

gentle hugs.................Jenny

 
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