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Old 02-24-2003, 12:22 PM   #1
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dck696 HB User
Smile Surgical advice on cervical stenosis & symptoms

I'm so glad I found this board! Please give me your expert opinions, and I'll be most grateful!

I am 43 and 1998 began having shoulder/neck pain. I've had myelograms and MRI's, and I've gone from "moderate C6-7 stenosis" to "severe C6-7 stenosis". Acually, the last MRI (2 years ago) said "C6-7 disc bluge, with positional cord impingement and severe segmental stenosis."

I've done the physical therapy, the Celebrex, the muscle relaxers, the Advil, the special pillows. I'm now on 200 mg Neurontin (I realize a low dose) which had been helping alot, but now it's not. My neurosurgeon is the best, and is conservative, which I'm glad. A year ago when he put me on the Neurontin, he said it was the "last step" before surgery.

I saw him again last week, and I have an MRI scheduled for tomorrow. My present symptoms are: Shoulder pain and tenderness, neck stiffness and "heavy headed" feeling, right hand is tingly and alittle numb, falls asleep alot in the night (thumb and index finger especially). I may be imagining it, but my right foot seems clumsy, because I seem to stub my big toe and trip alot (maybe I'm just a clutz!) My handwriting is very messey now and uncoordinated. Is this all in my imagination? WHAT I DO NOT HAVE is pain shooting down my arm, which I hear is common and a big indicator for surgery. I've never had that, but I have about every other symptom.

Last week dr. checked my reflexes and said they were still good.

Making my long story short (too late, I know) here's my questions:

--can severe stenosis improve? In other words, can this MRI say I've gotten BETTER?

--do you operate even when my symptoms are "tolerable", or are you risking permenant nerve damage?

--If dr. increases Neurontin as the next step, am I only masking symptoms and prolonging the inevitible surgery?

--Myelogram question: I've heard if you still require a myelogram at the time of surgery, they can do it after you go under anethesia at surgery time. Have you heard of this?

--I had carpal tunnel problems and surgery in 1997, could THIS be recurring and causing the hand/finger numbness?

I'm sorry to have so many questions! Please help answer any you can! Thank you so much!

 
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Old 02-24-2003, 04:53 PM   #2
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empi HB User
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Hi dck696

I had to respond to you because I had your symptoms. mine started weith numbness and tnglign (pins and needles in the left hand which thought was carpal tunnel (NOT!!). Then, the foot started "sticking to the floor" and then weakness in the legs, fatigue, the whole 9 yards. I suggest you get to see a Neurosurgeon if your doctor is not one asap.

I had a discectomy in 11-02 at c-4-c-5 one levem nfusion using donor bone no plate for ruptured disc. however, I still need a cervical laminectomybecause of the spinal chord narrowing but will know more after I see the doct on 3-7.03. I am doing great. the discectomy cured my symptoms and I would say that I am 90%. I had to wear a dreaded collar for 8 weeks but it was worth in in hindsight. I don't know if a disc is your problem but I also have stenosis, I will keep you posted. In the meantime, you have come to the right place. Everyone here is great.

I doubt you had carpal tunnel in the first place as I know too many people who had carpal tunnel surgery and it never was carpal tunnel in the first place.

I will have to have a myelogram too before they do the cervical laminectomy. I will keep you posted in the meantime, you do the same okay?

Maria

 
Old 02-24-2003, 06:13 PM   #3
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Thank you so much for your advice! It's funny you should say that about maybe I never had carpal tunnel problems at all, because in 1997 when I had an EMG for it, it barely showed any problem at all. I will have to say, however, that my neurosurgeon in Nashville did the "wrist tap" and I experienced some numbness in my fingers, which is typical for CPS. I've read about "double crush syndrome", have you? It's where the nerve can be pinched up high due to cervical problems, and also lower due to carpal tunnel or other problems.

My sister who has had 3 ACDF surguries told me that at her last one, she was afraid of the myelogram again so the dr. said "no problem" and performed it after she was under anesthesia. She never knew the difference. Sounds like a plan to me, and one I will beg for if this is my fate. Ask about it!

Keep in touch with your situation, also. Thanks again for responding.

Donna

 
Old 02-24-2003, 06:56 PM   #4
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halina HB User
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Hi,
There are a lot of knowledgable people here. My symptoms (arm and neck pain)started mid 2000. Ortho doc from X-rays told me to be used to it and live with it. But I feel that my life is a vegetation now. I tried PT twice, Arthrotec,Flexeril and epidural shots also twice. A new ortho doc made a MRI and I have:a severe disc bulge and possible superimposed herniation. Flattening of the cord more on the right than the left at the C5-6 level with foraminal stenosis.He suggested anterior cervical discectomy and fusion. I am going for a second opinion. Please advise.
Thanks.
Halina

 
Old 02-24-2003, 07:51 PM   #5
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Location: welland, canada
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melanie dawn HB User
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Hi DCK696,
I also have stenosis with myelopathy. As for your question regarding the shooting pain in the arm.
There are a couple of factors here, stenosis can cause myelopathy, symptoms include tingling, weakness, numbness, loss or deterioration of fine motor skills(writing eg), balance and coordination issues, This process may be relatively pain free. The shooting pain you are referring to is radiculopthy, and you would only have this if an exiting nerve root is compressed. Many people have severe stenosis and myelopathy without the radiculopathy.
What is important is your reflexes, hyper reflexes are a sign of cord compression/dysfunction. They can be a good way to help track the disease. My advise to you is that if your stenosis is symptomatic,ie; weakness,numbess, loss of balance, altered gait, I would seriously consider surgical intervention. The goal of spinal decompression is to halt the progression of symptoms. Remember that in severe cases loss of bowel and bladder function and paralysis are possible. And that the longer the compression and symptoms have existed, the higher the risk of permanent neurological damage.
My advice is to seek out the most experienced and competent surgeon available for consult and possible treatment. Not all neurosurgeons specialize is necks, so do some research and please take care of yourself. Learn as much as you can , and take advantage of the power that knowledge will give you.
Best of luck, Mel
__________________
Congenital Cervical Stenosis,complicated by:
Paracentral Disc herniations ,bone spurs C4/5,C5/6,C6/7
loss of lordotic curve
Advanced myelopathy inc. walking difficulty, loss of gag reflex with swallowing problems, neurogenic bladder, occipital neuralgia, spacticity

 
Old 02-26-2003, 01:15 PM   #6
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dck696 HB User
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Thanks to all of you who posted to help!

 
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