Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Cysts In Spinal Cord Leading To Nerve Compression?
Question: I have a cyst(s) in my spinal cord. Neurologist tells me that cysts in compressing my nerves causing numbness and tingling on both feet. not sure if it warrants seeing a neurosurgeon. what do you think?
Brief Answer:
It is important to discuss with neurosurgeon should the numbness be recent
Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The cyst in your spinal cord appear to be of benign origin and therefore they are stable or growing slowly.
2. The location, size and time since last MRI scan are important along with the duration and progress of symptoms.
3. Nerve compression might cause pain, tingling or numbness depending on the type of nerve fiber and the nerve tract involved.
4. If there was pain earlier for which you took lyrica and gabapentin then it was due to nerve compression and if you are having numbness right now then this is also because of nerve compression which might have progressed to involve specific nerves.
5. Having numbness and tingling on both feet might indicate growth of the cyst and I suggest you get an opinion from a neurosurgeon regarding the necessity for any surgical intervention. I am unable to get a clear picture as you have not mentioned the MRI scan details but the appearance of numbness and tingling is a concern that requires clinical discussion. If your MRI scan is done many months back then a review imaging is required.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
It is important to discuss with neurosurgeon should the numbness be recent
Detailed Answer:
Hi XXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The cyst in your spinal cord appear to be of benign origin and therefore they are stable or growing slowly.
2. The location, size and time since last MRI scan are important along with the duration and progress of symptoms.
3. Nerve compression might cause pain, tingling or numbness depending on the type of nerve fiber and the nerve tract involved.
4. If there was pain earlier for which you took lyrica and gabapentin then it was due to nerve compression and if you are having numbness right now then this is also because of nerve compression which might have progressed to involve specific nerves.
5. Having numbness and tingling on both feet might indicate growth of the cyst and I suggest you get an opinion from a neurosurgeon regarding the necessity for any surgical intervention. I am unable to get a clear picture as you have not mentioned the MRI scan details but the appearance of numbness and tingling is a concern that requires clinical discussion. If your MRI scan is done many months back then a review imaging is required.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
will get back with you later. looking for written mri report done 23 Mar 15.
Brief Answer:
Please write in with MRI report findings
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I will await your MRI report findings and proceed to discuss your problem in detail.
Regards,
Dr.Vivek
Please write in with MRI report findings
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I will await your MRI report findings and proceed to discuss your problem in detail.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dt of svc: 03/23/15
Procedure: mr thoracic (mri spine thoracic w/o co)
FINDINGS: The thoracic cord is abnormal from T9 to the tip of the conus. It is enlarged and shows diffuse T2 hyperintensity. A sharply defined fluid collection is not seen within the cord.
The intervertebral discs appear normal down to T7.
T7-T8: There is disc dessication and loss of disc height.
There is a minimal central disc protrusion with mild thecal sac effacement.
T8-T9: Minimal disc dessication.
T9-T10: Minimal disc dessication.
Beginning from T10 caudally is evidence of a an extramedullary fluid collection.
This is on both sides of the cord beginning at the lower margin of T9 and the is mainly anteriorly located extending from T11 to the tip the conus and into the upper lumber region which will be further described on the mri of the lumber spine report. This is felt represent an arachnoid cyst most likely intradural although the possibility this fluid collection in the subdural would be a less likely consideration.
Incidental note is made of a benign hemangioma in the left pedicle of T11.
IMPRESSION:
The distal thoracic cord from the lower margin of T9 the tip the conus is abnormal. It is swollen with increased signal intensity. This most likely represents a presyrinx state with diffuse cord edema. A well-defined fluid collection within the cord is not seen. This is felt unlikely to be a tumor. Transverse myelitis would be another unlikely possibility. There is anterior extramedullary fluid collection most likely intradural extending up to T11 and it is also seen to extend on both sides of the cord up to T9, and there is moderate cord compression. This most likely represents an arachnoid cyst in view of the extensive changes of arachnoiditis described on the mri on the lumbar spine.
There is a minimual central disc protrusion with mild thecal sac effacement T7-T8.
Dt of Svc: 03/23/15
PROCEDURE: mr lumbar (MRI Spine lumbar w/o)
FINDINGS: As was noed on the MRI of the thoracic spine, there is T2 hyperintensity and mild enlargement of the distal cord and conus.
There is a large extradural intraarachnoid fluid collection dissecting from L5-T11. This displaces the thecal sac and conus as well as the cauda equine posteriorly. At L5 and S1 there is noted to be extensive clumping of the nerve roots posteriorly and there is moderate thickening of the thecal sac. The findings are consistent with extensive arachnoiditis and a secondary arachnoid cyst that has dissected of the level of T11. The findings in the conus are felt to be to most likely to be due to the extensive intraarachnoidal adhesions and scarring and most likely represents a presyrinx state. It is felt less likely that the scalloped fluid collection dissecting anteriorly is in the subdural space.
There is desiccation of the intervertebral discs down to L4 without evidence of herniation or stenosis.
L4-L5: There is mild to moderate facet anthropathy and slight anterolisthesis. There is a tiny right facet joint synovial cyst. No neural compression. No evidence of lateral stenosis.
L5-S1: There is moderately several bilateral facet anthropathy with ankylosis of the left facet joint.
Incidental note is made of a possible benign Tarlov cyst in the caudal sacral canal.
IMPRESSION: There is extensive evidence of intraarachnoidal adhesions throughout the lumber spine most marked at L5-S1. There is an intra dural fluid collection having appearance of loculated fluid and a secondary intraarachnoid cyst that dissects cranially to the T11 level. This is most likely related to severe arachnoiditis.
There is T2 hyperintensity the distal cord and conus most likely related to a presyrinx state related to the arachnoidal scarring. This is felt less likely to be transverse myelitis or a primary intra cord tumor. If clinically indicated, the could could be further studied with a postcontrast study.
Could you please intrepet above MRIs in layman terms. My neurologist tells me that nothing could be done. I have to live with leg numbness/tingling. Later ordered 3 steroid injections at hospital setting. Improved condition for less than a week.
Referred to another neurologist. wants me to decide if I want to do another MRI and see a neurosurgeon. What procedure is done to remove the cyst.
Procedure: mr thoracic (mri spine thoracic w/o co)
FINDINGS: The thoracic cord is abnormal from T9 to the tip of the conus. It is enlarged and shows diffuse T2 hyperintensity. A sharply defined fluid collection is not seen within the cord.
The intervertebral discs appear normal down to T7.
T7-T8: There is disc dessication and loss of disc height.
There is a minimal central disc protrusion with mild thecal sac effacement.
T8-T9: Minimal disc dessication.
T9-T10: Minimal disc dessication.
Beginning from T10 caudally is evidence of a an extramedullary fluid collection.
This is on both sides of the cord beginning at the lower margin of T9 and the is mainly anteriorly located extending from T11 to the tip the conus and into the upper lumber region which will be further described on the mri of the lumber spine report. This is felt represent an arachnoid cyst most likely intradural although the possibility this fluid collection in the subdural would be a less likely consideration.
Incidental note is made of a benign hemangioma in the left pedicle of T11.
IMPRESSION:
The distal thoracic cord from the lower margin of T9 the tip the conus is abnormal. It is swollen with increased signal intensity. This most likely represents a presyrinx state with diffuse cord edema. A well-defined fluid collection within the cord is not seen. This is felt unlikely to be a tumor. Transverse myelitis would be another unlikely possibility. There is anterior extramedullary fluid collection most likely intradural extending up to T11 and it is also seen to extend on both sides of the cord up to T9, and there is moderate cord compression. This most likely represents an arachnoid cyst in view of the extensive changes of arachnoiditis described on the mri on the lumbar spine.
There is a minimual central disc protrusion with mild thecal sac effacement T7-T8.
Dt of Svc: 03/23/15
PROCEDURE: mr lumbar (MRI Spine lumbar w/o)
FINDINGS: As was noed on the MRI of the thoracic spine, there is T2 hyperintensity and mild enlargement of the distal cord and conus.
There is a large extradural intraarachnoid fluid collection dissecting from L5-T11. This displaces the thecal sac and conus as well as the cauda equine posteriorly. At L5 and S1 there is noted to be extensive clumping of the nerve roots posteriorly and there is moderate thickening of the thecal sac. The findings are consistent with extensive arachnoiditis and a secondary arachnoid cyst that has dissected of the level of T11. The findings in the conus are felt to be to most likely to be due to the extensive intraarachnoidal adhesions and scarring and most likely represents a presyrinx state. It is felt less likely that the scalloped fluid collection dissecting anteriorly is in the subdural space.
There is desiccation of the intervertebral discs down to L4 without evidence of herniation or stenosis.
L4-L5: There is mild to moderate facet anthropathy and slight anterolisthesis. There is a tiny right facet joint synovial cyst. No neural compression. No evidence of lateral stenosis.
L5-S1: There is moderately several bilateral facet anthropathy with ankylosis of the left facet joint.
Incidental note is made of a possible benign Tarlov cyst in the caudal sacral canal.
IMPRESSION: There is extensive evidence of intraarachnoidal adhesions throughout the lumber spine most marked at L5-S1. There is an intra dural fluid collection having appearance of loculated fluid and a secondary intraarachnoid cyst that dissects cranially to the T11 level. This is most likely related to severe arachnoiditis.
There is T2 hyperintensity the distal cord and conus most likely related to a presyrinx state related to the arachnoidal scarring. This is felt less likely to be transverse myelitis or a primary intra cord tumor. If clinically indicated, the could could be further studied with a postcontrast study.
Could you please intrepet above MRIs in layman terms. My neurologist tells me that nothing could be done. I have to live with leg numbness/tingling. Later ordered 3 steroid injections at hospital setting. Improved condition for less than a week.
Referred to another neurologist. wants me to decide if I want to do another MRI and see a neurosurgeon. What procedure is done to remove the cyst.
Brief Answer:
Neurosurgeon might like to do decompression of clumping nerves
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. There is a long segmment abnormality in the region of spinal cord which starts approximately in the lower chest level and goes down till the end of the spinal canal.
2. It has been described as a large extradural intraarachnoid fluid collection dissecting from L5-T11 that is causing pressure symptoms on the nerve roots along its course. There is also mention of a presyrinx in many places which means that obstruction to cerebrospinal fluid flow might be there.
3. In the lower end of spinal cord there is clumping on nerve roots which is described as extensive intraarachnoidal adhesions
4. The synovial cyst at L4 - L 5 level on right side is not significant.
5. At the sacral level and below the synovial cyst there is Tarlov cyst in the lower back is a cyst around the nerves. The Tarlov cysts might be treated surgically if causing symptoms involving lower back.
6. In layman terms, there is a long column of spinal fluid along most of the extent on mid to lower back and is responsible for most of the symptoms. As a result of this collection, there is clumping of nerve roots in the lower back region which also shows the presence of a Tarlov cyst.
7. The neurologist will not be able to do much in this case. I recommend you please consult the neurosurgeon. A contrast MRI might be done only if required. There might be some relief after surgical decompression with correction of presyrinx. Will be glad to know what your neurosurgeon feels after having examined you and having a look at the MRI scan.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Neurosurgeon might like to do decompression of clumping nerves
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. There is a long segmment abnormality in the region of spinal cord which starts approximately in the lower chest level and goes down till the end of the spinal canal.
2. It has been described as a large extradural intraarachnoid fluid collection dissecting from L5-T11 that is causing pressure symptoms on the nerve roots along its course. There is also mention of a presyrinx in many places which means that obstruction to cerebrospinal fluid flow might be there.
3. In the lower end of spinal cord there is clumping on nerve roots which is described as extensive intraarachnoidal adhesions
4. The synovial cyst at L4 - L 5 level on right side is not significant.
5. At the sacral level and below the synovial cyst there is Tarlov cyst in the lower back is a cyst around the nerves. The Tarlov cysts might be treated surgically if causing symptoms involving lower back.
6. In layman terms, there is a long column of spinal fluid along most of the extent on mid to lower back and is responsible for most of the symptoms. As a result of this collection, there is clumping of nerve roots in the lower back region which also shows the presence of a Tarlov cyst.
7. The neurologist will not be able to do much in this case. I recommend you please consult the neurosurgeon. A contrast MRI might be done only if required. There might be some relief after surgical decompression with correction of presyrinx. Will be glad to know what your neurosurgeon feels after having examined you and having a look at the MRI scan.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
The condition involves a large part of spinal cord and causing discomfort
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. The abnormality in your case extends over a large area from T 11 to L 5 and there are numerous nerves originating between these levels. These nerves are on many types and might be sensory, motor, autonomic, pain sensitive among others. These nerves are also part of the autonomous nervous system which causes sensations in stomach and bloating with loss of appetite. Therefore your symptoms are not XXXXXXX to a single nerve getting trapped and there are a bunch of them involved.
2. The numbness in feet and wobbling are also due to the nerves under pressure and also the pain when you sneeze hard. You might be aware that there is clumping of nerve roots in the lower back. The neurosurgeon might focus their attention to this and if any treatment is required surgically to improve few of your problems.
3. It is difficult to treat your symptoms entirely but attempts might be made depending on a clinical examination and then a decision might be taken whether surgery will benefit you.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
The condition involves a large part of spinal cord and causing discomfort
Detailed Answer:
Hi XXXXX,
Thanks for writing back with an update.
1. The abnormality in your case extends over a large area from T 11 to L 5 and there are numerous nerves originating between these levels. These nerves are on many types and might be sensory, motor, autonomic, pain sensitive among others. These nerves are also part of the autonomous nervous system which causes sensations in stomach and bloating with loss of appetite. Therefore your symptoms are not XXXXXXX to a single nerve getting trapped and there are a bunch of them involved.
2. The numbness in feet and wobbling are also due to the nerves under pressure and also the pain when you sneeze hard. You might be aware that there is clumping of nerve roots in the lower back. The neurosurgeon might focus their attention to this and if any treatment is required surgically to improve few of your problems.
3. It is difficult to treat your symptoms entirely but attempts might be made depending on a clinical examination and then a decision might be taken whether surgery will benefit you.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'm scheduled for MRI on 13 Jul. I will let you know MRI findings. Appt with neurosurgeon is not until late September. Also on waiting list.
Brief Answer:
Awaiting your MRI scan findings after 13 July scan
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. I will be awaiting your MRI findings after the scan is done on 13 July. Hoping that you are not in much discomfort.
Regards,
Dr.Vivek
Awaiting your MRI scan findings after 13 July scan
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. I will be awaiting your MRI findings after the scan is done on 13 July. Hoping that you are not in much discomfort.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
