central cord injury?

[bluegreenocean]

My neurologist discharged me from PT, saying that I've met maximum improvement. I was in a car accident 6 months ago. Someone going 50 miles an hour decided not to see my car or the red light and tried to drive right through me. I was fine right after but my neck started hurting as the police were investigating. I also felt a lot of tingling in my left arm. Right after, I went to the emergency room since my neck was hurting and I couldn't move it much.

I eventually ended up at a neurologist with tingling of the left hand, numbness of some of my fingertips, abnormal feelings when he pricked me with that needle (felt dull in some places but sharp in others) and weakness of both my arms and legs. My arms were weaker but my legs were so weak he said I had to be careful to make sure they didn't give out on me. I started PT and did passive excercise for a while, maybe until September. Then I started doing the hard stuff, but I didn't improve a whole lot.

Backtrack a little, the neuro had me get an MRI on the Sunday after my first visit to him because he wanted to get me in ASAP. At no time did anyone do anything to stabilize my spine. Anyways, all he saw on the MRI of both my cervical spine and lumbar spine and all he saw was a bulging disc at C2-3.

I am still having lots of spasms and tingling. I've waken up a few times unable to move my left hand. I don't understand how a bulging of disc C2-3 can cause this. I found an article about central cord injuries when I was researching something else, but I have one question: is it always able to be seen on MRIs?

Also, does anyone have a good website for rehab excercises since I have to do the rest by myself? My grip is weak, as well as my upper arms, shoulders, hip abductors and hip flexors. When I saw weak, I mean really weak so that it makes it hard to function, but I keep going!

Thanks.

[Kari in Pacific NW]

I have a central cord injury and my arms are affected the most, which is true in most central cord injuries: arms and hands more than legs. I don't know the answers to all your questions, but I do know that my most current MRI alone does not match the severity of my symptoms.

However, you need to obtain an attorney, an EMG, and a second/third opinion from a neurologist who specializes in spinal injuries.

[SCI-Nurse]

Neurologists have little or no training in physical rehabilitation. I would strongly recommend seeing a physiatrist (physician specialist in physical medicine and rehabilitation) instead. You also need an ASIA exam and classification by someone who knows what they are doing. MRIs often do not correlate with the degree of neurologic deficit.

(KLD)

[bluegreenocean]

Thank you. My neurologist made me sign a contract with him, I guess because of the meds that I'd exclusively see (or something of the sort, I really can't remember) which I was leery about and only use one pharmacy of my choice. I really like him and he seems to know a lot, but he is so vague.The issue is that I am not on any pain meds even though I am in pain, and I should be able to see the physitraist. I'll talk to my lawyer on Monday, because he wants me to settle but I don't think I should if I am still having these problems. I really want a second opinion. Apparently, I've reached maximum improvement but I really think I could do better, even though I am reallly tired of PT.

[TAM63]

The pain clinic contracts are simply to have you get your pain meds from only that doctor, and fill them at one pharmacy. This is just so they can keep close track of controlled drugs. If you don't comply with the terms of the contract, they can stop treating you. That's all that contract does.

You can see any other doctor you want - the only issue is you can't have the other doctor prescribe narcotics in addition to the first doctor.

Of course, you are free to switch doctors any time you want.

[Incoquad103006]

Physical Therapy

Physical therapy just hits the surface you have to take matters in to your own hands and if you want gains you need to push as hard as you can without hurting yourself . Make sure your injury is what they say it is. Make sure you are stable in that area ( i.e. fusion or not) get an mri to know the extent of your injury then work out as much as you can not only weights but walking /running/biking and all types of functional movements that all people without spinal cord injurys take for granted. It will take a long time to see minimal improvements. Just my take on the situation,opinions are like you know what Good Luck

Thank you. My neurologist made me sign a contract with him, I guess because of the meds that I'd exclusively see (or something of the sort, I really can't remember) which I was leery about and only use one pharmacy of my choice. I really like him and he seems to know a lot, but he is so vague.The issue is that I am not on any pain meds even though I am in pain, and I should be able to see the physitraist. I'll talk to my lawyer on Monday, because he wants me to settle but I don't think I should if I am still having these problems. I really want a second opinion. Apparently, I've reached maximum improvement but I really think I could do better, even though I am reallly tired of PT.

[jb3822]

If there is any residual stenosis that should be addressed in order to achieve maximal gains. Do get that EMG and see if there are any specific muscle groups that are out that could be recovered with a nerve or tendon transfer.

[PN]

After your injury, did they immobilize your neck using a collar, or other device? When I was in ICU, they had me wearing a Philadelphia collar.

[Wise Young]

My neurologist discharged me from PT, saying that I've met maximum improvement. I was in a car accident 6 months ago. Someone going 50 miles an hour decided not to see my car or the red light and tried to drive right through me. I was fine right after but my neck started hurting as the police were investigating. I also felt a lot of tingling in my left arm. Right after, I went to the emergency room since my neck was hurting and I couldn't move it much.

I eventually ended up at a neurologist with tingling of the left hand, numbness of some of my fingertips, abnormal feelings when he pricked me with that needle (felt dull in some places but sharp in others) and weakness of both my arms and legs. My arms were weaker but my legs were so weak he said I had to be careful to make sure they didn't give out on me. I started PT and did passive excercise for a while, maybe until September. Then I started doing the hard stuff, but I didn't improve a whole lot.

Backtrack a little, the neuro had me get an MRI on the Sunday after my first visit to him because he wanted to get me in ASAP. At no time did anyone do anything to stabilize my spine. Anyways, all he saw on the MRI of both my cervical spine and lumbar spine and all he saw was a bulging disc at C2-3.

I am still having lots of spasms and tingling. I've waken up a few times unable to move my left hand. I don't understand how a bulging of disc C2-3 can cause this. I found an article about central cord injuries when I was researching something else, but I have one question: is it always able to be seen on MRIs?

Also, does anyone have a good website for rehab excercises since I have to do the rest by myself? My grip is weak, as well as my upper arms, shoulders, hip abductors and hip flexors. When I saw weak, I mean really weak so that it makes it hard to function, but I keep going!

Thanks.

ocean,

I think that your description fits with the diagnosis of central cord syndrome. By the way, you don't have to have cord compression in order to get spinal cord injury. It is possible that your spinal cord contused (transiently and rapidly compressed) and there is no further compression of your cord by the time you got your MRI.

The good news is that you should recover almost completely from this is you push yourself aggressively to walk and exercise. It may take a year or more. I have known many people who have had symptoms like yours and who have recovered almost completely.

Wise.

[bluegreenocean]

Thanks everyone.

Wise, my legs are getting a lot better. I've been walking every day. They tried to put me on the bike at PT but I just couldn't tolerate it. I kept trying though. I've even been hiking twice (much shorter and flatter than what I am used to but it was great). I'm planning to get a treadmill or join a gym. I am still really worried about my arms but I am going to keep practicing and practicing and keep in mind that it can get better. I felt like I hit a plateau and I really didn't know I have a good possibility of getting better.

PN, the ER did not stabilize my neck at all. I was out of it, but my brother asked if it was good idea and and the dr. said it usually wasn't needed. I got tortocollis immediately so my neck was stuck sideways basically so I wonder if they could even get it in a brace if it was like that?

JB, interesting you bring up stenosis. The non-traumatic kind runs in my family. I'll have to ask if the dr saw it on my MRI at all, because that would explain some of this. I did have an EMG but I don't know the results. The dr did say something about my nerves being like a loose electrical cord. He uses all these anologies instead of the actual diagnosis.

SCI Nurse, I'll see if I can get my lawyer to let me see a physictrist. I never heard of it, but it seems like an excellent profession.

TAM, thanks for the info. about the contract. The first few weeks after the accident were a blur.

I need to find a good place that I can work out or just get a treadmill and some 2 -3 lb dumbells, and I am going to try to get a second opinion to see if anything can be done to restore some function, esp. in my arms, or for the spasms.

[bluegreenocean]

Another question...with a mild injury like this should the weakness resolve soon or will it take a long time? I plan to do as much as I can to rehabilitate, I am just thinking of all the things I miss and wondering when/ if I can do them again. Does the pain typically go away? The tingling is starting to get better and my arm feels a little less "dead" if you understand what I am saying, but I am still having a lot of pain and really really low strength in my arms to the point where its hard to wash my hair and open doors.

[Kari in Pacific NW]

No one really knows how long it might take--everybody is different. I am almost seventeen months post-injury and I can open doors but can't wash my hair.

If you are looking for home exercise equipment, I would suggest a table bike. These can be used on the floor with legs or on the table with arms. You can make them go forward or backward.

[jb3822]

Thanks everyone.

Wise, my legs are getting a lot better. I've been walking every day. They tried to put me on the bike at PT but I just couldn't tolerate it. I kept trying though. I've even been hiking twice (much shorter and flatter than what I am used to but it was great). I'm planning to get a treadmill or join a gym. I am still really worried about my arms but I am going to keep practicing and practicing and keep in mind that it can get better. I felt like I hit a plateau and I really didn't know I have a good possibility of getting better.

PN, the ER did not stabilize my neck at all. I was out of it, but my brother asked if it was good idea and and the dr. said it usually wasn't needed. I got tortocollis immediately so my neck was stuck sideways basically so I wonder if they could even get it in a brace if it was like that?

JB, interesting you bring up stenosis. The non-traumatic kind runs in my family. I'll have to ask if the dr saw it on my MRI at all, because that would explain some of this. I did have an EMG but I don't know the results. The dr did say something about my nerves being like a loose electrical cord. He uses all these anologies instead of the actual diagnosis.

SCI Nurse, I'll see if I can get my lawyer to let me see a physictrist. I never heard of it, but it seems like an excellent profession.

TAM, thanks for the info. about the contract. The first few weeks after the accident were a blur.

I need to find a good place that I can work out or just get a treadmill and some 2 -3 lb dumbells, and I am going to try to get a second opinion to see if anything can be done to restore some function, esp. in my arms, or for the spasms.

check on that and let us know