Re: Severe cervical spinal stenosis
It depends on whether that stenosis is central of the spinal cord canal or stenosis of the foramen where the nerves emerge on either side of spine. It also depends on what your symptoms are and how severe. That is quite tight for the cord, but not so for the foramen. Cigna is being ridiculous and I would appeal their decision with a letter of explanation from your Dr. The swallowing trouble is likely from scar tissue from previous surgery, and scar tissue shows up best with contrast. If you have to have surgery again, they could perhaps remove the scar tissue pressing on esophagus, but of course, need to know where it is, hence the necessity of the contrast. Appeals often work, if they understand the rationale. An enlarged thyroid could be causing the swallowing problem, so your thyroid should be checked by physical exam at least so no faulty assumptions are being made. The myelomalacia refers to softening of the spinal cord from compression and lack of oxygen due to compression of the blood supply. If the report says myelopathy, that is also an indication that the cord compression is causing lack of oxygen to the cord which can cause permanent damage. This is accompanied by pain, numbness, tingling, burning weakness in the arms especially or clumsiness of hands. This is more urgent to avoid permanent cord damage. A somato-sensory evoked potential test can clarify whether myelopathy exists if symptoms are vague or intermittent.
Last edited by ladybud; 09-28-2012 at 12:17 AM.
Reason: Added info. Correction.