Compression of the Spinal Cord & Hand Function - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes compression of the spinal cord and hand function.
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Compression of the spinal cord and hand function
• Compression of the Spi...
Cervical myelopathy is a form of neurologic impairment due to compression of the spinal cord in the cervical canal.
MRI is usually the study of choice to diagnose cervical myelopathy. The natural history of a cervical myelopathy is a
slow, stepwise deterioration over time with variable periods of stable neurologic function. Changes in hand
dexterity and coordination are among the earliest signs and these may be present in otherwise asymptomatic
individuals. The progressive cervical cord compression can result in intrinsic atrophy, weakness in grip and pinch,
small finger escape, and impaired ability to perform rapid alternating movement. Thorough history and physical
exam is important given the often asymptomatic, but progressive nature of cervical myelopathy. The lower cervical
nerve roots (C8-T1) are most severely affected. The clinical presentation of cervical myelopathy is highly variable.
The typical patient with cervical myelopathy will complain of symmetric numbness and tingling in the extremities.
The diffuse numbness in the hands is often misdiagnosed as carpal tunnel syndrome. It requires a high index of
suspicion given the progress deterioration in patients with cervical myelopathy. About 20% of patients in the
myelopathy group do have myelopathy signs on physical exam. Myelopathic hand describes a patient with
myelopathy of the cervical spine and its associated findings in the hand. The patient will have hand clumsiness and
gait disturbance. The patient may have decreased manual dexterity. The patient will have difficulty manipulating
objects such as buttoning and on buttoning her shirt. Patient may be dropping objects, because they cannot hold it.
The patient is usually an older patient who may complain of occipital headache.
What is the myelopathic hand?
The patient will have difficulty with grip and release. The patient will have loss of motor strength, will have sensory
changes and intrinsic wasting. There will be a finger escape sign and spasticity. The patient will have difficulty with
hand dexterity, will have hyperreflexia, a positive Hoffmann sign, a positive Romberg sign and gait disturbance. The
patient will feel unstable on their feet.
What is the finger escape sign?
Asked the patient to hold the fingers extended and adducted. The small finger will spontaneously abduct due to
weakness of the intrinsic muscle. The ulnar 2 digits drift into abduction and flexion within 30 seconds is also
described.
Grip and release test
Normal patient will make a fist and release it 20 times in 10 seconds. A myelopathic patient will not be able to do
that. In a positive grip and release test, the patient has trouble making a fist and fully extending the fingers. There
will also be loss of coordination and dexterity of the hand during rapid movement.
Hoffmann sign
A positive Hoffmann sign occurs when snapping the patient's distal phalanx of the middle finger leads to
spontaneous flexion of the other fingers (most common physical exam findings).
Babinski test
The patient may have a positive Babinski test which is positive with extension of the great toe.
Clonus test
The patient may have sustained clonus (more than 3 beats).
The Hoffman sign is only reliable in about 60%, Babinski in about 13%, and clonus in about 13%. The condition is
usually progressive (gets worse with time) and it rarely improves without surgery. Surgical treatment will entail
decompression and stabilization of the cervical spine. Early diagnosis and treatment of this condition is important to
achieve a reasonable, good outcome.

[@MM-yi9zn]

Thank you Sir it was the only podcast that was relevant & extremely helpful. Surgery has been recommended but it’s overwhelming.

[@TarikRom-hu3jj]

Any updates

[@MM-yi9zn]

This was without any doubt the Very Best explanation of the problems with my hand & especially the fingers. Marvellous. Surgery is probably the only remedy unfortunately. Thank you that was illuminating.

[@TarikRom-hu3jj]

Any updates on ur hand

[@lonniegray6613]

That was very much helpful thank you for your gift of knowledge

[@TheSarah121288]

Thank you DR

[@medicalbiochemistry_]

Nice presentation

[@sheilasmith1109]

Dearest,most magnificent teacher and Doctor I adore! Your videos are of SUCH great value and importance to doctor’s, students and patients in the world! Your wisdom from experience brought to us via your videos, are of vast importance with great outcomes for people who use them! I’ve referred others to your work, who’ve shared them with their surgeons, to help them explain their symptoms and actually have corrected their diagnosis and helped them achieve the correct diagnosis and surgical procedure! I want you to know how much I appreciate and admire your work! God bless you and please keep your work coming to bless the world, sir! ☺️❤️👍🙏❤️

[@nabilebraheim]

thank you

[@lera833]

Oui, je suis d'accord avec vous!! Mes remerciements et gratitude à notre cher Docteur !! Malheureusement quand je cherche de monter un de ces vidéo à mes médecins pour l'aider à trouver la cause des problèmes....ils sont jamais contents...même énervée 😒

[@Reminiscience-cn8io]

This is very helpful you explained the tests very well as in the hospital they don’t do that I have all the things you mentioned I’ve been suffering with pins and needles for about 5 years but I keep falling over losing my balance I’m now waiting for surgery after being diagnosed with c.m along with myleomacia and severe spinal stenosis your video has been very informative thank you x

[@ItssMella]

Hi, can I ask how your surgery went? My dad will be getting his vertebras fused soon.

[@Reminiscience-cn8io]

@@ItssMella it went very well it has helped massively 6 months later il never be fully back but my sleep has improved massively the tingling has slowed down it’s just at night it’s a big surgery but worth doing x

[@TarikRom-hu3jj]

I have 6 and c7 fracures and some d5 caused by and accident my symtoms are bladder and bowel i can control them but when its time is time i have double vision and ear noises just in the right pretty much. All the right is fuked up resulted in trouble walking and swallowing openning my full mouth my right jaw and speatch are slured prolem with contration i hope u can answer looking forward now its been 2 months nd half of the injery hopefulluly those sumptoms goes away im just texting you with the left hand hopefully i didnt make any .istakes also problems with erection my doc says just do u collar of the neck and back for 6 months and ull be fine but im not sure...

[@DH-cj7nm]

​@@TarikRom-hu3jjhello may i ask do you have double vision in one eye while the other is closed or double vision with both eyes open.

[@TarikRom-hu3jj]

@@DH-cj7nm yes i have problems when cloese one eyes everything is normal but i open both eyes i have double vosion....

[@liahuddart3660]

Thank you ..very helpful

[@apakyon9275]

Thank you very much Guru

[@GDMan-fb1jx]

Thank you for sharing,excellent description,now I need it fixed ❤

[@nabilebraheim]

You're welcome!

[@sureshbr2731]

Thank you. Sir......

[@ianboland3032]

❤Very good points I have had cervical cord compression for 7yr it. S not to bad only cause I do a lot off work on my posture. Hope it stays that way I. Am worried about surgery.

[@TarikRom-hu3jj]

Any upedates i hqve back and neck fractures my right hand leg are week i dont use my right hand also i have balance pr9blems its only 3 months and some weeks now should i wait or what....

[@mckenna9489]

Thank You x

[@videochannel389]

Hello from Puerto Rico. I’m heading in for an MRI soon. I had one a couple of years ago with no cord compression from some significant stenosis. Given my recent symptoms it sounds like I may have some Myelopathy. I am not asking for a diagnosis but about the time I felt some symptoms all of the joints in my hands where I have arthritis become inflamed and painful. It has been some weeks and the joints are still painful. Have you heard of patients experiencing the same experience? Thank you…

[@rakeshmistry602]

Please suggest treatment

[@ivanshnel9732]

✅

[@gamaltaher9714]

Thanks

[@deborahwright3271]

Thank you

[@pervaiziqbal3527]

MashaAllah v good

[@akolkar2530]

Dr how can we get your videos only some of youtube duplicated video seen by me difficult to fund your original video.

[@bmp713]

My MRI showed from C5-C7 moderate to severe canal narrowing with cord flattening, bilateral foraminal narrowing, and disc osteophyte complexes. All these focused around a reversed neck curve right at C5-C6 pressing on my spinal cord. Numbness on my fingers is the most obvious symptom, but also neck pain and tingling between shoulder blades, and subtle symptoms of unsteady hands, slight balance issues, and a positive Hoffman. What does it mean that extending my neck backward greatly aggravates the numbness on my fingertips, and the neck pain? Is this a sign of nerve root compression Radiculopathy or from cord compression from Myelopathy?

[@hayathallouche1069]

It is very helpful Thank you Dr

[@thegamingpanda727]

I’m going through something like this would my hand ever be as wrong as it was and is there anything I can do to stop it does a chiropractor help or anything

[@sajidnazir1774]

Thank you Sir

[@ivanshnel9732]

✔️

[@mur6679]

thanks

[@israelsales1154]

A good Physics Dr. Nabil is very Good at the physical things that we all. Needed to know. And of course i really love this

[@superscott165]

I cannot move my right thumb at the middle knuckle, it just straight all the time. My index finger also is starting to do that at the upper knuckle. Thoughts?

[@welcometoshivaniwonderland6676]

Thanks sir

[@ivanshnel9732]

✔️

[@qiuqiu6081]

Thank you Doctor 😊🙏

[@ivanshnel9732]

✔️

[@lmundiclan]

I am not able to get surgery, I do not have carpal tunnel. I used to be secretary to Sinatra and Buddy Rich’s agent. I have osteoporosis and rheumatoid arthritis as reasons why I cannot have the surgery to remove the calcium deposits causing pressure on the nerves in the neck. Unable to type with all ten fingers only thumb and first fingers. My both pinkies do not move normally as in your video. What can be done? I am a 78 year old woman.

[@bashirdahir5589]

PLZ prepare for the total hip replacement

[@MandyPants1975]

100% helpful. Thank you. I was hoping I had horrible carpal tunnel. But deep down I kinda knew it was this. I had c6-7 then c5-6 fused. I don’t want a third surgery. When c6-4 is fused my neck will have almost no rotation at all, and it will truly affect my independence as well as being able to drive. Is there a fusion method that has a swivel or moving part to it? I don’t know what to do. I’m beside myself, but I know something has to be done because I have crushing pain in both of my hands every day all day/ night. And my hands stop working on me. I cannot hold a utensil or write with a pen for more than three seconds before I drop it. I can’t even boil water because I’m afraid The doctor says take naproxen sodium you’ll be fine. I am not fine. I haven’t slept in a couple months. I don’t know what to do. I really need to know if another surgery will keep my independence. I am only 47.

[@mjrule888]

consider laminoplasty or disc replacement instead of fusion in order to preserve range of motion. Fusion is around for many decades and that's most of the surgeons had been trained to do. Surgeons do what they are comfortable doing not necessarily the best option for patients. Just like most of the people who don't want to step out of their comfort zone.

[@alyssamae9271]

Research Dr Jeffrey Cantor and Ultrasonic surgery. Impressive newer technique

[@TarikRom-hu3jj]

I have 6 and c7 fracures and some d5 caused by and accident my symtoms are bladder and bowel i can control them but when its time is time i have double vision and ear noises just in the right pretty much. All the right is fuked up resulted in trouble walking and swallowing openning my full mouth my right jaw and speatch are slured prolem with contration i hope u can answer looking forward now its been 2 months nd half of the injery hopefulluly those sumptoms goes away im just texting you with the left hand hopefully i didnt make any .istakes also problems with erection my doc says just do u collar of the neck and back for 6 months and ull be fine but im not sure...

[@marisamantovani601]

Buona sera volevo chiederle è un periodo che ho un dolore tremendo alla gamba sinistra anche la notte mi puo dare un consilio? X il dolore

[@nayaginayagi2121]

Sir please upload a video about spinal muscular atrophy... Please🙏

[@ivanshnel9732]

✅

[@marilureyes3547]

Cual vertebra esta afectada cuando el dedo segundo del pie derecho está rígido

[@alsharabyalsharaby1483]

please Dr nabil, talk about the abdominal aorta and its branches in a little details Thanks for every single word you say it

[@temptivaglamour4315]

E

[@noelbrazoban586]

Amigo dónde es tas su centro por favor

[@rhcorr]

Extremely helpful

[@ShantanuDebShantanu]

এই ভিডিওটা বাংলা অনুবাদ করে দিলে অনেক উপকৃত হবো কারন ভালো ইংরেজি বুঝি না কোন স্বহৃদয় ব্যক্তি যদি বাংলায় অনুবাদ করে দেন আমার অনেক উপকারে আসবে।

[@godschild5824]

I love you man- you are awesome :-)

[@sologybhunu1722]

Dr hw do we connect yu? im in Zimbabwe .

[@bhupatbhaikarmur7038]

Sir chiari malformation with syrinx surgery success full help me

[@omercan5996]

Is Y-Strap Manual Theraphy and physical therahy combined with Tape techniques good enough to solve these kinds of syptoms and relief patient ?

[@sheilasmith1109]

I would love to hear more about what you are thinking about this subject and work. I hope you will respond and converse with me! Thanks 🙏

[@sheilasmith1109]

Absolutely! How do we connect?

[@ItssMella]

Hi, any updates?

[@nishakhan2789]

Good morning sir

[@helenskelly7643]

I have that had the operation in 2009 I felt better for a we wile then it came back but they can't do anything for you once you had the operation just give you physiotherapy iam in a lot of pain killers for it xx

[@gaberased7907]

ياريت تكتب الترجمة للعربي وشكراً

[@ElliesDonna14]

What if you have already had cervical fusion and these symptoms have returned and are worse than before? First surgery was in 1998 and now I’m extremely worse and a lot of pain and numbness in arm and hand and loss of strength in hand

[@themysticmuse]

How are you?

[@cmbooks2000]

This is what keeps me from getting the fusion surgery. I have read repeatedly that it is not a cure, symptoms don't always change, and when there is improvement it is only for a limited time. Thank you for posting your experience. I hope you find a great solution soon.

[@TarikRom-hu3jj]

​@@cmbooks2000 any updates

[@hammerradiology1470]

Awesome. Thank you!

[@PrettiPetty24]

What does it mean when I stand and my arms get weak and heavy and tingly

[@nabilebraheim]

you may need nerve studies to make sure there is no compression of the nerve along its course from the neck to the wrist.

[@PrettiPetty24]

@@nabilebraheim I had an MRI but nerve study would be the best?

[@alkafi4570]

I will be thankful if you can help. I broke my left radius neck, it was type 4. its nonunion now after 6 months. what to do ? I live in Germany.

[@ivanshnel9732]

✔️

[@TarikRom-hu3jj]

Any updates

[@bg5760]

Could c8 nerve root compression/irritation cause hand/wrist/finger stiffness & extensor swelling?

[@TarikRom-hu3jj]

Any updates

[@bg5760]

@@TarikRom-hu3jj for me it doesn’t seem to be a nerve issue. Still don’t know what’s causing my issues…looking now at spike protein blood test for post Covid/vaccine issues(?) and autoimmune conditions(?)

[@TarikRom-hu3jj]

@@bg5760 I have 6 and c7 fracures and some d5 caused by and accident my symtoms are bladder and bowel i can control them but when its time is time i have double vision and ear noises just in the right pretty much. All the right is fuked up resulted in trouble walking and swallowing openning my full mouth my right jaw and speatch are slured prolem with contration i hope u can answer looking forward now its been 2 months nd half of the injery hopefulluly those sumptoms goes away im just texting you with the left hand hopefully i didnt make any .istakes also problems with erection my doc says just do u collar of the neck and back for 6 months and ull be fine but im not sure...

[@mushcompton]

Can someone be misdiagnosed with ALS?

[@anusreebose5255]

Hi sir , your video s are fantastic , very good , can you help out in case of scoliosis , my sister is suffering fron scoliosis what are treatment plz help , I am from India Thank you

[@bittunitishgameing1492]

Sir esaka upay

[@mohammedgulzargulzar4578]

ماشاالله تبارك الله أحسن الخالقين. شكرا

[@ivanshnel9732]

👍

[@kathlynpotts7016]

Dr Ebraheim- I have the exact hand you are describing. It became like this six weeks ago. I just had a three level cervical fusion to release pressure on the spinal cord. Do you have any information about the chance of my hand regaining strength and the hand prognosis once the pressure is removed? Thx

[@TarikRom-hu3jj]

Anyupdates

[@mozamilhalimi7760]

سلام دکتور من انگلیس نوشته نمیتوانم بایدتذکر دهم که من دو بارعملیات شدم البته رشته های عصبی زیر فشار مهره کمر قرار گرفته وباردوم قسمت مهره گردن یا ستون فقرات عملیات کردم فعلا دست هایم را باد می‌گیرد وبا دست هایم چیزی را گرفته نمیتوانم ‌پاهایم هم بی حس است را رفته نمیتوانم برایم معلومات بدهید

[@mozamilhalimi7760]

Can you please help me ? I have problem with my hand 🤚

[@user-vs2cl4xq5g]

Спасибо. Очень полезна тема, поучительная. Жаль, что нет перевода.

[@sylejmanbytyqi2392]

Po edhe une Kam keto probleme me Gishtin e madh te dores se Djatht po ashtu me kemben e Majt.

[@lera833]

Justement...je voudrais poser les questions si ils s'agit aussi de la même cause pour les problèmes des pieds...

[@lera833]

Vous croyez que les pieds ont les mêmes origines de problèmes comme la main ? Peut-être Notre cher Docteur pourra nous répondre si lui lis nos messages..)) Peut-être ça vient de niveau lombaire ?

[@ganasonali2232]

I'm having all this problem after spinal surgery in 2018.

[@lera833]

Bonjour, une question si c'est possible svp? À quel niveau vous avez eu opération ? Cervicale ? Et avant l'opération il n y avait pas ces problèmes ? Ils y a beaucoup de monde que après l'opération les gens se retrouvent avec les nouveaux problèmes neurologiques et par fois grave malheureusement ...bon guérison et courage !

[@somlal3012]

Pls send ur no...i am also suffer in this problem

[@ganasonali2232]

Had surgery due to leg pain where Dr insert 8 screws in 2018 now from then I m suffering 3 fingers pain, numbness, tingling sensation n also neck pain ..now the Dr just don't want to see...

[@DanielDaniel-hd5me]

Don't believe that if it works for John it will work for Peter I am seventy I refused for the surgery when the doctor could not give favourable percentage of recovery but I prayed to our Lord I feel I am slightly better now.❤

[@user-uv2wd1de1d]

कृपया हिंदी मे भी बताए ं Please translate in hindi

[@mariamatkova7237]

Prosím preložiť do slovenciny

[@winston9971]

I have that little finger issue on the right hand

[@TarikRom-hu3jj]

Any updares

[@abdikadirgaleef3966]

Can have the phone of the doctor

[@mariaciesielska6028]

Proszę wygenerować język polski we wszystkiech filmach na tym kanale ponieważ są bardzo interesujące. Dziękuję

[@ivanshnel9732]

✔️

[@takusamuelmd3432]

First to view

[@noughtygirl9538]

Hello doctor help please please This problem has gone to me . I do not know how if happened. When i woke up my hand numb i thought is would be find i 2, 3 minutes but it has hot happened for 15 days it is not fixed yet please help me please i request you pleaee

[@chethankumar555]

I too have same issue.

[@rakeshmistry602]

Sir please suggest treatment

[@RoxanaSattari-sy1gr]

make an appointment with your gp doctor soon!

[@marisamantovani601]

Il dolore parte dall,anca

[@zaraburonova9360]

🇺🇿👍

[@ivanshnel9732]

👍

[@user-ve3dg3hb4w]

Egzact

[@gerardochiariello6330]

In italiano no

[@sonijaiswal199]

Hindi me mtayege sr

[@abdikadirgaleef3966]

Asc

[@joanjohnsen7603]

I am going to tell my Chiropractor.

[@TarikRom-hu3jj]

What happen to u

[@ATLTraveler]

I pooped my pants on an airplane while watching this video

[@RoxanaSattari-sy1gr]

you should have worn a diper for adults!

[@theresa60]

Bitte deusch

[@areguapiri]

I do not trust surgery for this.

[@allaroundflat4634]

i believe This is what I Have!! My neurologist just keeps saying ALS. Now my symptoms are much worse MONTHS laters and testing and referring me everywhere with No help...Im now waiting to see ppl at Barrows Neurological for an "evaluation". I SURE HOPE THEY TEST FOR THIS!! So far Noone has been very thorough At All.

[@TarikRom-hu3jj]

How do u feel now