Floating Sensation While Walking After Spinal Injury

There is a feeling of sinking while walking?

Hello, Director Pan.
I recently suffered a spinal injury from a fall, but there are no fractures.
I've noticed a sensation of instability while walking, and my erections are not firm.
The doctor also observed that the knee and ankle reflexes on both sides are very strong.
Therefore, the doctor ordered a somatosensory evoked potential (SSEP) test, and the results are still within normal limits.
Given this situation, can we rule out the need for a CT scan or similar examinations? Can the SSEP results confirm that there is no compression on the spinal cord?

Chen, 20~29 year old female. Ask Date: 2007/01/19

Dr. Pan Yingda reply Rehabilitation

Basically, the diagnosis of spinal cord compression primarily relies on symptoms and physical examination.
Evoked potentials and imaging studies serve only to confirm our previous hypotheses.
The "floating sensation while walking" is a subjective feeling; I am not entirely sure what that feels like either.
You can perform a self-assessment: Do your legs feel weaker? Is it true weakness, or are you in pain and hesitant to exert force? Are there any enhancements in deep tendon reflexes (some people naturally have stronger reflexes, and I usually compare them with the upper limbs)? Generally, do you feel any tightness in your leg muscles or are you prone to cramps? How are your bowel and bladder functions? Any issues with sexual function? (Is it that you can achieve an erection but it is not firm after the injury?) Are there any abnormal sensations in your lower limbs, around the anus, or in the genital area? If the answer is YES, imaging studies are necessary.
However, due to the current health insurance policies, if there is no clear evidence, they may not cover the tests.
Therefore, you can request to pay out of pocket, and I believe your doctor will not oppose that.
If you decide to proceed, I recommend getting an MRI.
For young individuals who fall without fractures, the likelihood of spinal cord injury is low, so you do not need to worry too much.

Reply Date: 2007/01/19

More Info

Hello, thank you for your detailed question regarding the floating sensation you are experiencing while walking after your spinal injury. It’s important to understand that spinal injuries can lead to a variety of neurological symptoms, and the sensations you describe can be quite complex.

The floating sensation you are experiencing while walking may be related to several factors, including nerve function, proprioception, and muscle control. After a spinal injury, even without fractures, the surrounding soft tissues, nerves, and the spinal cord itself can be affected. This can lead to altered sensory feedback from your limbs, which may manifest as a feeling of instability or a floating sensation when you walk.

The fact that your doctor has noted strong reflexes in your knees and has ordered evoked potential tests is a positive sign. Evoked potentials measure the electrical activity in the brain in response to stimuli and can help assess the integrity of the nerve pathways. If the results are within normal limits, it suggests that there is no significant disruption in the nerve conduction pathways that would indicate severe nerve compression or damage.

However, normal evoked potential results do not entirely rule out the possibility of other issues, such as subtle nerve injuries or dysfunctions that might not be detected through this testing alone. It is also possible that the floating sensation is due to a combination of factors, including muscle weakness, balance issues, or even psychological factors such as anxiety related to your injury.

Regarding your question about whether a CT scan or other imaging studies are warranted, it depends on your clinical presentation and the judgment of your healthcare provider. If there are concerns about structural issues in the spine or if your symptoms worsen, further imaging may be necessary. CT scans can provide detailed images of the bony structures of the spine and may help identify any potential issues that could be contributing to your symptoms.

In summary, while normal evoked potential results are reassuring, they do not completely eliminate the need for further investigation if your symptoms persist or worsen. It is essential to maintain open communication with your healthcare provider about your symptoms and any changes you experience. They can guide you on the best course of action, which may include additional imaging studies or referrals to specialists such as a neurologist or a physical therapist.

In the meantime, consider engaging in physical therapy, which can help improve your strength, balance, and coordination, potentially alleviating some of the floating sensations you are experiencing. A tailored rehabilitation program can be beneficial in addressing the functional aspects of your recovery after a spinal injury.

I hope this information helps clarify your situation, and I wish you a smooth recovery. Please feel free to reach out if you have more questions or concerns.

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