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DiscussionRecommendation for a neurologist to evaluate me for spinal stenosis.
Spine Health | Last Active: Feb 22, 2023 | Replies (16)Comment receiving replies
Doug, thank you for your report. My imaging of my C spine did not show myelomalacia, and my Mayo surgeon, Jeremy Fogelson, told me that myelopathy does not always show up on an MRI, but can be present. My MRI showed no damage to the spinal cord, but I was getting muscle atrophy on the back of my shoulders and in the triceps. The short answer is that every symptom you listed can be associated with cervical spine issues. I actually had vertigo a few times because muscle spasms were causing independent rotating or tilting of my upper vertebrae and when that happened to C1 & C2 it caused extreme dizziness that could come on suddenly. Rotation of the C vertebrae stretches the vertebral arteries affecting flood flow to the brain much like what happens with Bow Hunter's syndrome. It also caused occipital headaches usually on one side, jaw misalignment, ear pain or a choking sensation.
Are your symptoms a new development that didn't occur in 2018? Generally speaking, surgery should be done before permanent damage happens, and not all patients feel pain from cervical cord compression and are surprised to find out they are at risk of paralysis if they were in an accident in their current condition. When myelomalacia shows up on an MRI as a white mottled appearance inside the spinal cord, it represents nerve axons that have died and dissolved in the spinal fluid. I said that here because many other patients don't understand what that means.
I agree that you need to see a specialist and there may be a long wait. What I have found is that many spine surgeons want you to see the neurologist that they prefer to work with so it makes sense to seek a consult with a spine surgeon. Dr. Fogelson sent me to neurologist, Dr. Bartleson, in the spine center at Rochester for testing and a full exam. The neurologist didn't say that I needed surgery based on his findings, but the neurosurgeon did recommend surgery. Your report and symptoms do match up to what a doctor might expect.
Here are a couple links, a Mayo podcast that defines stenosis measurements and treatment options. It is for patients, but covers a lot of useful information.
and a video presentation about surgery for cervical stenosis from a spine surgery conference
https://www.youtube.com/watch?v=8cW6ANDJah8
My surgery was a C5/C6 fusion with donor bone spacer and no hardware. I stayed in a neck brace for about 3 months until it fused. The surgeon offered this because it was a single level, and may not have done that if it was more than one. I had concerns about immune responses to metals because of reactions to pierced earrings in my past and having no hardware let me avoid any possible complications with that. If you have surgery, there would likely be hardware. It is a long recovery and the first 6 weeks were the most painful, but that is different for everyone. This is my patient story:
https://newsnetwork.mayoclinic.org/discussion/using-the-art-of-medicine-to-overcome-fear-of-surgery/
Also you need a better surgeon because of the C3 involvement. Many spine surgeons do not want to operate on levels that close to the skull, and because the Phrenic nerve that partially innervates the lungs for breathing emerges near there from the spinal cord. Fusions of these levels will limit movement. My C5/C6 fusion does not limit my head turning. That is mostly done by C1 & C2 with some help from C3 & C4. I also have thoracic outlet syndrome that causes compression on nerve and vessels between the collar bone and rib cage and near points where it passes through the heads of the scalene muscles and under pec minor near the armpit.
I will send you some information by private message. If you have more questions, please ask. In the links I have sent, doctors say that loss of balance is considered a serious issue when it comes from spinal stenosis, and with aging that can get worse. My elderly mom has no balance and spends her days in a wheelchair. The stenosis measurement of 8.1 mm is significant. That is discussed in the Mayo podcast video link. I hope this has been helpful.
Take care,
Jennifer
Replies to "@dgcosentino831 Doug, thank you for your report. My imaging of my C spine did not show..."
@jenniferhunter
Very nice patient story, thanks for sharing. It is very good to read this.