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Question:

Cervical Spinal Stenosis

Dear Ask The Doctor:
I recently experienced numbness in the right arm/hand as well as 1/2 strength loss in the right tricep/pectoral. Alittle in the the right bicep/forearm. Had an MRI which showed : Disc height loss and dessication at c4/c5, c5/c6 ,c6/c7 levels. Central canal at the mid c4 vertebral body measures 10mm in maximal anterior to posterior width. Narrow. Narrowing persists throughout the mid and inferior cervical spine. Consistent with congenital central canal stenosis secondary to short pedicles. No abnormal signal identifyed in spinal cord. c2/c3 - A tiny right paracentral disc protrusion. No central canal stenosis or neeural foraminal narrowing. c3/c4 - A right paracentral disc protrusion is identifyed. This is causing mild right neural foraminal narrowing. No signicant left foraminal narrowing. Mild central canal stenosis. c4/c5 - Bilateral posterolateral disc ossteophtye present. Moderate central canal stenosis and moderate bilateral neural foraminal narrowing. c5/c6 - Diffuse posterolateral disc osteophtye complex present, effacing the cerebrospinal fluid anterior to the cerival cord. Moderate central canal stenosis is present. Moderate to severe right neural foraminal narrowing and moderate left foraminal narrowing. c6/c7 - Diffuse posteralateral disc ossteophyte complex present,creating moderate central canal stenosis. Mild to moderate right neural foraminal narrowing and mild left neural foraminal narrowing. c7/t1 - normal. 1- Multi-Level disc dengeneration. 2- Congential central canal stenosis of the mid and inferior cervical spine secondary to short pedicles. 3- The most significant central canal stenosis is identifyed at the c5/c6 level. I am seeing a neurosuregeon next monday. My question is how do you think this will be treated? How can I get back all the feeling in my right hand/arm? And all the strenght in those muscles back? My MD said nerve damage may be permanent. I have been in this condition for 2 months now. Any opinions would be helpful.


Answer:

Your MRI results show quite severe spine disease in your neck and completely explain all your symptoms. You neurosurgeon will most likely suggest a laminectomy at multiple levels or laminoplasty. A laminectomy involves removing portions of the bones of the spine in the neck to relieve the pressure on the nerves and therefore relieve your pain. A laminoplasty involves reconstructing some portions of the bones in the spine with the same aim of relieving the pressure on the nerves.
Your MD is correct in that nerve damage may sometimes be permanent. This is dependent on the extent of damaged the nerves. Your surgeon will be able to tell you more after the procedure. Post surgery you will need to do physical exercises as directed by a therapist to regain some of the strength in the affected muscles though they may not return to full power.


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