Cervical stenosis: Leg weakness

Hello- I read your story and it's like reading my life. Same age and same problems. I have numbness from my right knee down the outside of my calf into my foot and toes. I also have burning from my left shoulder down to my elbow. The pain is indescribable. I am currently looking for another surgeon as there is no sense of urgency there. I spoke with his nurse yesterday to let them know the numbness had spread. I was told there is nothing they can do until I see him on the 18th. In the meantime im just supposed to deal with it I guess. My appointment was cancelled due to an emergency surgery. Now I have to wait another 3 weeks for an appointment. I'm at the end of my patience. Thank you for all of the information you provided. I'm glad that you are doing well!

@candrgonzalez I have been where you are now with leg weakness caused by cervical stenosis. I had a ruptured disc and bone spurs compressing my spinal cord at C5C6 and as that got worse, the leg problems increased as well as pain all over my body. I also had muscle spasms that pulled my cervical vertebrae out of the correct lordotic curve, and that increased my leg symptoms and I walked with an uneven gait, like walking with a limp and you can't walk normally if you try. This was something that was missed by every spine surgeon who saw me before I came to Mayo, and none of them thought it was related, but they misunderstand my case and these symptoms. When my physical therapist would realign my spine, I could walk normally again, until the spasms returned which essentially squeezed the spinal cord into a smaller space by shifting the bones. I was also loosing muscle in my arms and shoulders and a lot in back that I didn't notice until I looked in a mirror after my therapist pointed it out. Since my surgery, I got some of that muscle back, but there is still a deficit from what used to be there.

I would caution you about epidural injections in your neck. Doctors like to do that to put off surgery, and the effects are temporary. There are some serious risks too if they inject the wrong place. I had an adverse reaction to an epidural that caused a new paraestheisa pain that sent stabbing electric shocks into my hand and fingers, and if I moved at all, the pain increased. All I could do was get in bed, prop my arm on a pillow and try not to move. It didn't start to improve until about 5 days later, and then I still got stabbing pains, just not as frequently and it took about 6 weeks to stop happening. I had cold sensitivity in that hand for a year and a half. You don't have to do them. I refused to do any more. The injection won't fix anything. You can decide if that is something you want to try or not. The only real fix for cervical stenosis is surgery. If this is affecting your balance, my advice would be to start getting opinions on surgery and get several. Evaluate the doctors as best you can by looking at their training, area of interest, and read their research papers and look at how others in the field regard them. Are they a leader who is teaching at a medical school or teaching lab courses for surgeons who are in practice? There are independent ratings and lists like Becker's Spine where they list 100 spine surgeons to know and that gets updated fairly often. You can find out about current research and studies and who is doing what and where. That isn't foolproof; some of the surgeons who saw me were on that list, but didn't get it right. Learn all you can about this so you will ask good questions when you are at an evaluation. You want to be in a position to make an informed decision when the time is right. It took me 2 years to find a surgeon willing to help me because none wanted to risk their reputation and statistics of their surgical success on me. It was suggested that I could have another problem like MS which wasn't true. I never expected to be dismissed over and over for an obvious problem.

Balance problems also come from misalignment of C1 & C2 and that happened to me. It caused vertigo and I fell over. That is probably what scared Surgeon #5 out of helping me, but it is a real symptom that goes with a cervical spine problem. Skull /spine misalignment can be serious if there is also some instability or slipping of one vertebrae over another. I had 2 mm of movement of this slipping at C5/C6, and maybe some at other levels. If there is instabililty between C1, the "atlas" and the skull, that needs an expert evaluation before anyone tries to treat it. I also have thoracic outlet syndrome that causes tight muscles in my neck and chest, and it starts twisting my vertebrae just a little bit, but that is enough to cause bad headaches and nausea or dizziness.

Track your symptoms on a body diagram, and draw where you have pain or other symptoms, what you were doing at the time (because it can be different when your spine changes position) and date. You will know how fast your symptoms are changing. I wish I had come to Mayo first because that is where I found the true expertise in a surgeon who understood my symptoms and was willing to help. I found medical literature about cases like mine, and contacted a surgeon at Mayo with that and described how my symptoms were similar. One of the predictors was the epidural shot I had that had taken all the pre-existing pain away temporarily and that was common with the patients in the literature. By the time I had surgery, I could bend my neck and send an electric shock down my body because of spinal cord compression.

I was lucky when I contacted Mayo. I got an appointment a month later due to a cancellation, but I had been told it might be a 3 month wait. I'd seen enough surgeons and knew enough by that time, so I knew that I was getting good answers to my questions, and I had very successful surgery at Mayo and I've had a great recovery. All of this can cause permanent damage to the spinal cord, and that happens to patients who wait too long. That being said, I understand the fear that goes with this, and you will need to trust the surgeon you choose with your life, so choose wisely. I think I'm lucky that none of the previous surgeons would help, because I had the best of the best at Mayo, and I had excellent results. I wasted a lot of time waiting weeks for appointments, then weeks to discuss with a doctor, then weeks for something else, and on it went for 6 months while I just got worse and after all that a denial for help. At Mayo they efficiently refer you to other specialists as a team approach and they get this testing done in a few days. I had an offer of surgical help at my first appointment with the Mayo surgeon as opposed to no answers after over 2 years somewhere else. I was able to get scheduled for surgery within a couple weeks of my evaluation at Mayo and I'm doing great.

Here are some links, the medical literature I spoke about and my patient story. Let me know if you have any questions. I would be happy to answer.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/
Excerpts from "Cervical cord compression presenting with sciatica-like leg pain" from the European Spine Journal
http://europepmc.org/articles/PMC3111492/reload=0
"Funicular leg pain is a rare presentation of cervical cord compression."

"Leg pain or sciatica is a rare ‘false localizing’ presentation of cervical cord compression and there has been only a few cases described in literature [1–5]. The term sciatica has often been associated with disorders of the lumbar spine and pelvis, and we often tend to overlook other parts of the spine in the search for its cause. We report two cases of cervical cord compression, which presented with sciatica-like leg pain. Each case is unique and different from one another in their presentation and concurrent spinal lesions. We hope that the discussion of these cases and the accompanying literature review will make us more aware of this uncommon presentation of leg pain in cervical cord compression."

Please forgive me if this isn’t the place to ask this. I wasn’t sure if I should start my own post or reply to this one.
I am a 55 yr. old male with lumbar, thoracic and cervical issues. I had a microdiscectomy at L3 in 2010 and a few years later had L4 done also in 2015. I had neck issues off and on during these early years also but we were trying to focus on what was most important so we started with lumbar. Shortly after the L4 discectomy I ended up getting C4-C6 fused to alleviate the neck issues.
Things were OK for a while but soon started again as the adjacent cervical levels began to show signs of failing. I’ve been to PT and ended up with pain mgt and have done cortisone shots for L5-S1 issues and also in the neck followed by radio frequency ablation in June of this year. The ablation worked well for about 4 months but then wore off and I am back to daily headaches and neck pain. Two different neuro surgeons recommended another fusion, one at the level above the previous fusion and the my current doc recommends fusing the level above AND below the prior fusion so as to avoid having to go back in a year or two from now since the MRI indicates issues starting below now also.
Currently my symptoms are:
1. Occipital headaches – daily
2. Pain when turning my head left or right beyond minimal movements. i.e -. Turning when backing out of a parking spot or trying took over my shoulder at something.
3. Numbness and tingling in mostly the left hand but sometimes also the right.
4. Diminished dexterity, also mostly in the left hand, and am dropping/fumbling things often when I’ve been pretty sure handed all my life prior to this.
5. Numbness and itching that can’t be satisfied by any amount of scratching in my left toe that has started spreading to top of my foot and outside of my ankle.
6. 4 falls in the last 6 months or so, however, I am not entirely sure if it is from balance or just my left leg/foot not working properly, or maybe both.
7. Lastly, I have had an itchy/numb spot about the size of a grapefruit just inside of and beneath my right should blade. Again, no amount of scratching ever seems to alleviate it.
8. Along with the numb spot near my shoulder blade, I am now getting a crampy pain right in between my shoulder blades. Especially after yard work, house work or exercise.
9. I am not sure if this is even related to the spine issue but I’ve tentatively been diagnosed with chronic gastritis (probably from years of the USAF prescribing ibuprofen for every ache and pain. Vitamin M they called it. 😊) which leads to nausea or may just be tied to the headaches. They have reluctantly diagnosed me with IBS-C and a pancreas that is apparently becoming inefficient leading to dietary supplements.
Pain mgt wanted updated MRI’s of my lumbar and thoracic levels so I had those done and although, there were arthritic findings, the lumber was mostly unchanged with the exception of a Tarlov cyst or two at the sacral level. One of which may be on the S2 nerve but my current neuro is not worried about it. The thoracic MRI showed arthritis, mild disk height loss at nearly all levels and also a few hemangiomas that the doc wasn’t worried about either as they are normally incidental findings and the largest was about the size of a butter bean or pea.
The numbness in the left foot, daily headaches, falls and dexterity issues are concerning for me and I am trying to wrap my head around what to do next. My current neuro wants an updated cervical MRI done and I follow up with him in 2 weeks. From talking with him about the options I get the distinct feeling that he thinks it may be time for that surgery now. I’ve put it off for about a year or two hoping the “conservative” treatments might help.
Could the cervical issues be causing the other issues I am experiencing? This whole time I have been focused on trying to “separate” the issues into what level would be the most likely cause but it seems they are thinking this may be all stemming from the neck. (minus the GI issues, that is just my brain half wondering if they may be related since the GI docs can’t find much definitively wrong.
Sorry for the very long post but thanks in advance for any info/advice you can lend, it is greatly appreciated!

Please forgive me if this isn’t the place to ask this. I wasn’t sure if I should start my own post or reply to this one.
I am a 55 yr. old male with lumbar, thoracic and cervical issues. I had a microdiscectomy at L3 in 2010 and a few years later had L4 done also in 2015. I had neck issues off and on during these early years also but we were trying to focus on what was most important so we started with lumbar. Shortly after the L4 discectomy I ended up getting C4-C6 fused to alleviate the neck issues.
Things were OK for a while but soon started again as the adjacent cervical levels began to show signs of failing. I’ve been to PT and ended up with pain mgt and have done cortisone shots for L5-S1 issues and also in the neck followed by radio frequency ablation in June of this year. The ablation worked well for about 4 months but then wore off and I am back to daily headaches and neck pain. Two different neuro surgeons recommended another fusion, one at the level above the previous fusion and the my current doc recommends fusing the level above AND below the prior fusion so as to avoid having to go back in a year or two from now since the MRI indicates issues starting below now also.
Currently my symptoms are:
1. Occipital headaches – daily
2. Pain when turning my head left or right beyond minimal movements. i.e -. Turning when backing out of a parking spot or trying took over my shoulder at something.
3. Numbness and tingling in mostly the left hand but sometimes also the right.
4. Diminished dexterity, also mostly in the left hand, and am dropping/fumbling things often when I’ve been pretty sure handed all my life prior to this.
5. Numbness and itching that can’t be satisfied by any amount of scratching in my left toe that has started spreading to top of my foot and outside of my ankle.
6. 4 falls in the last 6 months or so, however, I am not entirely sure if it is from balance or just my left leg/foot not working properly, or maybe both.
7. Lastly, I have had an itchy/numb spot about the size of a grapefruit just inside of and beneath my right should blade. Again, no amount of scratching ever seems to alleviate it.
8. Along with the numb spot near my shoulder blade, I am now getting a crampy pain right in between my shoulder blades. Especially after yard work, house work or exercise.
9. I am not sure if this is even related to the spine issue but I’ve tentatively been diagnosed with chronic gastritis (probably from years of the USAF prescribing ibuprofen for every ache and pain. Vitamin M they called it. 😊) which leads to nausea or may just be tied to the headaches. They have reluctantly diagnosed me with IBS-C and a pancreas that is apparently becoming inefficient leading to dietary supplements.
Pain mgt wanted updated MRI’s of my lumbar and thoracic levels so I had those done and although, there were arthritic findings, the lumber was mostly unchanged with the exception of a Tarlov cyst or two at the sacral level. One of which may be on the S2 nerve but my current neuro is not worried about it. The thoracic MRI showed arthritis, mild disk height loss at nearly all levels and also a few hemangiomas that the doc wasn’t worried about either as they are normally incidental findings and the largest was about the size of a butter bean or pea.
The numbness in the left foot, daily headaches, falls and dexterity issues are concerning for me and I am trying to wrap my head around what to do next. My current neuro wants an updated cervical MRI done and I follow up with him in 2 weeks. From talking with him about the options I get the distinct feeling that he thinks it may be time for that surgery now. I’ve put it off for about a year or two hoping the “conservative” treatments might help.
Could the cervical issues be causing the other issues I am experiencing? This whole time I have been focused on trying to “separate” the issues into what level would be the most likely cause but it seems they are thinking this may be all stemming from the neck. (minus the GI issues, that is just my brain half wondering if they may be related since the GI docs can’t find much definitively wrong.
Sorry for the very long post but thanks in advance for any info/advice you can lend, it is greatly appreciated!

@rdflash0788 Hello and welcome! Joining an existing discussion that covers similar questions is a good idea because participating members get notifications of your input. Thank you for your very detailed description of your symptoms. You bring up some great questions.

The symptoms you describe are consistent with cervical spine issues. Surgeons often get focused on what conditions are related to particular levels, and those relate to the specific nerves that exit the spine between vertebrae at the nerve roots. The other type of problem can be spinal cord compression, and it's harder to pin that down specifically as to where symptoms will occur. The 4 mm of listhesis essentially makes the spinal canal smaller when it slides out of alignment. That is a lot of movement. The spinal cord needs to move inside the fluid in the canal when you change your body position or bend your neck or turn your head, and that can make the spinal cord either contact the hard "walls" of the canal or cause some spinal cord compression. That can affect any body parts below that level.

Some of the other issues that can cause similar or overlapping symptoms can also be attributed to a condition like thoracic outlet syndrome. This is something that I have (TOS) along with being a cervical spine surgery patient. TOS causes compression of nerves that travel to the arms in several places in the neck and shoulder area, and if your spine issues were caused by an injury such as a whiplash, there could have been injury to muscles that can cause TOS in addition.

The biggest issue might be the instability at C3/C4 causing the vertebrae slipping and it poses a risk for spinal cord injury. That is something to ask your surgeon about. It may be why they are recommending surgery. My experience is kind of unique in that I had a collapsed C5/C6 disc with bone spurs causing spinal cord compression with 2mm of retrolisthesis (backward slipping). I did not have issues at the nerve roots. My case was confusing to several surgeons because of the somewhat unpredictable nature of where the pain symptoms would be, and they changed location when I changed body positions. I was also working with a physical therapist who would realign my spine resolving symptoms temporarily until it slipped out of alignment again. I had pain go everywhere and also into my legs and feet. I had dizziness and vertigo. The reason that was happening was because my vertebrae were spontaneously rotating with muscle spasms which stretches the vertebral arteries inside the sides of the vertebrae that are part of the blood supply to the brain. All I had to do was look upward at birds flying, and that kinked the stretched arteries causing extreme dizziness and I lost my balance. It also caused intermittent issues emptying the bladder which is a symptom of pressure on the spinal cord.

I found this medical literature with a case similar to mine, and that led to getting help from a surgeon and a C5/C6 fusion that solved all the issues by freeing the spinal cord. I know you have concerns about how many levels would need future surgery. The longer the fused area that you have, the greater the stress above and below that fusion that could lead to more surgery. It sound like you have some tough decisions to make. Getting multiple surgical opinions is probably a good idea because you cannot undo a surgery once it's done. I had 6 opinions. Most missed the diagnosis of why I had my set of symptoms, and one got it right. He got the job.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/
What are your questions now that you have some more information?

Please forgive me if this isn’t the place to ask this. I wasn’t sure if I should start my own post or reply to this one.
I am a 55 yr. old male with lumbar, thoracic and cervical issues. I had a microdiscectomy at L3 in 2010 and a few years later had L4 done also in 2015. I had neck issues off and on during these early years also but we were trying to focus on what was most important so we started with lumbar. Shortly after the L4 discectomy I ended up getting C4-C6 fused to alleviate the neck issues.
Things were OK for a while but soon started again as the adjacent cervical levels began to show signs of failing. I’ve been to PT and ended up with pain mgt and have done cortisone shots for L5-S1 issues and also in the neck followed by radio frequency ablation in June of this year. The ablation worked well for about 4 months but then wore off and I am back to daily headaches and neck pain. Two different neuro surgeons recommended another fusion, one at the level above the previous fusion and the my current doc recommends fusing the level above AND below the prior fusion so as to avoid having to go back in a year or two from now since the MRI indicates issues starting below now also.
Currently my symptoms are:
1. Occipital headaches – daily
2. Pain when turning my head left or right beyond minimal movements. i.e -. Turning when backing out of a parking spot or trying took over my shoulder at something.
3. Numbness and tingling in mostly the left hand but sometimes also the right.
4. Diminished dexterity, also mostly in the left hand, and am dropping/fumbling things often when I’ve been pretty sure handed all my life prior to this.
5. Numbness and itching that can’t be satisfied by any amount of scratching in my left toe that has started spreading to top of my foot and outside of my ankle.
6. 4 falls in the last 6 months or so, however, I am not entirely sure if it is from balance or just my left leg/foot not working properly, or maybe both.
7. Lastly, I have had an itchy/numb spot about the size of a grapefruit just inside of and beneath my right should blade. Again, no amount of scratching ever seems to alleviate it.
8. Along with the numb spot near my shoulder blade, I am now getting a crampy pain right in between my shoulder blades. Especially after yard work, house work or exercise.
9. I am not sure if this is even related to the spine issue but I’ve tentatively been diagnosed with chronic gastritis (probably from years of the USAF prescribing ibuprofen for every ache and pain. Vitamin M they called it. 😊) which leads to nausea or may just be tied to the headaches. They have reluctantly diagnosed me with IBS-C and a pancreas that is apparently becoming inefficient leading to dietary supplements.
Pain mgt wanted updated MRI’s of my lumbar and thoracic levels so I had those done and although, there were arthritic findings, the lumber was mostly unchanged with the exception of a Tarlov cyst or two at the sacral level. One of which may be on the S2 nerve but my current neuro is not worried about it. The thoracic MRI showed arthritis, mild disk height loss at nearly all levels and also a few hemangiomas that the doc wasn’t worried about either as they are normally incidental findings and the largest was about the size of a butter bean or pea.
The numbness in the left foot, daily headaches, falls and dexterity issues are concerning for me and I am trying to wrap my head around what to do next. My current neuro wants an updated cervical MRI done and I follow up with him in 2 weeks. From talking with him about the options I get the distinct feeling that he thinks it may be time for that surgery now. I’ve put it off for about a year or two hoping the “conservative” treatments might help.
Could the cervical issues be causing the other issues I am experiencing? This whole time I have been focused on trying to “separate” the issues into what level would be the most likely cause but it seems they are thinking this may be all stemming from the neck. (minus the GI issues, that is just my brain half wondering if they may be related since the GI docs can’t find much definitively wrong.
Sorry for the very long post but thanks in advance for any info/advice you can lend, it is greatly appreciated!

Are you connected to the Veterans administration? Could this all be service related? I don’t know where you are but the V A in Minnesota is absolutely the best!

Please forgive me if this isn’t the place to ask this. I wasn’t sure if I should start my own post or reply to this one.
I am a 55 yr. old male with lumbar, thoracic and cervical issues. I had a microdiscectomy at L3 in 2010 and a few years later had L4 done also in 2015. I had neck issues off and on during these early years also but we were trying to focus on what was most important so we started with lumbar. Shortly after the L4 discectomy I ended up getting C4-C6 fused to alleviate the neck issues.
Things were OK for a while but soon started again as the adjacent cervical levels began to show signs of failing. I’ve been to PT and ended up with pain mgt and have done cortisone shots for L5-S1 issues and also in the neck followed by radio frequency ablation in June of this year. The ablation worked well for about 4 months but then wore off and I am back to daily headaches and neck pain. Two different neuro surgeons recommended another fusion, one at the level above the previous fusion and the my current doc recommends fusing the level above AND below the prior fusion so as to avoid having to go back in a year or two from now since the MRI indicates issues starting below now also.
Currently my symptoms are:
1. Occipital headaches – daily
2. Pain when turning my head left or right beyond minimal movements. i.e -. Turning when backing out of a parking spot or trying took over my shoulder at something.
3. Numbness and tingling in mostly the left hand but sometimes also the right.
4. Diminished dexterity, also mostly in the left hand, and am dropping/fumbling things often when I’ve been pretty sure handed all my life prior to this.
5. Numbness and itching that can’t be satisfied by any amount of scratching in my left toe that has started spreading to top of my foot and outside of my ankle.
6. 4 falls in the last 6 months or so, however, I am not entirely sure if it is from balance or just my left leg/foot not working properly, or maybe both.
7. Lastly, I have had an itchy/numb spot about the size of a grapefruit just inside of and beneath my right should blade. Again, no amount of scratching ever seems to alleviate it.
8. Along with the numb spot near my shoulder blade, I am now getting a crampy pain right in between my shoulder blades. Especially after yard work, house work or exercise.
9. I am not sure if this is even related to the spine issue but I’ve tentatively been diagnosed with chronic gastritis (probably from years of the USAF prescribing ibuprofen for every ache and pain. Vitamin M they called it. 😊) which leads to nausea or may just be tied to the headaches. They have reluctantly diagnosed me with IBS-C and a pancreas that is apparently becoming inefficient leading to dietary supplements.
Pain mgt wanted updated MRI’s of my lumbar and thoracic levels so I had those done and although, there were arthritic findings, the lumber was mostly unchanged with the exception of a Tarlov cyst or two at the sacral level. One of which may be on the S2 nerve but my current neuro is not worried about it. The thoracic MRI showed arthritis, mild disk height loss at nearly all levels and also a few hemangiomas that the doc wasn’t worried about either as they are normally incidental findings and the largest was about the size of a butter bean or pea.
The numbness in the left foot, daily headaches, falls and dexterity issues are concerning for me and I am trying to wrap my head around what to do next. My current neuro wants an updated cervical MRI done and I follow up with him in 2 weeks. From talking with him about the options I get the distinct feeling that he thinks it may be time for that surgery now. I’ve put it off for about a year or two hoping the “conservative” treatments might help.
Could the cervical issues be causing the other issues I am experiencing? This whole time I have been focused on trying to “separate” the issues into what level would be the most likely cause but it seems they are thinking this may be all stemming from the neck. (minus the GI issues, that is just my brain half wondering if they may be related since the GI docs can’t find much definitively wrong.
Sorry for the very long post but thanks in advance for any info/advice you can lend, it is greatly appreciated!

Yes, the neck and back issues are service connected and while the VA has increased my disability rating, I am not entirely sure I want them working on me. VA care in this area is not what it is in some areas like up around DC and northern Virginia where the politicians and retired generals all go for their care. If I end up not feeling very comfortable with this new doc then my next step will probably be Mayo to see if I can be seen at their Jacksonville, FL location.