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Cervical stenosis: Leg weakness
Spine Health | Last Active: May 31 2:01pm | Replies (83)Comment receiving replies
This thread has been very helpful. I’m sorry to hear about everyone’s spine issues. I’m grateful for you all and to Ms. Gonzalez for starting this thread.
Months ago, I began getting weakness in my right arm, then my left ( not as bad) and then both my lower legs. Like rdflash, I’ve had so many ortho surgeries from sports injuries that I thought all the affected joints were coincidentally acting up. But I went to a spine doc at the urging of my PT, got a cervical MRI and found out I have a lot of arthritis in my neck, and a bulging disc and bone spurs at C5-6. The bulge touches, but doesn’t compress the cord. I have smaller bulges at C6-7 and C7-T1 that approach but don’t touch the cord. I also have that nausea/lightheadness that kicks in after certain movements. My spine doc didn’t think the MRI explained my leg issues and nausea, so he sent me to a neuro who didn’t find any sign of neurodegenerative disease, and did a full blood work up as well as physical exam. Unfortunately, I saw him on a day that was probably my best physically over all this time.
My spine doc referred me for more PT. He said my MRI wasn’t good but that surgery wasn’t in the cards right now. Since those appointments, I’ve begun developing tingling in my back around T1 and radiating to the edge of my left shoulder blade. I have no idea what this is. At T1 I have only that minor bulge and a mild to moderate left facet arthropathy. I’d be very appreciative of any thoughts on this.
Replies to "This thread has been very helpful. I’m sorry to hear about everyone’s spine issues. I’m grateful..."
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@cudabinacontenda I can tell you from experience that the spinal cord does not want to be touched at all. When you have an existing disc and bone spur complex in the central canal, it can be raking across the spinal cord when you move your neck. When you add muscle spasms that happen with spine problems, it can be moving the vertebrae around and affecting alignment or rotating them and that can increase pressure on a place that is getting touched by essentially making the spinal canal a bit "smaller". That was happening to me, and I had vertigo because of it. Spasms can stretch the vertebral arteries that run inside the sides of the cervical vertebrae and then a movement like looking upward kinks a stretched artery. This is part of the blood supply to the brain. What are the movements you describe that are causing light headedness?
I have to say it makes me crazy to hear of another surgeon telling a patient that leg symptoms are not related to cervical central canal stenosis. I heard this from 5 surgeons, and they were all wrong. It was the 6th surgeon at Mayo who knew that these symptoms of cervical stenosis were related to leg pain, gait disturbances, nausea, vertigo, bladder or bowel disturbances or pain anywhere in the body below the level of compression.
The spinal cord is supposed to be free to move with the spinal canal and floats in spinal fluid. If you bend your neck, the cord needs to move inside to allow that to happen. Imagine a garden hose with a rope inside. Now bend the hose. Did the rope move a little bit? It has to move. If the rope is held tight, it will bind up against the inside of the hose. The bone spurs and bulging or ruptured discs can hold onto the spinal cord and that can be an intermittent problem at first depending on neck and body positions. As that progresses and bone spurs grow bigger and multiply, then the cord can be compressed and unable to move in what they call a tethered cord. Myelopathy (spinal cord damage) may show up as a white mottled area within the spinal cord at the point of compression on an MRI. My surgeon told me that myelopathy can be present when this compression is beginning and not yet show up on the MRI.
This would be something that would be good to discuss with your physical therapist because they understand how the body needs to move and what is normal and what is not. Your PT also has to write notes and reports and send that to the doctor who ordered it, so that should help if the doctor actually reads the notes. Sometimes they do not. You may want to look at my response to @rdflash0788 and look at the medical study link that I shared. You may want to ask if your surgeon thinks your case may be like that one in the literature. This is the literature I found after 5 surgeons refused to help me, and I sent it in to surgeon #6 and wrote a letter saying that this literature seemed to describe my experience. I asked if my case was like this one. I suggest always ASK that as a question so you won't be perceived as pointing out a mistake or telling a doctor how to do his job. A doctor can refuse to help and then you'd be looking for another surgeon for an opinion. That's not a bad idea either because multiple opinions can help you, and you can pose the question about the literature which describes "funicular pain" from the start. That is what I had to do after I'd been dismissed because the surgeon missed this, then I found the answer, and none of my doctors would help me approach the surgeon with this information and point out his mistake. I knew he wouldn't listen to me and that is when I turned to surgeon #6 at Mayo for help. That is the reason I help here on Connect to share this knowledge.
Sometimes bone spur growth can progress rapidly. I saw mine double in the area they covered within 9 months on MRIs. I was also charting my symptoms on body diagrams and dating those, so I knew how fast the symptoms were progressing. That helped me know that I needed help and a time frame, but it also scared surgeon #5 out of helping me because he could not explain the pain symptoms. I had this "funicular pain" which was described at the time as a "rare presentation" of pain related to spinal cord compression.