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  • Cervical Myelopathy

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    Old 06-13-2016, 10:04 AM   #1
    inspirations7
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    Cervical Myelopathy

    It's been a year this June since I had my cervical/lumbar MRIs. I've gone to a couple of neurosurgeons for assistance. One ignored me and never called back. I wrote about this on the board some time ago. A good while later, I contacted another neuro at Resurgens in Johns Creek, Georgia, because I was having some mild bowel issues, which went away. He told me my back looked like a 71-year-old back, and that if I were having real problems with my bowels, it would be very noticeable and I'd end up in ER. He asked if I had pain, which I have very little, and he said, "I'm sorry I can't help you."

    So, this year, a year later, I visited a hemotologist who is following me for MGUS, which may or may not lead to multiple myeloma. It is rare for it to progress. I told her, again, about my back, and my legs, ankles trying to give way with me, and she sent me to a different group. But the doc she wanted me to see handled knees and ankles. So, I chose an orthopedic spine doc instead. He looked at my now year-old MRIs, and said he wasn't 100 percent, but very confident I have cervical myelopathy and needed three discs decompressed. He would remove the three and replace them.

    Question: He also wanted me to contact all my doctors and let them know I will be having surgery. Do I need to contact ALL of them? My heart doc? I have mild to moderate issues. Same with the pulmonary. I have asthma. Neurologist? Hemotologist? Eye doc, since I have vitreous detachment, etc. What about gastro since I have GERD? I have not seen any of these docs, except my neurologist and hemotologist in a long while.

    How serious is cervical myelopathy? My legs have given away with me periodically. And I am terribly off-balance quite a bit. If surgery doesn't help, he'll be looking at lumbar since it's pretty bad too. He is board certified and fellowship trained. He did say that my issues may not get better since I've dealt with this for some time. He's just trying to prevent more progression.

     
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    Old 06-13-2016, 05:49 PM   #2
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    Re: Cervical Myelopathy

    Well, I don't want to scare you from proceeding, but I think you really need to get another opinion. Did this surgeon want a new MRI before scheduling surgery?

    If you are speaking of having artificial disc replacement, 3 to be exact, this would be a very big surgery and probably would not be approved by most insurance carriers. Unless the FDA has changed their approval, two cervical levels was the most one could have replaced...in the US that is. In Europe doing two or more levels is frequently performed.

    Myelopathy is a neurological deficit of the spinal cord caused by compression to the spinal cord. This can be caused by things like herniated discs, osteophytes, etc...generally something pressing into the cord causing compression of the spinal nerves.

    If you wish to be treated by this surgeon, you should follow his instructions. He must have a reason why he wants you to contact your other doctors.

     
    Old 06-14-2016, 04:39 AM   #3
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    Re: Cervical Myelopathy

    Quote:
    Originally Posted by teteri66 View Post
    Well, I don't want to scare you from proceeding, but I think you really need to get another opinion. Did this surgeon want a new MRI before scheduling surgery?

    If you are speaking of having artificial disc replacement, 3 to be exact, this would be a very big surgery and probably would not be approved by most insurance carriers. Unless the FDA has changed their approval, two cervical levels was the most one could have replaced...in the US that is. In Europe doing two or more levels is frequently performed.

    Myelopathy is a neurological deficit of the spinal cord caused by compression to the spinal cord. This can be caused by things like herniated discs, osteophytes, etc...generally something pressing into the cord causing compression of the spinal nerves.

    If you wish to be treated by this surgeon, you should follow his instructions. He must have a reason why he wants you to contact your other doctors.
    Yes, Teteri, I'm going in for a cervical MRI this morning.

    I was so shocked when he said removal of three discs that I didn't ask ANY questions--so unlike me. So all I know is what I've said above. However, I"m supposed to talk to him on Friday. I'm trying to sort out what I need to ask. He did ask me if I wanted a second opinion, and like I said, I was so in shock, as was my husband, that I said no. Of course, after thinking it through, I need to have another opinion.

    I am on Medicare, with a supplement, I hope that it is covered as we don't have it. We both are still working. He's 65 and I'm 72. We will be working for a while, God willing.

    I need to ask him, among other things, why he wants me to contact my other doctors. If you have some thoughts on questions, I'll add them. Oh, when you do a second opinion, do you have to go to the doc in person, or can he ascertain everything he needs from the MRIs?

    My original contact, in case you're wondering, was July of last year. I'm pretty sure I added my MRI impressions. Thank you so much for your help then--and now.

     
    Old 06-14-2016, 05:43 AM   #4
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    Re: Cervical Myelopathy

    We'll come up with some questions you will want to ask on Friday. I will look for your other posts and read through them again. I will try to get back with some comments later today.

    Yes it is better to see the surgeon in person because the MRI is just one piece of information the doctor uses in making a diagnosis.

     
    Old 06-14-2016, 06:22 AM   #5
    inspirations7
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    Re: Cervical Myelopathy

    Thank you, Teteri. I'm heading out in a few minutes for the MRI.

     
    Old 06-16-2016, 05:00 AM   #6
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    Re: Cervical Myelopathy

    Quote:
    Originally Posted by teteri66 View Post
    We'll come up with some questions you will want to ask on Friday. I will look for your other posts and read through them again. I will try to get back with some comments later today.

    Yes it is better to see the surgeon in person because the MRI is just one piece of information the doctor uses in making a diagnosis.
    Good morning, Teteri.
    I'm coming up with a few questions, including is it normal to have good days (several in a row) with cervical myelopathy? This past week, I only had one small episode where I went off-balance; no problems with legs giving way. However, I'm having very painful spasms (I guess that's what you'd call it) across the small of my back, several times during the day the past few days, to the point of my legs nearly giving way. I think that may be from my lower back though. I've had these episodes for about a month or so. Memorial Day was particularly bad, as was yesterday. (Three or four times a day.)

    Anyway, I wanted to ask that question. Because I certainly don't want to be treated for myelopathy if it's something else entirely.


    Thank you so much for your help. You are a blessing.

     
    Old 06-16-2016, 04:54 PM   #7
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    Re: Cervical Myelopathy

    One thing you should ask is whether there is any sign of myelomalacia. This is a disease of the spinal cord which does require treatment or at the very least, watching. It is a softening of the spinal cord. It can be caused by disc herniation and other degenerative issues or by injury.

    One thing to remember is that the spinal cord runs from the base of the skull to about the beginning of the lumbar spine. Any injury of the spinal cord can cause pain or loss of movement at the level of injury or below. At the cervical and thoracic levels, a serious injury can result in paralysis. Most issues of the lumbar spine cannot cause paralysis. This is in part due to the termination of the spinal cord around T12-L1 in most people. Below this the nerves bundle together to form what is called the cauda equina. When these nerves are seriously compressed, it often results in a radiculopathy rather than a complete loss of movement or paralysis. Due to this, cervical issues take priority over lumbar issues unless the cervical problem is minor.

    You need to find out if he is talking about a fusion or artificial disc replacement.


    You can always ask what would happen if you didn't have surgery or if you could wait to have surgery.

     
    Old 06-16-2016, 06:06 PM   #8
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    Re: Cervical Myelopathy

    Thank you so much, Teteri. This is really helpful. I'll add this to my list. I'm seriously considering a second opinion. On top of all this, I have GERD and a hiatal hernia. And, any of my scars don't heal quickly or well. Not to mention a host of other docs ...

    Again, thank you!! I appreciate your taking the time to do this.

     
    Old 06-17-2016, 06:05 AM   #9
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    Re: Cervical Myelopathy

    Whoever possible, I always recommend a "second" opinion or more when there is a big difference in treatment/surgery suggestions. With my first lumbar surgery, my discrepancies went from fusing one level to four or five.

    Let us know what you find out today.

     
    Old 06-17-2016, 08:39 AM   #10
    inspirations7
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    Re: Cervical Myelopathy

    Quote:
    Originally Posted by teteri66 View Post
    Whoever possible, I always recommend a "second" opinion or more when there is a big difference in treatment/surgery suggestions. With my first lumbar surgery, my discrepancies went from fusing one level to four or five.

    Let us know what you find out today.

    Teteri,

    Yes, it is myelomalacia. That's what has him so concerned. Yes, he wants to replace three discs-half plastic/half cadaver. Keep in hospital overnight. He says sooner, rather than later. He also said as soon as possible. I did tell him I wanted another opinion, for sure.

    Thanks for your help!!

     
    Old 06-18-2016, 07:23 AM   #11
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    Re: Cervical Myelopathy

    I do not have any personal experience with disc replacement so cannot offer any valid suggestions. I am not familiar with disc replacement using cadaver bone. With three discs, is this supposed to be covered by insurance.

    I would just caution you to do your homework, research the surgeon, maybe ask to speak to one of his patients who has had a similar procedure. The surgeon may be doing cutting edge work that most spine surgeons aren't doing yet...or...you may be signing up to be a Guinea pig!

     
    Old 06-27-2016, 11:07 AM   #12
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    Re: Cervical Myelopathy

    As you get ready for your appointment on Wednesday, I think you will want to find out if you have myelomalacia. But I think if I were going in, I would let him take the lead. Sometimes a surgeon will realize it is a second opinion and he will ask what the other surgeon planned...but often they won't ask, in which case I found it helpful to just approach the appointment as a first time visitor to any spine surgeon.

    Answer his questions in detail but quickly, and stay away from anything extraneous. Remember, you won't have much time, so I would wait to ask questions as you see if he leaves something out.

    I am assuming he will be focusing on the cervical spine....find out, if he is talking about fusion, why it is necessary and if so, is it necessary right away. Ask about disc replacement ( using artificial discs).

    I wouldn't waste time at this point asking details about recovery. Use your time to find out why surgery is necessary, what it would accomplish and what would happen without it.

    Read up on myelomalacia if you haven't done so, so you understand whatever the surgeon says about it. Jot down questions you might have about it while reading...and take your notes with you to the appointment. But don't get bogged down with them...your focus needs to be on what the surgeon is saying. From what we read about him, he sounds like a good communicator, so I don't think you will need to talk to get things going!

     
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    Old 06-27-2016, 12:55 PM   #13
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    Re: Cervical Myelopathy

    Thank you so much, Teteri. Yes, I think that asking if I have myelomalacia is one of my first questions. The ortho practice already asked if it was a second opinion or not, and also asked what the previous doctor said.

    I asked about scar tissue since I have a ton of adhesions after ovarian cyst removal 40 years ago. Also, I have a list of other conditions. Should I only leave it at several conditions? mitral valve regurgitation, heart plaque, asthma, sensory-motor polyneuropathy, MGUS (precursor to Multiple Myeloma), osteoporosis, GERD, hiatal hernia, trouble swallowing sometimes. I have some other ones, but they are not as serious.

    I'm asking about a cascade event since other discs are deteriorating, particularly in lumbar area, with compression of S1 nerve root at L5-S1, severe DDD and foraminal stenosis. I also asked about retrolisthesis in cervical. And what should I be doing prior to surgery to take care of myself. Am I asking too much?

    I've included 7 doctors names and phone numbers for notes to be sent. Is that all right?

    Again, thank you so much for taking the time to do this. I'm at a loss. This has certainly put a wrench in my plans. Oh, by the way, I'm off-balance more and more frequently. Legs are not giving way much at this point, though, and that's a good thing.

    Could cervical issues, I think mine starts at C3 or 4, affect your ears and throat? I'm having trouble swallowing my larger vitamins ... And my ears are all stopped up. I went to ENT a couple of days ago, and she said everything was fine, except my jaw was out of line. Said I needed to see dentist. Oh, well.When I have time.

     
    Old 06-28-2016, 04:01 PM   #14
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    Re: Cervical Myelopathy

    I have never heard of cervical issues causing swallowing difficulties or blockage in the ears....but as you know I know much more about lumbar issues.

    Good luck tomorrow. I am eager to hear what this surgeon thinks needs to be done!

     
    Old 06-28-2016, 05:48 PM   #15
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    Re: Cervical Myelopathy

    Thank you so much, Teteri! You are a blessing! I'll let you know tomorrow.

     
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