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  • Mild to severe C-spine stenosis- Can anyone help?

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    Old 02-26-2003, 06:37 PM   #1
    winged phantom
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    Unhappy Mild to severe C-spine stenosis- Can anyone help?

    Hi All,
    I need your help before I go back to my neurosurgeon. It's hard to be concise about these delicate things, so....
    In 1989 I had a microdiskectomy at C5-6 with no fusion. I seemed to heal well, but I think I did reinjure myself a few times. You know how you slip off a curb or a step and jam your spine? That type of thing did not help. So I developed constant pain, which my PCP finally labeled fibromyalgia.

    This past year, and particularly the past few months, have been a medical nightmare of pain for me, and I consider that "I don't have a life" anymore. My PCP sent me for an MRI, and here are the results:
    ...straightening of normal cervical lordosis which may be reflection of muscle spasm or positioning. Mara signal is normal at all levels. There is loss of signal in the intervertebral disc spaces suggesting multilevel disc dessication. Sagittal images reveal significant disco genic disease at the C4-5 through C6-7 levels. Specific abnormalities as follows...

    C2-3: spinal canal generous and neuroforamina are patent. No disc herniation or protrusion.
    C3-4: Mild central disc bulge causing a mild impression upon the ventral surface of the thecal sac...minimal canal stenosis... neuroforamina are patent... no disc herniation.
    C4-5: Moderate canal stenosis with relative effacement of the arachnoid space and mild flattening of the cervical cord. This appears to be the product of a broad based central and para central disc bulge...accompanying narrowing of the neuroforamina.
    C5-6: Moderate to marked canal stenosis causing effacement of the arachnoid space and flattening of the cervical cord... enhanced by right worse than left para central disc bulge... no frank herniation... neuroforamina narrowing, right worse than left.
    C6-7: Severe canal stenosis with complete effacement of the arachnoid space and flattening of the cervical cord. The stenosis is enhanced by a moderately large broad based disc bulge probably with a small extruded disc fragment at the left para central region.... neuroforamina significantly narrowed...
    C7-T1: spinal canal more generous now with only mild stenosis... no disc bulge or herniation identified... neuroforamina patent.

    At no level is abnormal core signal identified.

    This does not mention the spurs, but they are there, too. Most of my symptoms involve feelings of heaviness across my neck, upper back, and shoulders. I feel like Atlas, with the weight of the world on me!

    Then about a month ago, I developed feelings of prickling down both legs and into my feet. I think that has been there for some time, only not as pronounced, but my PCP, feeling sorry for me by this time agreed to a lumbar MRI:
    L-SPINE FINDINGS: No disc herniation identified at any level... a mild broad based disc bulge at L3-4 level causing some narrowing of the lateral fornices.... varying degrees of ligamentum flavum and facetal hypertrophy in the mid to lower lumbar spine consistent with (DDD)...varying degree of canal stenosis which is most severe at the L3-4 level and is... moderate. Cornus medullaris terminates at the T12-L1 level... vertebral body height and vertebral body alignment are preserved.

    In October I saw one NS, and he prescribed EDS and possible trigger point injections, as well as flexion and extension X-rays. He said until he saw whether things were really loose in the X-rays, he would not at this time tell me I had to have surgery.

    So I had the 3 EDS, and I think they certainly helped some of the pain and certainly mobility and flexibility. The anaesthesiologist could find no real focal point in order to do trigger point injections, though, so we didn't do them.

    Just after the first EDS, I was able to see another NS, and so he was able to hear how that had helped, and he saw all the X-rays, as well as the MRI films. He said the EDS would only stall for some time, and he definitely recommended surgery, plating with titanium at three levels. He said he would use something he had helped to develop (the plate or screws? I don't know)....

    So, because of the severe neck problems, I had to have an "awake fiber optic nasal intubation" for my abdom. surgery. This second NS immediately told me to not have an endo trach tube, when I told him I already had surgery coming up. The intubation was awful, and I remember fighting off the techs, trying to cram that tube down my nose (I don't think they has me under enough, and I didn't know what I was doing! It just hurt!!!!) I'll have to have it for the neck surgery, too. I'll bet all of you have had it, too!

    So is it true that I NEED surgery? Is this optional at all? I've read briefly here of all the various tests you have gone through, and none of them have been prescribed for me. Is stenosis different? More cut-and-dried in the approach for it?

    I see this second NS again in another few weeks (he's really hard to get in to- have to jump through hoops!), this time to specifically ask surgery-type questions. And I need to know more about what to ask. If possible, should I seek a third opinion? If I did, it would be an office mate of the second NS.

    It's hard for me to sit long (writing this has been a real trial), but I wish I could read more of what has been posted here to hear your stories. Just not yet.

    Thanks for all your help...

    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

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    Old 02-27-2003, 01:24 PM   #2
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