Is A Surgery Required If I Have Shown Improvement In The Strength Of My Right Hand ?

Posted on Tue, 1 May 2012

Question: hi my mri says there were anterior thecal impressions at c4/5. c5/6 and c6/7. These were casusing bilateral exit froaminal compromise at c4/5, left sided foraminal stenosis at C5/6 AND FURTHER bilateral foraminal compromise at C6/7. There was minimal cord indentation at C6/7 AND NO ASSOCIATED SIGNAL CHANGE. THE CANAL WAS ADEQUATE AND THE CEREBELLAR TONSILS WERE IN NORMAL POSITION. My British trained Osteopath says that since treating me I have improved and my strength is returning in my right hand although my thumb is weak and I cant hold a pen properly. Do I need a surgery?

Answered by Dr. Sapan J. Pandya (1 hour later)

Hi Nickemens.

Thanks for your query.

Yes, you may avoid surgery for the moment as you are showing improvement.

With more efforts and time you will retrieve the use of your thumb too.

The canal space is adequate but there is some foraminal compression.

You may concentrate on physiotherapy regularly.

I suggest you to take B-Complex pills which will help in nerve regeneration and rejuvenation.

Also try to avoid aggravating the compression, which would have occurred because of lifting heavy weights or using computers for prolonged periods.

You have not mentioned what caused your compression in first case, was it an accident that aggravated it?

Even in surgery there are many options apart from open surgery. Endoscopic surgery shows excellent results.

I hope I have satisfied your queries.

I will be available for your follow up queries if any.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sapan J. Pandya (1 hour later)

Thankyou, the grip strength also affects my index finger which will not bend at the last joint, so I cannot make a full fist. Today I noticed my medial epicondyle is more prominent on the right, which my Osteopath attributes to wasting of the flexor muscles in the forearm. The injury was caused by lifting and straining my neck shoulder, which my Osteopath called Neuropraxia? He has told me to eat plenty of protein, thankyou for the advice on b complex viamins. Would the MRi have shown a Pancoast Tumour and would that give rise to any of these symptoms. I was a heavy smoker for twenty years and gave up 9 years ago.

Answered by Dr. Sapan J. Pandya (2 hours later)

Hi Again,

You are very right about Pancoast Tumour. Pancoast Tumour has some co-relation with smoking.
Pancoast Sydrome may mimic Spinal Nerve Root Compression. But Flushing and/or sweating on one side of the face, and eventual lack of sweating on one side of the face is very common in Pancoast Syndrome, which is not that present in Spinal MRI.

But to be on the safer side, you may go for CT scan of chest with special focus on apex of lungs.

All the best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sapan J. Pandya (2 hours later)

Thanks again, just finally what are your thoughts on wasting of the flexor muscles?
I mentioned in the last email my medial epicondyle is more prominent on the right, which my Osteopath attributes to wasting of the flexor muscles in the forearm. Should I be concerned about this, or as you said the muscle will come back once the neuropraxia heals?

thanks in advance

Answered by Dr. Sapan J. Pandya (3 hours later)

Hi,
Our muscles have an XXXXXXX strength of regeneration. Thus wasted muscles can regenerate back with proper exercise and electric stimulation (TENS).
So do not worry your wasted muscles can thus be fully regenerated.
Keep patience and exercise with full will power.

Above answer was peer-reviewed by : Dr. Raju A.T