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Spinal Cord Disorders Message Board

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I have numbness in my arms, especially during sleep. I wake up with aching, heavy arms, hurting elbows in particular. I also have bad tendonitis in right elbow now. Long history of whiplashes and general abuse as a youngster from car accidents, later motorcross racing, etc. Just moving my head around, I hear gravel, rice krispy pops, squeeking etc. Here are the guts of my MRI report from 11/10:

Neurosurgeon who has operated on my lower back for severe herniated disc, spinal cord tumor and cauda equina read this report for my neck (ordered by another doctor) and said, nothing alarming in it. You're past the real bad stuff and are lucky to be walking around.
Here we go:

"There is a mild reversal of the normal cervical lordosois, its apex at C5-C6. Craniocervical junction region appears normal. Cord is normal in caliber and intensity.

C2-C3: There is a small central disc herniation/protrusion which effaces the ventral subarachnoid spaces but does not result in any significant central stenosis.

C3-C4: A minimal retrolisthesis and diffuse disc bulge is present without associated stenosis.

C4-C5: A diffuse disc ridge complex is present extending into the neural foramina. There is some effacement of the ventral and dorsal subarachnoid spaces consistent with mild central and lateral recess stenosis. No significant foraminal stenosis is noted.

C5-C6: The disc height is diminished. A diffuse disc ridge complex is present effacing the ventral and dorsal subarachnoid spaces resulting in mild to moderate central stenosis and moderate bilateral subarticular zone stenosis, left greater than right. There is a superimposed central to slightly left paracentral disc herniation/protrusion. This results in left subarticular zone stenosis.

C6-C7: Diffuse disc bulging and marginal osteophyte formation are present. There is a mild effacement of the ventral subarachnoid spaces but no significant central stenosis."

So, what should I do?
You need an EMG of your arms to see if the numbness is from compression in the neck or in the arms. Numb arms can be from carpal tunnel syndrome or cubital tunnel syndrome or even thoracic outlet syndrome......all impinge nerves at different areas(carpal in wrist, cubital in elbows and thoracic in shoulder area). You might have one of those and that would mean a different fix to start with.

Your neck isn't too bad compared to many I've read here, just a lot of little stuff all the way through the neck. You do have moderate nerve compression at C5-6 but in terms of what spine docs will fix, until they see the word "severe" they don't operate. They rate spinal cord and spinal nerve compression with the terms minimal, mild, moderate and severe and they don't fix it until it gets to severe.

But your symptoms seem severe so I wonder if you don't have nerve compression elsewhere in your arms. And the test to find that out is the EMG....tells you if the nerve signals have slowed down between 2 points so they "zap" you from one area to another and read how fast or slow the signals go. Not painful but annoying. But it will give you the answer as to whether it's neck or arms and where in the arms.

Ask you doc for an EMG(electromyelography).

Jenny(fused C3 to T1)
Thank you for the reply, Jennybyc. I had gone in to see an orthopaedist about my numbness and tendonitis in my right arm, but complained mainly that my numbness had gone down into my right hand and has stayed somewhat numb for (then) 2 months, now eight months. He ordered an EMG, which HURT, but revealed that it was not from the ulnar, carpal or (I forget what are) the tennis elbow nerves. He said the problem emanates from the neck, ordered an mri w/ and w/o contrast and told me to see the back doctor in the group. That Dr (orthopaedic surgeon) had missed a spinal cord tumor when I was briefly under his care four years ago, so I just said thanks and took the report with me to a followup visit with the neurosurgeon who removed the benign spinal cord tumor in 2007. He said basically what you did, only bluntly. "You're getting old!"

So, I know from the EMG that my neck is said to be causing some problems in my arms, which get worse, but my neurosurgeon says its not that bad from the report. I hate to complain too much, but I can hardly open doors or turn keys in the ignition some days from the tendonitis, esp in my rght hand. Sometimes really bad carpal tunnel lockups, then fine next day. Sometimes excruciating ulnar nerve pain, then fine the next day. . . but always the tennis elbow pain, even after all the cortizone allowed, the last in December. I don't want surgery from an orthopaedist on my neck, so I'm sorta stuck. Oh well, I guess I am just getting old.
Good, so that is ruled is the neck. But as I said, your worst area is labeled as "moderate" and they don't do anything until it get worse. Too much of a chance of doing more damage than they can fix.

I'd suggest you see a neurosurgeon at a major teaching hospital associated with a medical school. There are new surgeries out there for problems like yours that don't involve fusions. You might be a good candidate for those. But they are new enough that only the best docs do them as they have to teach them.

I don't know where you are in NJ(I was born in Orange) but I know they do the "fusionless" surgeries at New York Presbyterian/Columbia Medical Center.....the big hospital up by the GW Bridge.

I'd go for a second opinion if I were you.

Thanks Jenny.

THe neurosurgeon I saw is with the neurosurgery group at Robert Wood Johnson University Med Ctr in New Brunswick, NJ., a teaching hospital. He did not mention fusionless, but I did not ask, either. I will as this gets worse. Thanks for your help.

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