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Double Crush Syndrome

Just a recap of my cervical spine journey.  I had 3-level ACDF from C4/5 down to C6/7 in Sept 2018 for a myriad of problems (cervical stenosis, 3 herniated discs, DDD, moderate and severe narrowing of the nerve roots).  Everything was great by 6-months and released to resume normal activities.  At 11 months post-op, left side symptoms returned.  Tried months of conservative treatment.  Had CT with myelogram that showed some new mild bone spurs in the left C7 nerve root.  CT scan also showed that I was not fused across the C6/7 plane and that a screw in the C7 vertebrae was loosening up.  I had a regular NCS done which revealed "chronic and inactive C7 nerve root damage" and "mild cubital tunnel syndrome" for compression of ulnar nerve.  Had an Axon-III nerve test done which showed that damage/injury was at the C7 nerve root exit.  Tried 2 months of conservative treatment for elbow (bracing and OT).  Had diagnostic and therapeutic injection done on elbow a month ago.  Spinal surgeon said he did not want to do anything further (including steroid injections) for the C7 issue until I had the elbow issue resolved and out of the way.  He did say that it is possible that in certain positions, the "mild encroachment" becomes moderate and that we just do not see that on the singular position for the CT scan.

Today, I went to follow up with hand surgeon.  I will be having both a cubital and carpal tunnel release of the ulnar nerve.  I have been told that when you have compression in one place (perhaps the C7 nerve root), you are susceptible to compression elsewhere like the cubital tunnel (i.e. Double Crush).   I am only agreeing to surgery on the left side so that I can continue to figure out the cervical involvement .  I am cautiously optimistic that my weakness is due from the ulnar compression and that this surgery will eliminate it.

Please share your stories for any of you who have had Double Crush syndrome.  Did you end up having surgery for the other location of impingement?  Did it help?  Did it completely resolve your issues?  Or did you feel it was just a necessary step to eliminate in getting back to the business of figuring out the cervical side?

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Comments

  • memerainboltmemerainbolt IndianaPosts: 4,464

    Kand

    I have never had this problem, the double crush syndrome. I just want to tell you how sorry I am that you are still having problems. I hope your next surgery will eliminate the pain you are in.

    Please keep us posted on how you are doing.
    Sandra

  • Hi Sandra,

    Thanks for the good wishes and encouragement.  The hand surgeon said it would do nothing for the symptoms above my elbow.  My constant pain is across my shoulder and down my tricep.  My tricep is weak (rated 3 out of 5).  So, while this ulnar nerve surgery will help and will likely eliminate the hand numbness, I just do not know how much it will improve the hand weakness, but am hopeful.  But, it simply will not help the constant pain and the upper arm weakness.  I just see this as a step to knocking things out so that my spine surgeon will continue to look for what is wrong.  He just seems reluctant to connect my pain and weakness to the non-fusion and movement of that level, even though the nerve tests point to problems at that level.  I am not wanting unnecessary surgeries.  I feel like this ulnar nerve problem isn't bad enough that I would have chosen surgery to fix it....thus, it is unnecessary.   I am only agreeing to do it so that my spine surgeon will continue to treat me (as he said that he did not want to do anything more on my spine, not even try injections, until I got the ulnar nerve resolved).  In my heart of hearts, I think we are headed to a revision spine surgery, but I do not think my surgeon is willing to concede to that until I am 24 months post op.

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