Am I worried over nothing? Neurological trouble

[Tachtig]

I'm a fairly new SCI. I was diagnosed with cervical meylopathy on stenosis on my C5,C6,C7 area and had a laminectomy decompression surgery 8 months ago.

1,5 month later my surgeon ordered a check up MRI and said the surgery went wel. 3,5 months after that MRI I had another check up to see how the white area/bruising on my spinal cord would develop. My surgeon thought it would remain the same or maybe got a little smaller, but the MRI showed an increase of white area on my C7.

My surgeon said it was probably still my spinal cord developing because of the decompression surgery but did want to do some tests. So they tested the stability of my spine with a CT scan with my head in different positions. And besides that I got another MRI with contrast liquid.

My surgeon and a radiologist said they couldn't find a reason why the white area got bigger so he was sticking to his conclusion that it was my spinal cord still being affected by the decompression surgery. He did say that my spinal canal was still really narrow around my C7 but that he could see some spinal fluid on the left side of the cord. It wasn't much but he said the cord wasn't being pinched.

Since my surgeon wasn't 100% sure he did send my case and MRI to another surgeon in a different hospital who basically said the same thing. That my complaints come from the decompression and that it lasts for a year.

So here is my concern. Lately I've been experiencing pins and needles in the palm of my left hand and sometimes get numb fingers. And my right arm/hand is giving me trouble since last week. I experience more trouble typing on a computer, the hand gets shaky when i do something like put my contacts in, it's harder to move my hand up through the wrist. Also I experience spasms in my triceps from time to time.

When I talk to my surgeon about these problems he says that it's just part of the first year and that it's normal that i feel these changes but that they will disappear again to the best situation I've had after my surgery.

So do I just ignore these things and just go with what my surgeon says that it's normal to experience these things in the first year? I can understand the pins and needles, but the neurological trouble with my arm is kind off worrying me.

Thanks for reading!

[SCI-Nurse]

Has the term "myelomalacia" been mentioned?

Have you gotten a second neurosurgical opinion?

I will ask Dr. Young to comment on your post when he has time.

(KLD)

[Tachtig]

No the term has not been used, they both said it might be because my spinal cord is still responding to the decompression or that it was already there but didn't show up on the previous MRI.

I had 2 neurosurgeons look at the MRI's. And they both said there was nothing they could see that would really explain the extra white part.

And I believed that opinion as well. And after explaining to both I get these neurological problems like really weak legs for days in a row and my right arm and hand getting hard to make certain movements or start shaking really bad they both said it's all part of the first year experiencing these weird symptoms. And that they will probably just go away again because after surgery I have had moments where I didn't have these problems.

But I'm still kind of worried about it. So that's why I posted this topic. To find out if I should be a little more persistent when something like this happens or that I'm just overreacting and should just trust the opinion of both surgeons.

[Wise Young]

Originally Posted by Tachtig

I'm a fairly new SCI. I was diagnosed with cervical meylopathy on stenosis on my C5,C6,C7 area and had a laminectomy decompression surgery 8 months ago.

1,5 month later my surgeon ordered a check up MRI and said the surgery went wel. 3,5 months after that MRI I had another check up to see how the white area/bruising on my spinal cord would develop. My surgeon thought it would remain the same or maybe got a little smaller, but the MRI showed an increase of white area on my C7.

My surgeon said it was probably still my spinal cord developing because of the decompression surgery but did want to do some tests. So they tested the stability of my spine with a CT scan with my head in different positions. And besides that I got another MRI with contrast liquid.

My surgeon and a radiologist said they couldn't find a reason why the white area got bigger so he was sticking to his conclusion that it was my spinal cord still being affected by the decompression surgery. He did say that my spinal canal was still really narrow around my C7 but that he could see some spinal fluid on the left side of the cord. It wasn't much but he said the cord wasn't being pinched.

Since my surgeon wasn't 100% sure he did send my case and MRI to another surgeon in a different hospital who basically said the same thing. That my complaints come from the decompression and that it lasts for a year.

So here is my concern. Lately I've been experiencing pins and needles in the palm of my left hand and sometimes get numb fingers. And my right arm/hand is giving me trouble since last week. I experience more trouble typing on a computer, the hand gets shaky when i do something like put my contacts in, it's harder to move my hand up through the wrist. Also I experience spasms in my triceps from time to time.

When I talk to my surgeon about these problems he says that it's just part of the first year and that it's normal that i feel these changes but that they will disappear again to the best situation I've had after my surgery.

So do I just ignore these things and just go with what my surgeon says that it's normal to experience these things in the first year? I can understand the pins and needles, but the neurological trouble with my arm is kind off worrying me.

Thanks for reading!

I suggest that you wait, for the following reasons.
1. The increased signal on MRI means that there is more water in the spinal cord (MRI signals reflect the concentration of hydrogen and the biggest source of hydrogen is of course water in the spinal cord). This suggests that you may have more edema in your spinal cord. Edema can result from many causes including ischemia (reduced blood flow) and inflammation.
2. Your symptoms are not yet alarming yet, i.e. your hands are not going numb for long periods and you are not developing weakness.
3. Your surgeons have already done what they can. The next step is to open the dura and see if there is tethering of your spinal cord and remove any adhesions that they find. Most neurosurgeons in the United States and Europe are not willing to do this without stronger evidence of loss of function.

Wise.

[Tachtig]

Thank you Dr Young for your answer. I appreciate it!

I developed weakness in just my right hand and talked to my GP and also to my physiotherapist in rehab about it. My GP thought I might have injured it because I work behind a computer a lot and use that hand for the mouse and that it would recover. My physiotherapist took a test where he measured the strength of my hand with a small device where I had to press on on a small pad while holding the device.

My physiotherapist consulted with a doctor in the rehab centre specialized in SCI where I train 3 days a week. The doctor said to wait a while and if it got worse I could call anytime.

So I waited a week and did the test with the device again and my strength was twice as good as the test before, so I am recovering strength again.