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  • cervical laminectomy with carpal tunnel

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    Old 12-13-2014, 10:19 PM   #1
    1986er
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    cervical laminectomy with carpal tunnel

    Hi.
    This last June I had C3-C7 posterior cervical laminectomy. I had 2 months post surgery where my hands had strength (one of the reasons I had the surgery was because I was always dropping things etc) After 2 months post op I have pain back in my left arm and my hands are weak again, I have a clumsy walk, my shoulders are weak and have loss muscle tone. I was hugged by an old friend 3 months post surgery and it felt like I was being total body electrocution. Since then I have been going downhill. I had a new MRI done, that shows focal myelomalacia and my Dr. says I need to see my surgeon. But my surgeon says there is nothing she will do and suggests I go to a pain clinic. So I go to pain clinic only to be told I need to see neurologist because I have way more than pain going on. Neurologist wanted to do EMG to see how my nerves and muscles in arm and hands are. My report shows I have carpal tunnel and he says it has nothing to do with my neck. (Mind you, I have not had and office job where I abuse my hands for over 15 years) Now comes the ironic part. In Sept 2012 I had my 1st cervical surgery (c4-5 disc replace with titanium plate done by orthopedic surgeon) 3 months later, out of the blue I develop a rt trigger thumb that locked straight within a month of getting it. It had to be surgically repaired. So this past June, I have the 5 level laminectomy (no fusion) and every day I regret having this surgery, but again 3 months post surgery, my other thumb gets trigger and suddenly locks, but now with the EMG I just recently had, the Neurologist says I also have carpal tunnel. I said my neck and my troubled nerves (when I touch the back of my neck, I get shooting nerve pain down my arms) has to be the cause of my carpal tunnel and trigger thumb, and he says no, not at all, they are two separate issues. I beg to differ. He also has no concern at all that I have focal myelomalacia. None at all. He wants me to have surgery on my carpal tunnel and PT on my neck because he says my electrocution I am getting from my nerves is related to "tight" muscles. Well, I can barely touch the back of my neck, let alone someone else touch it. Asking here, has anyone ever had anything close to my predicament? I am by all means going for a 2nd opinion, as I am so frustrated. I feel worse today than I did prior to my 5 level laminectomy. I do not feel my neck was stable enough for this intense of a surgery. (Also, my neck issues date back 28 plus years to me getting a whiplash and concussion) Any help would be greatly appreciated. I am so tired of feeling like crap, and I am afraid my future is going to be showing me a wheel chair sooner than later. Thanks all for reading my post.

     
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    Old 12-16-2014, 12:21 PM   #2
    teteri66
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    Re: cervical laminectomy with carpal tunnel

    I just have lumbar issues but I certainly agree with your analysis of your situation. Obviously none of us are doctors so always keep that in mind when reading on a board like this, but, it is very unusual to do a multi level laminectomy without fusion. When the lamina is removed, the main supporting structure for that segment of the spine is removed or at least weakened. When there are several weak links all in a row, there is too great a distance for the healthy segments to support...and you end up with instability, which creates a host of other issues.

    I believe that electrocution-style hug you felt is caused by the myelomalacia...which as far as I know, is a cause for concern. At the very least, I know it needs to be followed and checked to be sure the damage is not worsening.

    There is a board member who goes by ChuckStr who I believe has myelomalacia. I hope he sees your post and responds.

    You definitely need to find a new spine specialist...either a fellowship-trained orthopedic spine surgeon or a neurosurgeon who limit the practice to neck and back only. Be very careful in choosing a new doctor. Take your time and do your research. You need to find the best trained, experienced spine surgeon that is available to you.

    Try not to be frustrated. You are on the right track. If I were in your shoes I would make the spine doc the priority and figure out later whether the carpal tunnel stuff is cervical spine caused or just localized.

     
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    Old 12-17-2014, 01:13 PM   #3
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    Re: cervical laminectomy with carpal tunnel

    Wow. Run fast to a new spine surgeon. That is an enormous laminectomy and I have no idea how your surgeon thought that would be ok without fusion. It may be difficult to find another surgeon both willing and qualified to take a look. I think MN is Minnesota, right? If so, Mayo would be where I would go in your shoes. They will be used to dealing with second opinions on prior surgeries.

    Its sort of debatable whether I have myelomalacia or not. One radiologist read it that way but a previous radiologist specializing in spinal/neuro radiology did not and confirmed their opinion later on. Also the 5 surgeons and 3 neuros indicated they doubted myelomalacia as well. At any rate I've read quite a lot about it. It can definitely cause the type of electric hug feeling you describe. It is a significant finding and requires prompt attention. If the instability from your laminectomy is causing trauma to the cord resulting in myelomalacia, a host of problems, some of which may be permanent, can result. This is even more reason to get into a competent spine specialist as soon as possible. Gait disturbance and incoordination of the hands are primary symptoms of myelopathy which could indicate deterioration of the health of your spinal cord. The spine specialist can evaluate and monitor the situation.

    If the neurologist competently performed an EMG/NCS that shows carpal tunnel, then he is technically correct that it is separate from your neck issues. Spinal issues like radiculopathy or myelopathy show differently on EMG/NCS then a peripheral nerve palsy such as carpal tunnel. That said, it is difficult to say that your hand symptoms are due to carpal tunnel when you have these spine problems. To me, the spinal issues are much more worthy of investigation at this point.

    Get to a new spine specialist and let us know how it goes...

     
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    Old 12-17-2014, 01:16 PM   #4
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    Re: cervical laminectomy with carpal tunnel

    Oh, one more thing, I would be very careful if you do go with PT. I'm a huge advocate of PT and it can do wonders, but in the state your spine is in, it would be pretty easy to do more damage.

     
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    Old 12-25-2014, 07:52 AM   #5
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    Re: cervical laminectomy with carpal tunnel

    Thanks all for your replies. Since I have posted the above, I have been referred to an Ortho hand surgeon regarding my carpal tunnel. THANK GOD, he took one look at me (the way I hold my head) and reviewed my records and said my hand issues are not important right now, and that I should not even be "walking around" much less driving to my appointment. He referred me on an emergency basis to the spinal surgeons group that are affiliated with his ortho group (knowing already, I am from here on out I am going to always get a 2nd opintion) The next day, I went to the spinal surgeon appointment. He looked at all my MRI's and did 4 more cervical spine Xrays and put his hands in the air and simply said that I was way too complex of a case for anyone in his group to take on. He referred me to the University of Mn. Dept of Neurosurgery. They are seeing me as soon as Jan. 8th. In the mean time, I need to lay low. I am so scared, yet I thank you both for responding to my post. I have a sense of relief knowing I am not the only one out there. Of all Dr's to finally listen to me, it takes an orthopedic hand surgeon to realize I am not just making this crap up. Both he and the spine surgeon I saw the following day were appalled the surgeon did that huge of a level of lami without any hardware. I am sure everyone is afraid to touch me now. I spoke to my Dr. about going to the UofM and she said that or the Mayo would be the best place to be. Both are about as competent as they get. So, fingers crossed and a couple weeks out, hoping I have somewhat of a healthy future to look forward to. I shall keep you posted. Merry Christmas!

    Last edited by 1986er; 12-25-2014 at 08:02 AM.

     
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    Old 12-25-2014, 04:19 PM   #6
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    Re: cervical laminectomy with carpal tunnel

    It sounds like you are finally on the right track and will soon receive some accurate plan of treatment, etc.

    I had a difficult to diagnose issue and, in my experience, the orthos were much more willing to think "out of the box," to study the MRIs a little longer, and contemplate what else, other than the obvious, could be causing my symptoms. The neuros went for the most obvious and were not interested in going any further beyond that.

    Be very certain you are seeing a neurosurgeon who works on the spine and does not spent most of his/her time doing brain surgery. U of Minn neurosurgery dept seems to be primarily the latter. You may want to get another opinion before proceeding with a complex surgery!

    Happy Holidays.

     
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    Old 12-25-2014, 09:10 PM   #7
    1986er
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    Re: cervical laminectomy with carpal tunnel

    Thank you for your comments and concerns. I really do appreciate them, and to tell you the truth, I believe you are on to something when you were talking ortho's VS neurologists. However, from here on out I have promised myself that I will obtain 2nd opinions. And, luckily, I did my homework prior to this coming up appointment at the U of M ,and I found to my surprise, this neurosurgeon I am seeing, specializes in spinal cord injuries, in fact, she has many studies and stem cell research going on to replenish what is damaged in your spinal cord. So already, I am feeling a little more at ease, that I am seeing the right person. Although, I do know, the Mayo Clinic is also in my state, and I wont hesitate to travel there should I feel the need. Now it's just the waiting game for my appointment to get here, in the mean time, I watch every step I make (literally) as we live in a winter wonderland right now. Ugh. I shall keep you posted of my outcome!

     
    Old 12-26-2014, 01:49 PM   #8
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    Re: cervical laminectomy with carpal tunnel

    That was a very responsible thing the local spine surgery group did, to refer you into U of Minn. Surgeons, at least in my experience, are not generally the most humble of people.

    I'll add one more plug for someone who does only spine surgery and has done a lot of it. I would ask, and if the Dr hasn't done something more than like 1000 of these surgeries I'd personally go to someone else. I don't know anything about the U of Mn spine surgeons but I did read that Mayo has a couple of nationally recognized spine surgeons at their clinic, for what it's worth.

    Good luck and please let us know how everything goes.

     
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