Curious to poke the minds of some of the docs on here. In a nutshell, my husband had been suffering from what we thought were debilitating migraines since last summer. Frequency and severity of the headaches increased. Then he developed numbness and weakness in his left arm.

Due to family history (his father passed from a brain aneurysm) he decided to get it checked out. Had MRI and was diagnosed with severe spinal stenosis in the C5-C6 and C6-C7 area causing cord edema. All this appears to be due to bone Spurs.

My question: how is it a 33 year old develops bone Spurs? Everything I read about this says it's common in older adults, like 50+. The doctor also remarked how it's rare to see this in someone his age. Can this just be bad luck? Or should we be thinking about some underlying cause?

He is slated to see an orthopedic surgeon on 4/21 and we hope to have a lot of our other questions answered then. The initial doctor he saw who did MRI was a brain surgeon and couldn't answer his questions as she said she doesn't deal with the spine. So everything from cause to what type of surgery he'll need are giant question marks for us until we talk to the new guy.

Does he have any symptoms outside of migraines? Any tingling/numbness in his arms or hands? Weakness in the extremities? Reflexes impacted? In my experience not common at all for that age group to have severe stenosis unless they have a previous history of trauma to the area. Definitely worth getting a second opinion.

Yes, he has tingling, numbness, and weakness in the left arm along with constant neck pain and stiffness. Not sure about reflexes. He just had his nerves in neck//shoulder/arm tested last week (not sure what the test was for. He said they shocked him a lot.)

I've seen his scans and the compression on the cord is very obvious. It's a wonder he isn't having more significant symptoms.

We are seeking second opinions of surgeons in the Houston area and potentially up in Birmingham. We live in Auburn, AL

The cord edema is obviously a concern. Sometimes people just have bad luck with their spine. Did they it classify as central canal stenosis or bilateral foraminal stenosis?

Those are the details we weren't given from initial doc but hope to receive from the spinal surgeon. Can it be both? Is that possible? I'm not a radiologist but based on what the MRI report says (and shows) that would be my guess.

He's had no injury or trauma to the neck. He traveled internationally for work a lot first 5 years, then desk/office work the next 4, now back to travel but just regionally (car) when not having an office day.

Honestly, I want to blame this on his tree cutting service he did on the side last summer. Removed some large ash trees with chainsaws, he the only one working the saw the whole time. But who knows.

Sounds like he has a component of congenital canal stenosis. He probably didn't have much room to work with. I'd be curious what the other levels of the cervical spine look like. This is really taxing my memory, but there is a measurement called the Torg ratio to help determine. There measurements may be based on plain film images rather than cross sectional imaging like MRI.

Plain film, as in x-rays? He hasn't had any x-rays done, just the MRI of the brain and neck.

He was traveling for work yesterday and today but is now on his way home due to the pain and nausea. This is what typically happens: the pain is moderate daily but every so often (sometimes more frequently between episodes) the pain ramps up and he says he feels like his head is splitting in two and is physically ill. He has to take a combination of Zofran and ibuprofen to lower it from debilitating to tolerable. Have not been able to identify a trigger for these periods of intense pain.

We have a telehealth consult set up with Dr. Alexander Ropper in Houston on 4/26. Heard this guy is good.

Yes, x-rays. I probably shouldn't have mentioned it bc I don't think it's relevant to your husband's condition. I was just qualifying that the Torg ratio may be based on measurements from X-rays. The concept should hold true for MRI as well.

Based on your brief description, I would highly suspect he has a component of congenital central canal stenosis in his cervical spine. You're doing he right thing by shopping around for a surgeon. Personally, I'd try to see 3-4 total, some ortho spine and some neurosurgeons and ask around a ton.

Chris Chaput is in San Antonio and I know several people personally that he has operated on their cervical spines with great success.

I just got diagnosed with this at 4 cervical disk levels and I am 46. I have not had trauma, either. Mine was listed on the MRI report as "disk osteophyte complex with severe bilateral foraminal narrowing". It was not affecting my spinal cord, though. Get in to a good spine neurosurgeon or spine orthopedic to see what they say. I would get a second opinion if they are wanting to go straight to surgery.

This is all very interesting and we'll definitely keep it in mind as we begin our discussions with the doctors. I also appreciate the recommendations for specialists. Looks like we will be getting this taken care of in Texas, afterall.

Side note, it is virtually impossible to get medical records transferred. That has been almost as frustrating for my husband to deal with as the pain.

How is he doing? I had similar symptoms from a different cause (herniated disks c5-c7) causing severe stenosis. And I let it go for years and years. I had the disks replaced in Jan 2020 and my quality of life is so so so much better. I hope he's able to get to a quick resolution.

Husband had surgery last Friday, 4/30. They removed the herniated disc and all the bone Spurs and arthritis to open up the canal space and relieve pressure. They fused C5 and C6.

Recovery has been a little tough pain wise. As of Tuesday night he was still complaining of a headache and aches in his upper arms. He's been on Hydrocodone and muscle relaxers. Unfortunately, just as he was starting to feel a little more human he caught a stomach virus from our toddler yesterday morning. I feel terrible for him.

He has a follow-up appointment on the 13th. I'm hoping the headache is more from the virus and not an unsolved issue from the surgery. It was pretty bad. Time will tell, I guess.

just saw this

impingement causing cord edema is bordering surgical emergency (especially with weakness) -- high risk for worsening impingement causing paralysis -- glad he got it taken care of, but usually thats more of a prompt fix


the MRI you described would not cause cervicogenic headaches -- needs to trial one of numerous migraine prophylactic medications

aggiesportsfiend10 said:

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Husband had surgery last Friday, 4/30. They removed the herniated disc and all the bone Spurs and arthritis to open up the canal space and relieve pressure. They fused C5 and C6.

Recovery has been a little tough pain wise. As of Tuesday night he was still complaining of a headache and aches in his upper arms. He's been on Hydrocodone and muscle relaxers. Unfortunately, just as he was starting to feel a little more human he caught a stomach virus from our toddler yesterday morning. I feel terrible for him.

He has a follow-up appointment on the 13th. I'm hoping the headache is more from the virus and not an unsolved issue from the surgery. It was pretty bad. Time will tell, I guess.

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2 month follow-up? How is your husband doing?

Headaches and neck pain are all gone. However, he's developed new pain and numbness in his other arm (can't remember if he's complaining of his left or right.) Been messaging the surgeon and they finally got back to him.

3 month follow-up with surgeon is on the 26th. They're asking him to get a new MRI of the entire spine this time to see if the arm is related to an issue farther down the spine than they previously imaged. Last scan only showed cervical area.

He feels okay otherwise, just concerned about the arm. I'm leaning towards carpal tunnel since he had that repaired a year ago in the opposite arm. All in all, we will see what scan shows and doc says.

I give him a hard time for his body falling apart on me so early, but a friend pointed out that he'll probably outlive us all since all his parts are being replaced. Fair point.

Update after follow-up appointment yesterday:

I was mistaken when I said it was the opposite arm beginning to trouble him. In fact, it's the same arm that's developed numbness again. However, surgeon said his mri and xrays all looked good so he's referring him to complete some PT and will see him again in September.

Husband wasn't pleased with the encounter. Said the doc was in there with him less than 30 seconds and didn't show him any images or explain anything as to why the arm is numb again. Felt like the appointment was a waste of time, especially considering we had to travel to Houston from Auburn, AL. This all could have been discussed over the phone, in my opinion.

That's really terrible. His outcome will likely be worse based on that encounter. Loss of trust with someone who was supposed to help. Was PT not recommend to begin with following surgery?

PT was discussed prior to initial surgery but ultimately doc decided he didn't need it because he was "young and healthy." But that seems to be the route we are going now, three months later.

Any update?

Depending on the initial imaging & how long the cord edema was there, it could cause a permanent "structural" issue, meaning that spot in the cord could be permanently damaged - the repeat C-spine MRI would show if this was the case or not


It is possible for areas to "re-wire" and let neighboring areas pick up the slack, but it's less common in the cord than the brain

I hope your husband is doing better.

I'm not sure how I missed this thread originally. When I read the OP, I was almost wondering if it was my wife that posted it, but then I saw the date. You basically described my exact symptoms from about 10 years ago.

I suffered from headaches pretty much 24/7 for years in my early 30's. After a lot of imaging, I had cervical stenosis, bone spurs, arthritis, bulging and/or dessicated discs, etc. I had C6/C7 fused in 2013 at age 34 (the disc was pretty much obliterated). I woke up from surgery migraine free and haven't had one since. I still had some arm numbness and neck pain, but I diligently did the PT and that eventually went away after a while.

10 years later, I still do the PT a few times a week, especially the various stretches, or I feel the pain starting to return. No more headaches, though, so I'm very glad I had the procedure done.

Hi all. It's nice some of y'all have kept up with this a year later. A nice little community we've got here.

The headaches were better for a little while after the surgery, but they seem to have come back. As well as the neck pain. There hasn't been a return of any numbness that I am aware of, though I do know the opposite arm is bothering him but we suspect that to be a carpal tunnel issue (he only had one wrist fixed back in 2020).

He did a few rounds of PT and is doing the exercises at home now because unfortunately, our health insurance isn't covering PT and we do not feel like paying $400/appointment. We went on a trip last month and borrowed a fancy massage gun from a friend one morning when he was really bothered with pain and he said it helped a lot. I am now looking into buying a massage gun for him to have on hand.

I am pretty sure he is done seeing the surgeon in Houston. He was not pleased with him. I very much understand the headaches may not be related to the neck as his doctor claimed, but I just can't get over how much his neck pain and migraines seem to go together.

We never got to see the follow up MRI scan. Doc only said "things look fine. Try PT." and walked out. It was less than a 30 second encounter and my husband was very unhappy.

He met with his new PCP in February and really likes him. He will follow-up with him if the PT isn't resolving the migraines and/or neck pains.

Our lives have changed a bit since my last post. My husband took a job offer that moved us back home to Texas here in Lavaca County. We purchased 20 acres and plan to build our forever house on it eventually so we are living the minimalist style with our 4 year old in a decent sized trailer in the meantime. Hi stress is better, I just wish I could help him find relief for what seems to be daily pain in just varying levels.

We live in Moulton but he works in Victoria. His PCP is in Shiner and he saw the PT there at Sievers.

I looked at the bill again and realize it was a combined bill so $400/appt isn't accurate. The initial visit was $268. After that it was $186. Still, we're not looking to pay nearly $200 an appointment when he can do the exercises at home.

Our new insurance isn't great (BCBS). One of the sacrifices we made by choosing to move back near family. But at least we have it.