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    Old 04-21-2015, 07:27 PM   #1
    Scelte
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    Csm

    Hi - thank you for reading. I posted last night for first time, my post showed up in wrong location. I thank the person who responded 😊

    I have a few quick questions:

    1 - although mri report had typo and was off by section; the only mention of cord was moderate to severe stenosis. Neurosurgeon indicated I have mild:moderate at another location? And that I have congenital stenosis? Is this gross difference common?
    2- the symptoms seemed to be more radiculopathy (by pt and original neuro) until neurosurgeon mentioned myelopathy ... He is almost positive? Yet - reflexes diminished? Is this some sort of rare presentation; I thought hyperreflexia for cord?
    3- most importantly; if I do have compressed cord is it easy to further damage? I'm wanting to walk around in bubble wrap!

    this post is not as inclusive as I would like; typing is aggregating neck - spasms and pain much worse due to tension; fear future and thankful for my faith. are there non surgical success stories out there? Articles to read? Forums for people who have lived long term with this (non surgical treatment CSM)?

    Thank you again

     
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    Old 04-22-2015, 03:42 AM   #2
    ChuckStr
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    Re: Csm

    I'm not sure I understand your first question. Is it that the radiologist suggested moderate/severe stenosis at one level and the surgeon suggested mild/moderate stenosis at a different level? My experience has been radiologists tend to test things as a little more severely than surgeons but I would think it would be strange that they wouldnt agree on problem areas. I've had good luck discussing radiologist findings with my surgeons to straighten out any discrepancies.

    It's not unusual to have both radiculopathy and myelopathy together. Also, it is common to not have every symptom of csm. Its certainly possible to not exhibit hyperreflexia for instance. More common symptoms include incoordination, gait disturbances and various sensory symptoms in upper/lower extremities such as tingling, twitching and heaviness.

    The likelihood of further damage depends on many factors including the extent of cord compression and if there is an accompanying spine instability. According to my surgeon, the likelihood of severe injury is basically the same as the.normal population unless you have very significant compression. This is something to discuss with your spine specialist.

    I've had a couple of severe bouts of radiculopathy and also suffer from early stages of Csm. I've had many different conservative treatments and have received benefit frim several. So far I've been able to keep most of the pain and other symptoms at bay and avoid surgery. I do have a little residual weakness in my left wrist extensors and i have some minimal sensory symptoms in my legs likely do to csm. The important thing is that I have follow up's with my surgeon and another neurologist to ensure the csm symptoms are not progressing.

     
    Old 04-22-2015, 09:39 AM   #3
    Scelte
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    Re: Csm

    Thank you for reply.

    Mri had typo and so impression still reflecting error. Findings of moderate to severe stenosis at c5/c6 with extensive productive bony change.

    Surgeon suggested mild:moderate spinal cord compression at c4.

    Mri report does not mention cord at c4:c5 only roots.

    Are you saying cord compression is same as stenosis?

    Quote:
    Originally Posted by ChuckStr View Post
    I'm not sure I understand your first question. Is it that the radiologist suggested moderate/severe stenosis at one level and the surgeon suggested mild/moderate stenosis at a different level? My experience has been radiologists tend to test things as a little more severely than surgeons but I would think it would be strange that they wouldnt agree on problem areas. I've had good luck discussing radiologist findings with my surgeons to straighten out any discrepancies.

    It's not unusual to have both radiculopathy and myelopathy together. Also, it is common to not have every symptom of csm. Its certainly possible to not exhibit hyperreflexia for instance. More common symptoms include incoordination, gait disturbances and various sensory symptoms in upper/lower extremities such as tingling, twitching and heaviness.

    The likelihood of further damage depends on many factors including the extent of cord compression and if there is an accompanying spine instability. According to my surgeon, the likelihood of severe injury is basically the same as the.normal population unless you have very significant compression. This is something to discuss with your spine specialist.

    I've had a couple of severe bouts of radiculopathy and also suffer from early stages of Csm. I've had many different conservative treatments and have received benefit frim several. So far I've been able to keep most of the pain and other symptoms at bay and avoid surgery. I do have a little residual weakness in my left wrist extensors and i have some minimal sensory symptoms in my legs likely do to csm. The important thing is that I have follow up's with my surgeon and another neurologist to ensure the csm symptoms are not progressing.

     
    Old 04-22-2015, 08:32 PM   #4
    ChuckStr
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    Re: Csm

    No cord compression is not the same as stenosis. All stenosis means is narrowing. It can be narrowing of the area for the spinal cord in which case it is called central canal stenosis, or narrowing of the space for the nerve roots to exit which is called neuroforaminal stenosis. Cord compression means there is something actually pressing on the spinal cord. Obviously though, the more central canal stenosis there is, the more likely you will have compression because there will be less "buffer" space around the cord.

    I'm not sure why the radiologist and the surgeon would disagree but I do know it can be difficult to see definite compression on MRI. Many times compression is "inferred" by the symptoms and the presence of severe enough stenosis. In my case I have moderate canal stenosis. You can arguably see compression on my MRI axial images at C5/C6 although there isn't any frank deformity of the cord. Taken with my symptoms though, things point in the direction of CSM .

     
    Old 04-23-2015, 01:06 PM   #5
    Scelte
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    Re: Csm

    Well - the stress is a literal pain in the neck! Lol!

    I sent my report and a bunch of symptoms from probably five different issues (ie shoulder surgery; broken toes etc) - walked in sat down and mentioned my most prevelant current symptom (thumb index numbness)... Found weakness right leg and arm but ... I've favored leg and had surgery...
    In fact the entire journey began due to pain in right bicep while working out and pinky issues ... They sent me to nuero; I wanted pt. Did Emg which shows lil something in neck area (I do not have report). Then mri of neck and pt program (which we stopped early until saw specialist). Sat around all winter; stiff! Gained weight. Obviously this was causing it's own progression.

    Back to specialist. He had report; walked in sat down told him my current symptoms and a few that went back 15 years. He pointed to the disc that had been incorrect from typo on impression part of report and told me he saw compression (the finding in mri didn't even mention stenosis for this particular disc).
    I've asked for referal to pain management to no avail. Asked if the compression he was referring to was in addition to the one on report that mentions stenosis. No response.

    He checked me after showing compression; then said he thinks CSM. I like him - liked that he basically said 3/3/3 and that I need to come back before too late. My problem is he didn't describe anything about surgeries; and I am left holding onto an image of myself as a disabled elderly person.
    I need to find pain management and trustworthy interim care.

     
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