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Dr. Andrew Rynne

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Can a radiologist or neurosurgeon determine which nerves are compressed?

Answered by
Dr.
Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5172 Questions

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Posted on 5 days ago in Bones, Muscles and Joints
Question: Hello Dr. Aashish XXXXXXX
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You have helped me previously And I have returned to ask More questions That I hope you can Answer
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The below link allows you to download a "zip" file of my February, 2016, MRI. Additionally, you might want to look on my dashboard which may Also have the Radiologists report on my MRI.
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https://drive.google.com/open?id=0B2QjpyAJZSh_c2M3RzJNY3JkM1k
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INFORMATION: On March 1, 2016, I was diagnosed with cervical spondylosis with myelopathy, .that demonstrated itself as Nerve pain, Confined to only my 2 pinkies.
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QUESTION 1: Regarding the reading of an MRI taken of the cervical neck for nerve compression, is a Radiologist / Surgeon able to determine the specific Spinal cord nerve(s) being compressed That was causing The specific Nerve pain symptom in just my 2 pinkies?
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INFORMATION For several months before my scheduled Surgery, I was wearing a cervical hard collar with an adjustable chin support. When I wore the Hard cervical collar and adjusted the chin strap upwards, the collar took the weight of my head off of my neck. I immediately felt a dramatic reduction in the Nerve pain In both my pinkies.
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QUESTION 2 Being that the nerve pain was Dramatically relieved when I wore the Hard collar, Does this signify that the the spinal cord nerve(s) Were being "decompressed" And more importantly that they were NOT "irreversible"?
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My surgery was delayed for one month. During that month the hard cervical collar lost its effectiveness to where I had no relief at all.
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Additionally, during that month, the nerve pain symptom had spread from just my pinkies to both hands and up my forearms to my elbow joints.
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The surgery relieved the nerve pain in my forearms but left the nerve pain symptoms PERMANENTLY throughout both hands
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QUESTION 3: Would this signify that during the one month delay in surgery, that some of the damaged spinal nerves were still "reversible" as demonstrated by the relief of pain in my forearms and that the spinal cord nerves responsible for the nerve pain in my hands, had now become "irreversible"
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QUESTION 4: Can the radiologist/neurosurgeon, Determine, which specific nerves within the spinal cord that were Compressed by my cervical spondylosis with myelopathy?
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QUESTION 5:Can the radiologist/neurosurgeon, Determine, which Specific spinal cord nerves Were still reversible and those that were irreversible?
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.QUESTION 6: s it strictly based on the patient's evaluation of their symptoms before and after the decompression of the spinal cord surgery?

As always thank you for your time and detailed answer
doctor
Answered by Dr. Aashish Raghu 1 hour later
Brief Answer:

Answers

Detailed Answer:

Hi,

Answer 1 - Yes, a Radiologist or Neurosurgeon can determine which nerves are compressed. Since you say pinky finger it indicates C8-T1 nerve roots.

Answer 2 - The reversibility of the symptoms are largely unpredictable. There may be complications of surgery or further degenerative changes that can cause the symptoms.

Answer 3 - There was only momentary relief due to the supposed distraction effect of the collar. Usually such symptoms take a few months to heal. You could wait and watch for recovery in such cases of possible neuropraxia.

Answer 4 - Yes

Answer 5 - The reversibility of the damage to nerve roots cannot be commented upon with surety on such investigations.

Answer 6 - Patient's perception of the pain definitely matters. There are so many factors that affect the surgical outcome.


Hope I have answered your query.

Take care

Regards,
Dr Aashish Raghu, Orthopaedic Surgeon
Above answer was peer-reviewed by : Dr. Prasad
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