Question
I am 3 years post surgery for a laminectomy . I had fusion from c4 to t1. I have chronic neck pain on my right side and tingling in my thumb and next finger tips.

Am EMG indicated carpal tunnel in my left hand/wrist (mild) and some nerve degeneration in both arms. The muscles are fine. I had an MRI with contrast . It indicated decompression of the sac with increased signal of the cord with mild myelomalacia in the level of c4-5. There is no disc herniation. There is no abnormal intradural enhancement. Any advice on eliminating the chronic pain and tingling or next diagnostic steps will be appreciated.

Thanks,

sid

Answer
Hello Sidney,
Thanks for your question and my sincerest hope for a speedy recovery.  I am quite concerned about your reported myelomalacia. The most common cause of this condition is bleeding within the spinal cord or due to an inadequate blood supply weakening the spinal cord and as a result making it susceptible to damage. Unfortunately there is currently to my knowledge no known cure for nerve damage due to myelomalacia. My suggestion is to see a neurologist to discuss if you actually have nerve damage. As far as treatment, the specific treatment will be entirely dependant on the actual diagnosis ie. is the tingling and chronic pain due to permanent nerve damage or something else. You may also benefit from seeing a pain specialist. I have even heard that some people have benefited with hyperbaric oxygen chambers, however there is no good data that I have seen that confirms that.

I so wish I could offer you more insights but at this time I would certainly require more information.  


Can you please take a moment out to rate my answer and consider to reate me as expert of the month.

Also please let me know how you are doing,
Best of luck for now,

Dr. Ron Nusbaum