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Thread: Semi-Paralysis in Biceps, Deltoids

  1. #1

    Semi-Paralysis in Biceps, Deltoids

    I had a laminectomy at C3/4 thru C6/7 in August. When I woke up from the surgery I was in tremendous pain, but everything worked. The next morning I could not move my arms and could barely move my hands and wrists. All sensation was normal and bathroom functions were normal. I entered therapy and my hands and wrists improved to almost normal, but my arms made little progress.

    MRIs were done and they showed significant spinal cord swelling. My doctors did not agree on what happened. One group felt that the swelling had occurred because of the severe compression at 5/6 prior to surgery and that the cord swelled when the area was opened up. The surgeon believed I had a spinal cord stroke.

    Three months later. Everything is normal except my biceps and deltoids: I score 2+/5 on physical strength tests. I cannot raise my arms, bathe or dress myself above the waist. I am not in real pain although I do get muscle pain just below my neck. I am getting occupational therapy and I do a number of exercises every day. I am not taking any spinal-related medications. I am a positive person.

    What can I expect?

  2. #2
    Was your laminectomy due to spinal stenosis or disk disease? We see a lot of people who have spinal stenosis and have impairment after the surgery that they did not anticipate, even thought the surgeons are generally good about warning that this can occur. It rarely reflects poor technique or substandard care.

    It sounds like you have a central cord type of incomplete spinal cord injury, although usually there is also impairment in the elbow flexors and extensors, wrists and hands with this type of injury. It could be more root damage.

    Have you seen a physiatrist? Are you getting therapy (OT and PT)? Have you seen any recent improvement? Did you go to a formal inpatient SCI rehab program immediately after your surgery?

    It is not possible to determine how much more return you will get. It will take at least 24 months after the injury to determine who much it will be. Meanwhile, getting therapy, exercising, and learning how to use adaptive techniques and equipment to maximize your independence are important tasks that should be on an ongoing basis.

    (KLD)

  3. #3
    The laminectomy was due to severe stenosis, with the worst level, C5-6, having only 5.7 mm of space for the spinal cord. I do not have any problems with my elbow extensors, wrists, or hands, just like you stated.

    I saw a physiatrist prior to surgery, but not post-op. I see both a spinal rehab doctor and my surgeon; both are wonderful. I am getting OT, but not PT; I was told that since my walking is 100% normal that the insurance would not pay for PT. The OT states that she continues to see improvement each week, that as she supports my arms or hands as I do exercises, that whatever she is supporting feels lighter and that I do more on my own.

    I do see a slight ongoing improvement in what I can do, but it is not obvious to me how much is because I am adapting or actually improving. Recently I became able to "walk" my fingers up a wall almost to shoulder height. However, I cannot raise my arms at all without something like a wall. I can make slight "snow angels" by lying on the bed and extending my arms. My right arm is much better than my left, but I am right-handed and my left hand was semi-paralyzed prior to surgery so I hardly used my left arm for quite some time.

    I was sent to a spinal rehab center about two weeks after surgery. I do have adaptive equipment, such as eating utensils, but have recently been able to use non-adaptive items. I am able to eat by pivoting my arms off the side of the table; I can even do this in a restaurant and no one seems to notice. I can drink with a straw. I am able to function alone other than meal prep, showering, and dressing above the waist.

  4. #4
    Senior Member skippy13's Avatar
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    Welcome to Care Cure Kari. There are a lot of us with mostly upper body/arm issues here. Central cord types. Each is different, but have in common what brought us here. Sounds like you are making some good progress. Best of luck and welcome from another pacific northwester.

  5. #5
    Today I got the results of my latest MRI. Unfortunately, I was told over the phone, and do not remember everything exactly. The main message, however, is that I no longer have any stenosis and the cord is no longer swollen. The surgeon was very optimistic.

    I continue to improve: I can move my right arm 45 degrees away from my body while lying on the bed (no gravity), and my left arm about 25 degrees. I can do laundry and dishes very slowly and very carefully. I can hold a book in order to read. I still cannot bathe or dress myself above the waist.

  6. #6
    Good news. Are you also getting formal therapy with PT and OT? You should.

    (KLD)

  7. #7
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    As I have a similar injury, shoulder pulleys thrown over a door, will help move the arms up and down and keep them supple, a little exercise mini bike that you use with your arms will get the rotator cuff moving too, keep pushing your arms against a wall to strengthen to try and get the muscles working again. It takes a long time.

  8. #8
    I have been getting occupational therapy. I have both the pulley that goes over a door and a tabletop bike! : )

    Thanks for the advice and encouragement!

  9. #9

    Mild linear high signal within the anterior cervical spinal cord?

    My latest MRI shows great improvement. MRIs taken a few days post op showed significant spinal cord swelling; this new one does not. I am able to understand the entire report with the exception of this phrase: mild linear high signal within the anterior cervical spinal cord.

    A little background (I've posted before, but just in case...) I had a four-level cervical laminectomy in August. The next morning my arms were virtually paralyzed, and my hands were too but to a lesser extent. The surgeon felt I had had a spinal cord stroke; the other doctors felt my spinal cord had been so severely compressed that it had swollen upon being decompressed. I spent twenty-eight days in the hospital and made some improvement, gaining normal hand and near-normal wrist usage, but having significant deficits in my biceps and deltoids. I left the hospital with a score of 1/2 on a scale of 1 to 5 for my biceps and deltoids; I am now at 2 and 1/2 and continue to improve, albeit extremely slowly.

    The surgeon read me the results of the MRI over the phone; he was enthusiastically positive. I was so overwhelmed by all the information that I did not ask about the high signal. I have since gotten a copy of the radiologist's report (and a CD of the MRI). Of course, I will ask him about the high signal during my next appointment, but in the meantime I am hoping someone can share their expertise with me. What is the significance of the mild high signal?

  10. #10
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    i think high signal means just swelling, as I remember I had a T signal as well on my MRI's.

    2.5 isn't bad, if you can get it to 3 you will be able to move with gravity which would be great, my left side was at 0 and never came back..my right was at 2 or 3 and is close to normal now, it took a long time though.

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