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    Old 05-11-2003, 12:56 PM   #1
    Randy99
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    Question Cervical Spinal Stenosis?

    I was diagnosed with cervical spinal stenosis three years ago. My symptoms started after extending my head all the way back and lifting up my body when trying to reach for something under the furniture. What's bothering me is that my symptoms don't seem to be as common. I do not have any pain. Both of my MRI's (the last one a year ago) showed I have cervical spinal stenosis. On a scale of 1 to 10 (with 10 being the worst), the doctor (whose a highly regarded orthapedic surgeon) rated it a 5. He said I do not need surgery. I have no pain. What I do have is:

    1)When I lift my body to get out of bed, using my arms to push me up, my neck will tremble.
    2) My reflexes are extremely fast. If I drop something, my body jumps to catch it so quickly like it never did before. It's kind of like a fast jerk. However, the doctor's say the reflexes that they test are not nearly as bad as I feel they are.
    3) When I reach for something up high with one arm, my arm will begin to tremble.
    4) After I open a can of tuna and as I squeeze the water out, my fingers will tremble.
    5) When I am sitting at work, and I turn my head and upper body towards one side, and my legs are lifted off the ground, I feel a weakness in my legs.
    6)When I shower and I extend my left hand to wash my right shoulder, my entire left arm will shake. It will shake even more if I had just exercised with weights. (I do limit my exercise with weights since this happened).
    7) After I exercise, sometimes my fingers will feel rubbery.
    8) My handwriting is somewhat awkward and has changed.
    9) It seems I am still very strong, but in certain positions, my body reacts.
    10) I do have TMJ, but on occasion, I almost feel like the stenosis will affect my jaw, mouth, and tongue. I have no trouble chewing or swallowing, but if I drive a car for a long time, my tongue and mouth tends to feel awkward.

    What I am concerned about is:
    Is something pressing on a nerve that can be causing this?
    Do nerves die from this, and then you become paralyzed?
    Are these symptoms from cervical spinal stenosis?

    Over the past three years, I have seen 5 neurologists (two who were very well known) along with 2 orthopedic surgeons. No one felt the need to send me for an MRI of the brain.

    Can anyone help to calm me down and convince me that I can live this way without any serious ramafications?

    Thanks in advance for your help.

    Randy


     
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    Old 05-11-2003, 06:16 PM   #2
    Eugene2003
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    Randy,

    I have spinal stenosis at the C4-C5 level. I have had unexplained problems yet to be diagnoised. Spinal stenosis can be very serious. If the spinal cord is compressed you can damage it permanetly. That is what I'm going through. I may have to have suregery for the third time. My situation is more severe. I already have damage to the spinal cord. Get a second opinion about your condition. Sorry, if I scared you! Have a nice day!

    ------------------
    EH
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    EH

     
    Old 05-11-2003, 06:30 PM   #3
    Randy99
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    Thanks for your reply.

    If I had compression in the spine, wouldn't it have shown on the MRI? More than one doctor told me it
    was not compressed. I can honestly say that a lot of my problems come with movements that I feel involve the cervical spine.

    Please help with more opinions. They would be greatly appreciated.

    Thanks,
    Randy

     
    Old 05-11-2003, 08:25 PM   #4
    winged phantom
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    Hi Randy,
    Welcome to the board! I don't know if I can really help you, but I'll see what I can do. To figure out which nerves affect which areas of the body, the dermatomes will tell you that. Now most of what you described was trembling of arms/hands/etc. Is it only trembling? You said no pain, but what about prickling (paresthesia) sensations? In at least one or two instances you said you had weakness, though, and I think that is a more typical symptom.

    You said you were diagnosed with stenosis, but if it doesn't show up on the MRI, how was it dx'ed? I think there either has to be demonstrated compression of the spinal cord or of the nerves (by spurring, etc.). I don't really know at what point a surgeon decides when to do surgery. You said you have "moderate" stenosis (5 on a 1 to 10 scale)? I think my neurosurgeon (NS) probably would not be too much in a hurry to do surgery with moderate stenosis, but severe is another thing. And I would think that symptoms are another thing, too.

    From what I understand, stenosis doesn't have to involve any pain at all, and some people do not demonstrate pain even with a high degree of stenosis... which makes it very dangerous for them. Stenosis is a progressive problem, but no one can tell whether it will be stable for some amount of time or be rapidly progressive. This is an individual thing that cannot be determined in advance.

    Have you had an EMG or other test to determine nerve damage? It may or may not show stuff, though...

    I'm really not very good at all this, but I think you owe it to yourself to see a good NS for his/her view. Yes, there are some very good ortho guys who do a fine job on necks, but it seems you have many unanswered questions, so I would suggest the NS at this point to get a different perspective.

    Welcome to the board... Hopefully some of the others who know more than I will also chime in with opinions.

    wr

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

    [This message has been edited by winged phantom (edited 05-22-2003).]
    __________________
    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 05-12-2003, 03:30 AM   #5
    Midge130
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    Randy,
    Hi! I'm pretty new too, but I have spinal stenosis so maybe I can help a little. Spinal Stenosis 'IS' compression of the spinal cord. My MRI showed the compression. I'm having a myelogram done in June to see if it's a bone spur or a disc causing the compression. Go see another NeuroSurgeon and see if he/she will do an MRI on you.
    Midge
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    -Born a premie in 1964-8 wks early
    -C-section 1990, 1992, & 1995
    -Shoulder pain since 2000
    -C4-C5 bone spurs causing central canal stenosis. Annular tear.
    -C5-C6 mild narrowing of canal.
    -C6-C7 disc bone spur and annular tear.
    -C7-T1 bone spur and annular tear.
    -No surgery;I'm not bad enough yet!

     
    Old 05-12-2003, 10:06 AM   #6
    melanie dawn
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    Hi Randy,
    Welcome aboard!
    First lets start with what spinal stenosis is, by definition it means narrowing of the opening of the spinal canal. Now you can have stenosis without frank cord compression, What needs to be understood is that when your head and neck are flexed, the cord gets wider and the canal gets narrower. The opposite is true, with extension.So while your cord may not be truly compressed, it may be occasionally pressed.
    So of the utmost importance is, an MRI which includes pictures taken with your neck in flexion and extension.
    One the main determining factors in the stenosis treatment, is the effect of the stenosis on your reflexes. Although I had many symptoms, pain, numbness etc. It wasn't until all of my reflexes became abnormal that the stenosis becomes a surgical must.
    Also have you seen a Neurologist or Neurosurgeon. I think myself that i would want a very thorough neuro exam.
    You must remember that surgery is a last resort, because all surgerys carry risks. Also that , once you have had surgery, you are at a much higher risk of needing further spinal surgery.
    I hope this information helps, please, get a neuro consult if you haven't had one. And remember the changes in the spinal canal which occur with movement.This explains alot of the different symptoms that come with movement.
    Please take care of yourself and once again, welcome
    Mel

    ps; i forgot to mention, that the rule of thumb is, the pictures(mri) alone are not the deciding factor. They must correlate with the symptoms. Some people have up to 50% of the cord compressed without symptoms. While for others, any minimal irritaion of the cord produces multiple symptoms.

    [This message has been edited by melanie dawn (edited 05-12-2003).]
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    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 05-12-2003, 07:58 PM   #7
    winged phantom
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    Mel, that was a great answer... And I don't think I've ever seen that answer before... why not, I wonder? Other web sited don't seem to link things like that! I wish I had known that before my surgery. But I think with the spurring also causing stenosis (right, that can also be stenosis, can't it?), I think surgery was in my future anyway.

    Randy, the thing that has eluded many of us, and I know I never was told this in 1989.... once a cervie, always a cervie. Whenever you have surgery, I think you're pretty much assured you'll have it again... and maybe again, should you live long enough. And not all doctors produce the same results, unfortunately. You have to think long and hard and look at your symptoms and see what you can live with in making the decision whether or not to have surgery.
    wr
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    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 05-13-2003, 03:36 AM   #8
    Randy99
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    I can live with these symptoms. I am only afraid that I will be permanently damaged from not getting the surgery. Can my nerves die from all the fast reflexes I feel as well as the jerking upon certain movements? Does this cause paralysis? These are my real questions.

    Thanks
    Randy

     
    Old 05-13-2003, 08:08 AM   #9
    melanie dawn
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    Hi Winged and Randy,
    Yes winged, spurs are also a part of stenosis. Anything that causes narrowing. That is the literal definition of stenosis, narrowing. And I'm glad that you found the post helpful. You picture a garden hose, when it bends , it is narrower at the bend. That is the simplest way I know how to describe it. That is why the flexion and extension pictures are so valuable. they look at the spinal canal and cord in the various positions, and how that effects the space,looks for what is known as the pincer effect.

    Randy, you need to really discuss this with your dr, or NS. Yes you can live with the symptoms, but if you have really brisk reflexes, then you are already symptomatic. My understanding is, once symptomatic, the symptoms will not go away. For a small percentage they remain the same, stable, for many years. For others there is a steady progression of symptoms. The goal for surgery with stenosis is not to reverse the process, but to halt the progression of symptoms.
    I hope this helps, Mel

    ps , I just reread your question Randy, Yes the stenosis could result in paralysis, loss of bodily function control. With a very narrow spinal canal, you are at risk of serious cord injury with a fall or other accident. Please do online search of cervical stenosis, with and without myelopathy.

    [This message has been edited by melanie dawn (edited 05-13-2003).]

    [This message has been edited by melanie dawn (edited 05-13-2003).]
    __________________
    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 05-15-2003, 07:25 PM   #10
    NYFUSED
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    Hi to all.
    Please also note that anyone with metal/titanium or any implant in the cervical or lumbar spine areas should have a myelogram. MRI'S AND CAT SCAN'S do not always pick up stenosis, herniate disc's etc. The metals cause shadowing which can result in false/positive results. I am living proof!!! Had MRI and CAT SCAN and they only showed bulging disc c4-5. Had myleogram and its showed spinal stenosis c4-5 c6-7. spurring at c6-7 and bulging disc c4-5. This was only revealed cause I opted for a second and third opinion after my NS told me it was all healing pain. Original NS has not been given these results.

    Good luck to you all

    Lori
    Laminectomy L4-5
    ACDF C5-6-7
    Posterior Foraminotomy c6-7
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    lami L4-5, ACDF C5-6-7, post. lami-foraminotomy c6-7, staph infect. revision acdf c4-5-6-7 new c4-5 2004. STILL IN PAIN 24/7

     
    Old 05-15-2003, 07:39 PM   #11
    winged phantom
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    I'll have to bookmark this page, because I'll never remember that. But that's an important thing for us to know, Lori. Thanks for the heads up.
    wr
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    • 12/29/89 C5-6 Microdiskectomy (no fusion)
    • 4/9/03 ACDF C4-7 with plating and donor bone

     
    Old 05-18-2003, 08:13 PM   #12
    NYFUSED
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    WR,
    It's funny that my NS was not aware of that fact. The 2nd and 3rd opinion NS'S told me about the shadowing and also mentioned that NS that did my surgery probably didn't want me to find out what was really going on. You really have to be your own doctor. If I did not seek other opinions I would be walking around with stenosis-myelopathy doing more damage. I listened to my body and knew 100% that it was NOT healing pain. Good luck to all.
    Lori
    __________________
    lami L4-5, ACDF C5-6-7, post. lami-foraminotomy c6-7, staph infect. revision acdf c4-5-6-7 new c4-5 2004. STILL IN PAIN 24/7

     
    Old 05-19-2003, 09:36 AM   #13
    janie francine
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    Hi, I'm new to the board. I also have stenosis caused by 2 decent bone spurs on C5 and C6, a result of a whiplash I received 18 years ago. I have lived with chronic pain since then and it's getting worse. I have a difficult time turning my head left and right, weakness, pain and numbness in my arm, locking of finger joints and if I lie on my back I sometimes have difficulty swallowing. I haven't had an MRI (I can't have the test that injects dye as I'm allergic to the dye), but a friend and excellent orthopedist says I'm a definite candidate for the surgery. My GP said she wouldn't do it unless the pain was unbearable. I've recently started taking Vioxx which has helped with the symptoms and gives my neck more mobility, but I also know that my neck is getting worse (I've seen the changes in the Xrays over the years). I'm terrified of the surgery and the possibility that it would mean more surgeries (this seems to be a common complaint/issue)and other complications, but I also recognize that my neck continues to deteriorate. I'm 49 and in good shape. I've lived with the pain for so long and have been able to "deal" with it, although it is getting worse and I feel like I'm able to less than before. I know no one can make the decision for me, but would appreciate some input from folks. Thanks.

     
    Old 05-20-2003, 10:42 AM   #14
    GinaB
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    Janie,
    I too am allergic to the contrast, but was pre-medicated to have a myleogram. I had it without incident. You should check into that.

     
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