Cervical Spine Issues and Surgical Options: A Patient's Journey

Cervical spinal cord issues and surgery?

Hello, Vice Dean.
I would like to consult you.
I have congenital S-shaped scoliosis, with a lumbar curvature of 90 degrees and significant thoracic curvature.
In 2000, I developed a gastric condition that led me to sleep in a raised position for many years.
In 2013, I discovered some lateral curvature in my cervical spine, and after experiencing weakness in my hands, I was diagnosed with cervical spinal canal stenosis.
There are two segments that are tightly connected.
After training my hands, I can barely manage to draw on the computer for a few hours at home.
Dr.
Wei Guozhen does not recommend surgery and also mentioned that traction is not suitable.
In 2016, I also discovered hearing loss and nerve damage in my left hand.
After experiencing gastric flare-ups in 2017 and 2021, I have now developed Barrett's esophagus with low differentiation.
After the gastric flare-up in 2021, I noticed significant muscle loss in my legs.
My left palm appears somewhat darkened, and my fingers often bend involuntarily, causing discomfort when I make a fist.
My right hand is even thinner, and my thumb has atrophied (I have always had issues with my legs).
I experience weakness in both legs, and due to my gastric condition, I was shocked to see myself losing weight, which led to panic attacks and increased weakness.
Last August, I noticed that sometimes when I get up from bed, I feel weak for a moment.
Wearing a magnetic necklace helped improve this, and later I flattened my pillow, which further improved my condition.
However, I still experience increased acid reflux, and my legs remain prone to weakness (sometimes my relatives take me out for walks, which exhausts my muscles).
My lower back only feels sore when I practice leg raises on the bed, push against the wall, or stretch my spine.
I once dreamt about a device called "ysio" related to X-ray imaging, which suggested that more than half of my gastric issues are related to my cervical spine (as well as emotional suppression).
I have several questions regarding my limbs: 1.
Is there a connection between acid reflux and the cervical spine? (Currently, I am not frequently depressed, but I feel emotionally suppressed due to my congenital conditions—cleft lip and single eye—and I have faced challenges in both career and relationships.) Could this suppression affect my autonomic nervous system? Is it detectable? 2.
Is the atrophy of the muscles in my right thumb related to this? 3.
Should I consider surgery for both my cervical and spinal issues? Should they be done simultaneously? I am afraid that my body will deteriorate further, and I am particularly concerned about the risk of Barrett's esophagus progressing to esophageal cancer.
Thank you.

Chen Qiming, 40~49 year old female. Ask Date: 2024/03/07

Dr. Zhang Junwei reply Neurosurgery

1.
Gastroesophageal reflux should not be related to the cervical spine.
2.
Muscle atrophy of the right thumb is a possibility.
3.
Without detailed medical history and physical examination, an accurate answer cannot be provided.

Reply Date: 2024/03/07

More Info

Your situation is quite complex, involving multiple health issues that intersect, particularly with your cervical spine condition and gastrointestinal problems. Let’s break down your questions and concerns regarding the cervical spine issues, potential surgical options, and their relation to your overall health.

1. Is there a connection between acid reflux and cervical spine issues?
There is some evidence to suggest that cervical spine problems can contribute to various systemic issues, including gastrointestinal symptoms. The cervical spine houses nerves that can influence the autonomic nervous system, which regulates bodily functions, including digestion. If there is nerve compression or irritation in the cervical region, it could potentially lead to dysfunction in the autonomic nervous system, which might exacerbate conditions like gastroesophageal reflux disease (GERD). However, this connection is not straightforward and varies from person to person. It is essential to consult with a gastroenterologist to evaluate your acid reflux symptoms and determine if they are related to your cervical spine condition or if they stem from other causes.

2. Could the muscle atrophy in your right thumb be related to your cervical spine issues?
Yes, muscle atrophy in your right thumb, particularly if it is accompanied by weakness or numbness, could be indicative of nerve compression or damage in the cervical spine. The nerves that control the muscles in your hand originate from the cervical spine. If there is a herniated disc or spinal stenosis in the cervical region, it can lead to compression of these nerves, resulting in weakness, atrophy, or sensory changes in the hand. A thorough neurological examination and imaging studies (like MRI) can help determine if there is a direct correlation between your cervical spine condition and the muscle atrophy in your hand.

3. Should you consider surgery for your cervical spine issues?
The decision to undergo surgery for cervical spine issues should be made after careful consideration of several factors, including the severity of your symptoms, the degree of nerve compression, and the impact on your quality of life. If conservative treatments (like physical therapy, medications, or injections) have not provided relief and your symptoms are progressively worsening, surgery may be warranted.
In your case, given the complexity of your condition, it might be beneficial to consult with a neurosurgeon or an orthopedic spine specialist who can evaluate your specific situation. They can provide insights into whether a single surgery addressing both cervical and lumbar issues is feasible or if it would be better to stage the surgeries to minimize risk and recovery time.

4. What are the risks of surgery, and how can you prepare?
Surgery on the cervical spine carries risks, including infection, bleeding, nerve damage, and complications related to anesthesia. However, if your symptoms are significantly affecting your daily life, the potential benefits may outweigh these risks. Preparing for surgery involves:
- Preoperative Assessment: Undergoing a thorough evaluation, including imaging studies and possibly additional tests to assess your overall health.

- Discussing Concerns: Communicating openly with your surgeon about your fears and expectations. They can provide detailed information about the procedure, recovery, and what to expect.

- Postoperative Care: Planning for your recovery, including physical therapy and follow-up appointments, is crucial for a successful outcome.

Conclusion
Your health journey is undoubtedly challenging, and it’s essential to approach your treatment options with a comprehensive understanding of how your cervical spine issues may relate to your overall health. Consulting with specialists in both neurology and gastroenterology can provide a more holistic view of your condition and guide you toward the best treatment options. Remember, it’s crucial to advocate for yourself and seek second opinions if you feel uncertain about the recommendations you receive. Your well-being is paramount, and addressing both your cervical spine issues and gastrointestinal health will be key to improving your quality of life.

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Hello: The question you are asking is too broad. I recommend that you visit the outpatient clinic for a detailed explanation and treatment from a specialist. Sincerely, Dr. Ding Hsien-Wei, Neurosurgery.