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Suggest treatment for weak quadriceps after a cervical spine surgery

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Orthopaedic Surgeon, Joint Replacement
Practicing since : 2002
Answered : 4340 Questions
I had moderate central stenosis in the cervical spine at c-4, also minimal at c-6, with severe foramiinal stenosis at c-3. This went undiagnosed for sometime, as I had very high strength levels in all areas of my body, at 60 I was still benching 315 lbs. Got slowly weaker and weaker. Neuro Dr. Said that I should make almost complete recover, although legs my take years. Very discouraged by rate of recovery, now 18 months. Hamstrings and gluts are quite good, but quads are very weak. Am I being unrealistic in my expectations both short and long term. I know 1mm a day for nerves to heal and innervate. Can I still look to progress 2-3 years after ADCF. WORKING HARD EATING GOOD.
Posted Thu, 20 Mar 2014 in Brain and Spine
Answered by Dr. Naveen Kumar Sharma 1 hour later
Brief Answer: You can have problem in lumbar spine also. Detailed Answer: Hello, I have studied your case in detail. You have gone through surgery of cervical spine 2-3 years back and now you are saying that your quadriceps is not recovered. You have not mentioned about your hand functions. Are they Completely normal because cervical spine problem make shoulder and elbow muscles weak as well. If your weakness is only in thigh I would recommend you to get an Mri of lumbar spine and cervical spine . There could be compression of nerve at lumbar region. Which was missedat time if your neck ssurgery. If there is severe compression at lumbar spine than you may need surgery of lumbar region als. If your mri is normal at lumbar spine than other possibility is that It can be a case of incomplete removal of compression at neck level. So my advice is to get a mri of neck and back region to find out which site is still compressing your nerves and than plan accordingly. You can post your finding in this forum . meanwhile Tablet methylcobal, gabapentin and baclofen also helpful in such compression if it is not very severe. I hope this answers your queries. Let me know if I can answer any other question for you. Thanks. Take care.
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Follow-up: Suggest treatment for weak quadriceps after a cervical spine surgery 44 minutes later
Had procedure 18 months ago, deltoids are great very strong. Lats also good, index and first three fingers showing good grip. All muscle functions rated strength readings of five for function by my Rehab Dr. Triceps coming back slowly, but they are responding. Had MRI of lumbar and showed no stenosis or compression. Leg press and leg curls quite strong. Major point of weakness is quads on thigh extension movement. Main question, will muscles in quads continue to grow stronger since their is contraction and I can flex the muscles. Main issue is going up and down stairs, need assistance on descent. Hoping for increased nerve flow given some time. Don't want to sound like a victim , not my style, but living it day by day can get to me somewhat. If you have heard of recoveries in cases like mine, that would bring hope. Thank you for your time and effort in this matter.
Answered by Dr. Naveen Kumar Sharma 5 hours later
Brief Answer: quadriceps will recover Detailed Answer: hello, So if you are able to walk and rise stairs that means quadriceps are at least plus 3 power, i hope they will gain their strength further. It is not only issue of nerve growth but muscle strength also. So i would like to encourage you to continue your muscle building exercises. If you can not do them actively, keep them doing with assistance.I have seen few patients who recovered completely, and it depends on strong will also. From your question i can feel that you are a determined person, so have patience and continue physiotherapy. In next 6 to 7 months you will recover faster. It was my pleasure to answer your followup query. Any further question is welcome.
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