Patient Name : Mr. Ghadage
Age : 65 years
Introduction
A 65-year-old man presented with multiple neurological symptoms including neck pain, tingling, hand weakness, imbalance, and urinary incontinence. MRI revealed C3–C4 cervical canal stenosis with spinal cord compression.
He underwent C3–C4 laminectomy at The Spine Doctor – Bavdhan, Pune, leading to a dramatic recovery with improvement in every symptom.
Patient History & Presentation
The patient reported:
- Neck pain for 5 months
- Tingling and numbness in the left upper limb
- Left upper limb radicular pain
- Fine motor dysfunction (dropping objects, difficulty gripping)
- Bilateral lower limb tingling and numbness
- Increasing imbalance while walking for 3 months
- Urinary incontinence for 11 days
- Sleep disturbance due to symptoms
On examination:
- Painful, restricted neck ROM
- Significant weakness in hand grip and upper limb muscles (3/5 on left)
- Brisk reflexes on the left (upper motor neuron signs)
- Sensory deficits in the left upper limb
- Gait imbalance
- Signs consistent with cervical myelopathy due to spinal cord compression
Diagnosis & Radiology Findings
MRI Cervical Spine
- Altered cervical alignment
- Severe C3–C4 degenerative stenosis
- Asymmetric disc bulge indenting spinal cord
- T2 hyperintense signal—suggestive of cord edema/myelomalacia
- Foraminal narrowing with nerve root compression
MRI Lumbar Spine
Additional multi-level degeneration and canal narrowing, but primary pathology causing neurological decline was the C3–C4 lesion.
Lay Explanation:
The spinal cord was severely compressed at C3–C4, causing weakness, balance issues, and bladder symptoms — a condition known as cervical myelopathy.
Surgical Procedure – C3–C4 Laminectomy
Performed to decompress the spinal cord and restore neurological function.
Steps:
- Posterior approach under general anesthesia
- Removal of lamina at C3 and C4
- Decompression of spinal cord
- Relief of pressure from ligament thickening and disc bulges
People Also Ask:
Is cervical laminectomy safe?
Yes. It is a standard and effective procedure for cervical myelopathy.
When is surgery needed for cervical stenosis?
When weakness, imbalance, or bladder symptoms appear.
How long does recovery take?
Initial improvement occurs within days; major recovery over weeks to months.
Post-Operative Recovery
Day 1
- Neck pain improved
- Tingling reduced
- Better balance
- Improved gait
- Stronger hand grip
- Beginning of bladder control improvement
Day 2
- Enhanced fine motor skills
- Stronger upper limb muscles
- Clear improvement in gait and coordination
- Sleeping better
Day 3 (Discharge)
- Walking confidently with stable gait
- Major neurological improvement
- Upper limb symptoms significantly reduced
- Lower limb tingling decreased
- Bladder control regained
2–4 Weeks
- Independent walking
- Fine motor skills restored
- No radicular pain
3 Months
- Near-complete neurological recovery
- Full independence in daily activities
Long-Term Outcome
The patient achieved:
- Improved power in hand grip and upper limbs
- Normalized gait and balance
- Full bladder control
- Marked reduction of neck and limb pain
- High satisfaction and restored quality of life
This case highlights the success of cervical canal stenosis treatment in Pune using evidence-based surgical care.
Why Surgery Was Necessary
- Progressive cervical myelopathy
- Hand weakness affecting daily function
- Imbalance and risk of falls
- Urinary incontinence (red flag)
- MRI-confirmed severe spinal cord compression
- Risk of permanent neurological damage if untreated
About Dr. Sangram Rajale
Dr. Sangram Rajale is a leading Spine Surgeon in Pune, specializing in:
- Cervical & lumbar stenosis
- Myelopathy treatment
- Minimally invasive spine surgery
- Laminectomy, fusion, and decompression procedures
- Complex nerve compression syndromes
He leads The Spine Doctor – Bavdhan, providing ethical, evidence-based, and highly successful spine care.
FAQs
Neck pain, hand weakness, imbalance, tingling, gait instability, and urinary symptoms.
Yes — it decompresses the spinal cord and prevents further damage.
When there is neurological deficit or red-flag symptoms like incontinence.
Yes — especially when treated early; recovery continues over months.