--for spinal-based nerve compression to produce neuropathic symptoms, but generally these compressions, especially of the nerve roots, will produce symptoms that are not limited to the typical burning nerve pain and/or numbness that small fiber neuropathy is associated with; there are generally disruption with large fiber modalities as well (sensory, motor, or both).

And, yes, while it is possible for there to be bilateral symptoms with spinal compression issues, due to likely asymmetry of disc or osteophyte problmes, generally the symptoms, even if bilateral, tend to be asymmetric as well (one side is worse than the other).

All this leads me to question the diagnosis of SMALL FIBER neuropathy--small fiber neuropathy affects the unmyelinated or thinly myelinated nerves that subsume the sensations of pain and temperature and of most autonomic functinos, and is much more likely to have a systemic etiology (metabolic, toxic, autoimmune) than a localized one.

I have neuropathic symptoms both from an idoipathic body-wide acute onset small-fiber syndrome AND from cervical and sacral spine compressions, and the symptoms are rather distinct; the former involves primarily generalized neuropathic pain and the latter shoots or tingles along very specific nerve pathways (such as, in the case of my right-side C6/C7 cervical radiculopathy, along the medial nerve of my right arm and into my thumb/forefinger/middle finger).