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Spinal Stenosis Question....

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Unread 09-29-2007, 03:37 AM   #1
Megan
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Default Spinal Stenosis Question....

...from some other posts. If PN is due to spinal stenosis would the manifestation of the PN be only below the level of the spinal stenosis or those immediate nerves damaged by the SS? So if the spinal stenosis was in the lumber region for example, then only the lower part of the body affected by the spinal stenosis would have altered sensations?

Likewise if someone had a spinal stenosis higher up in the cervical or thoracic spine they could have arm/hand neuropathy???? What about facial neuropathy - would spinal stenosis be eliminated from the equation completely?
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Unread 09-29-2007, 01:25 PM   #2
babs3169
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Megan.

I am going to keep a watch on this thread. I have just been diagnosed with stenosis via MRI of spine -- found in the Cervical region and have facial, arm, hand, leg, and foot numbness and pins and needles. I've had a normal EMG/NCS and am totally perplexed as to the reasons.

I am still in the diagnosis stage (since June 07) and therefore, I am very interested in the replies to your thread.
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Unread 09-29-2007, 04:23 PM   #3
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Default Megan

My mother had an emergency operation in 2000 because of spinal stenosis in the lumbar region. As well as being in absolute agony,she was also getting numb toes and other symptoms.If the surgeon hadn't operated within a 2 week window she would have lost the use of everything below the waist. I don't remember her getting any weird symptoms in the upper body. Luckily here operation was a complete success and she recovered fully. I hope this maybe helps...
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Unread 09-29-2007, 10:50 PM   #4
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Hi Babs,

I, like you are in the early stages of diagnosis but unlike you, they have found nothing concrete yet!

Interesting about your 'cervical' spinal stenosis, which is quite high up the spine. I know I definitely need to brush up on my spinal nerves and the regions that they influence, but interesting that you have facial symptoms. From the small amount of researching I've done it seems that different nerves affect the face, like the Trigeminal nerve and it doesn't have to be agonising pain like I always imagine Trigeminal pain to be. However I really do not know.

Was your spinal stenosis relatively 'silent' before you had PN symptoms? Did you have any clue that you had a potential spinal cord compression problem? Accident, previous surgery, trauma, scoliosis???

My predominant symptoms are not numbness and pins and needles as yours are. I think numbness and pins and needles would 'fit' with SS very well (although I do have these at times). My main symptoms are burning, buzzing and weird temperature disturbances like icy. So I do not think I have SS but I'm looking at all possibilities.

Is a spinal MRI or CAT scan the only way that spinal stenosis can be diagnosed?
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Unread 09-29-2007, 11:43 PM   #5
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One would expect symptoms to be below the level of the stenosis. I had this in the lumbar area, and the symptoms were all from L4 down. If one has cervical stenosis, I'd imagine the symptoms could be anywhere below the level, including the arms.

But the face, I dont' know. Those nerves are very very high up, and I think they're even higher than the neck. Did you google it?
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Unread 09-30-2007, 06:35 AM   #6
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Megan,

I have had two cervical fusions and also have bilateral foraminal stenosis at various levels; no impingement...yet contact. I will say before my fusion of the C3/C4 the pain did NOT refer downwards...it went up the back of my head. The higher levels refer pain, tingling, etc. upwards. My C2/C3 has arthritic facets and I can feel tingling along my jawline at times. Or, if I aggravate it, I will have pain at the base of my skull. The C5/C6, prior to that fusion, referred pain right down into the base of my thumbs and the spinal cord was compressed. I should add that I had burning or PN type of symptoms in my hands PRIOR to the second fusion but after both surgeries...it is gone. I also have stenosis in the lumbar and of course it refers pain and burning downwards...and into my feet. I have buzzing in my left leg and wouldn't you know it...the lumbar/sacral issues are worse on the left. So, all in all, this is more radiculopathy causing PN like symptoms. I will also add that my Neurologist and spinal PM have both said many times...ANYTHING going on in the cervical spine can refer pain or altered sensations anywhere in the body and can travel up and down.

You can check out the dermatome charts to see where specific nerves travel. But keep in mind too dermatomes can overlap. I had one NS INSIST that the pain from the C3/C4 would travel downward...as in neurological deficits. But it didn't...it went straight to the back of my head causing horrible cervicogenic headaches. I just thank goodness I found the Spine Group I did after 3 years of heck. They found the culprit right away. And I should also add that when I get injections; different types in the lumbar, the burning in my feet goes away. Yet my lumbar isn't bad enough yet to warrant any surgery. So, this is why in my case, I know it is more stenosis causing the majority of these sensations. I even had a podiatrist once, without knowing my history at all, ask me if I had a pinched nerve in my lumbar/sacral area. He did NOT think it was PN at all!

Anyway, yes, an MRI or CT scan would reflect the stenosis. I just had a CT scan done for my cervical spine because of the "artificats" in other words, fusions. And my spinal PM went through each and every pic pointing out where the stenosis is. Also, I have had normal EMG's...every time! But remember EMG's are subjective and are just considered a tool in figuring things out....small piece of the puzzle is what I am trying to say. What really determined my pain generators besides having MRI's or CT scans, were injections. I am just about ready to have a Selective Nerve Root injection for the C6/C7 since it is taking on the load of the fusion above it. Again, no impingement...but I have aggravated the nerve root(s). And what are my symptoms? My index fingers are stiff, wrist flexors are stiff and there is slight burning in my hand, shoulder and forearm. So, you see...a person might THINK it is true PN when in reality it is all coming from the spine.

And don't get me wrong. I know PN is real and can be measured. And there are many causes for it. All I am saying is that if you have stenosis, it can and does cause various sensations.
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Unread 09-30-2007, 11:24 AM   #7
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Yees, Kathi that is an important point: what looks like pn could be spinal disease. That's why I added MRIs onto the checklist for the neuropathy workup on lizajane.org.

I myself never had an MRI until I'd had the neuropathy for years. And THEN I was diagnosed with spinal stenosis a year ago. Who's to say which really came first? I know people with spine disease who have persistent neuro issues, because they were operated on so late in their disease.
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Unread 09-30-2007, 01:36 PM   #8
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Default Dermatome Chart

There is probably a better one, but here is a dermatome chart. http://catalog.nucleusinc.com/enlarg...it.php?ID=4941

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Unread 09-30-2007, 08:29 PM   #9
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Default Megan~

I have Spinal Stenosis and also Peripheral Neuropathy. It is my understanding they do not cause each other. Spinal Stenosis is a narrowing of the spine. It can be found by a MRI, Diskogram or CT Scan. It causes pain when standing or walking and can be very painful. You can get it in the face & arms. check out: http://www.nlm.nih.gov/medlineplus/spinalstenosis.html

Peripheral Neuropathy can be caused by many things. Mine is caused by diabetes. It does have to do with the nerves. And my case, my feet are so numb, I can't feel nothing. Check out:
http:///www.nlm.nih.gov/medlineplus/...disorders.html
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Last edited by Fancylady_2006; 10-01-2007 at 08:55 AM.
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Unread 10-01-2007, 05:37 AM   #10
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Fancylady,

Exactly! There is radiculopathy and neuropathy...two difference processes. I supposedly have both as well. And I say supposedly because the idiopathic small fiber PN was very minute according to the QSART. And, the PN diagnosis has since changed to Central Pain Syndrome or Central Sensitization. In any case...all neuropathic pain which just simply has to be treated as best I can.
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