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    Old 06-21-2010, 09:44 PM   #1
    MJml
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    Help - I'm the 10%

    Hi I had a mva in feb. Recvd flexion x rays which went back to my neurosurgeon - he advised me that sometimes these ligament injuries are missed in the MRI - anyways here is the deal - I have a ligament injury in my back w/ spinal cord instability . ---- I'm freaking out - my neuro put me in a collar & advised fusion surgery in July - I'm tring to get a second opinion - yet my symptoms are progressing - numbness tingling - in hands & feet help.. What di you feel us my next step - go directly to er - to a spinal orthopedic surgeon specialist ? - I went for 2nd opinion - they want to order a ct scan - in reading on line - that CSM be inconclusive to what I'm actually dealing with. My first neurosurgeon wants to have surgery - yet not until July - why us he not rushing ?? Please help !

     
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    Old 06-22-2010, 10:10 AM   #2
    feelbad
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    Re: Help - I'm the 10%

    i did respond to your other post mj, did you read that yet? what exactly do you mean by 'i'm the 10%"? and also what does 'that CSM may be inconclusive" mean? what exactly is a CSM? i did not see that abbreviation anywhere else in your post, thats why i am asking?

    what did your latest MRI actually show then? do you have a copy of that latest one yet? it really would help hon if you could post that summry so we can compare it to the initial one you posted in the other thread right after the actual MVA?

    i know i asked this same question in the other thread but what i need to actually know here is what i asked you there about that collar and when or if ANY new symptoms showed up or if ANYTHING suddenly felt worse or exascerbated right after that hard collar was actually placed on you? if this did appear very shortly after that collar was placed, it could be that the collar was NOT actually even properly 'fitted' for YOUR particular necksize so it can change how things just were and are within the more damaged areas too? it really 'does' have to fit YOU and your actual necksize to properly stabilize the c spine without making things even worse when it is either too big or too small? i simply fitted alot of collars onto trauma patients over the many years i worked EMS, and it can matter alot when someone has actual c spine level damage and that coller is simply not big enough to not allow limited movement or too big and tends to pull apart the vertbrae a bit too much too?

    while seeing an actual spinal ortho specialist would be a good idea here, i am wondering just how long that would take to even get in for an initial appt? but if you can get one sooon here then i would go for that. just when in july does this NS want to do that surgery on you, do you have the date yet? unfortunetly it is more than likely HIS actual surgical schedule that is making you wait here? i had to wait too for a month for one surgery and weeks for others. it kind of depends upon what that last MRI actually stated as to how much realistic cord contact you have there at this point at i think it was c 5-6? you just DO have some level of real compression going on at that spot or your reflexes would not have changed? but at the very least here you would need the decomp fusion type of surgery for what type of damage/injury you just have there? this will also relieve the cord compression too.

    getting that CT may not be such a bad idea actually since you have already had that new MRI done too? the thing here is, every different form of scan actually picks up very particular areas much better than others do? its just the nature of what gets used as far as the CT that uses raditation and slice pics a bit differently than the slice pics of an MRI would show? and the same thing with MRI that uses actual magnetism to obtain its pics would show? the more solid boney structures will show much much more defined and clearly upon any CT than with MRIs since x rays and CTs use standard radiation that just sees those structures sooo much better than MRI will? so it would not hurt to obtain that CT only to see what THAT will pick up that the MRI may not have? this, in my opinion anyways, just would give a much better overall type of view that you just cannot obtain with only one type of scan would kinda thing?

    but i WOULD let that doc know mj, if the exascerbation of the symptoms actually started very shortly after that collar was added to the mix, ask him if you can simply be sent for a 'fitted" collar from one of the orthotic facilitys that simply 'do' this all day? that is how i finally got a good fitted collar for my second c spine surgery after suffering with that stupid philly collar that even ann adult small was going to be wayyy too big for me and it was. i finally got a miami j peds size for c spine surgery number two, and that was soo much more comfortable. you are going to HAVE TO obtain a good well fitting collar for that surgery anyways, so why not get it now and hopefully the better fit will also minimize your more pronounced symptoms?

    but i would let the NS know just how really scared you are about your symptoms hon. the good thing here is you DO have that limited movement protection just by even wearing that collar at all? so the chances of YOU actually moving the wrong way and doing more damage are way minimized right now for you just having that on at all? so he at least has your neck somewhat stabilized til he can fix this. since we are getting to the end of june here mj, depending upon just 'when' in july he has that opening for your surgery, it realistically is not "too' far away?

    believe me hon, i DO very much know what it is like to have to live with an unstable cord, but that collar really does help in minimizing the possibles here that would still be there if he did NOT have you IN that collar right now. you just need to make certain about that really 'good fit' with it. just how DOES that collar actually feel on you? while they are not exactly really comfortable to wear, the bottom should not be coming up over your mouth area when you just sit down in a chair, you should NOT be feeling ANY actual like 'digging into" any area of your body type of pain, and it should not be attacking your ears there either? but it should be keeping you from really being able to actually turn your head full to either side like only slightly to the L or R with not any real or too much 'play' or wiggle room but not like choking you either? just make certain THAT is well fitted. and DO call that NS if you just really do feel that something just is not 'right" in whats going on with you. but i would do that CT just to really get a much more well rounded look with areas that will show up much better than they did on the MRI. just try and hang in there mj, really. i know this is NOT at all easy, but stabilization IS at least there for you too right now.

    knowing what that summary of the new MRI state really would help tons right now just to see what did not actually show on the first one and esp any real progression too? marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 06-22-2010, 06:35 PM   #3
    neuroguy
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    Re: Help - I'm the 10%

    If you have been diagnosed with CSM, and your MRI shows cervical stenosis (your spinal cord getting "squished" in the canal), and you have instability in your cervical spine (which would have been seen with a "slip" on the xrays) -- then a cervical decompression and fusion is what you need.

    There is no use going to an ER -- because they would simply refer you to a spine surgeon as an outpatient.

    Getting a second opinion from a spine specialist (neurosurgeon or ortho spine surgeon) is fine, but make sure you get all your films and take them with you. CSM is not an emergency because you have had progressive symptoms over months to likely years, so surgery is usually performed electively.

     
    Old 06-23-2010, 06:53 AM   #4
    feelbad
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    Re: Help - I'm the 10%

    just what exactly IS "CSM"? can someone plaease enlighten me there? i have just never heard of it? thanks, marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 06-23-2010, 10:29 AM   #5
    MJml
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    Re: Help - I'm the 10%

    Meaning- 10 % of the people who come in after a mva r not diagnosed w/ ligament injury. Now my MRI shows no ligament injury ? And what I meant about the ct scan was it can be inconclusive- the CSM should have been the word can- sorry but thr is actually a CSM - it's a muscular thing in the neck I googled it sorry about that - anyways here is the latest - went for my 2nd opinion - regarding surgery or no surgery - she wants to send me now to take a bone scan - 1 st she wanted a ct that was fine now a bone scan - I still have pain in my neck w/ numbness & tingling - why all the test? ?? What is the bone scan going to show ? I already know I have a bit of osteo- due to cheerleading & such/ please help what to do ? - she's leading torward surgery as well

    Last edited by MJml; 06-23-2010 at 10:36 AM.

     
    Old 06-24-2010, 06:04 AM   #6
    feelbad
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    Re: Help - I'm the 10%

    honestly? i am also wondering about that bone scan too now. esp vs what she wanted previously, the CT?? i do not ge that either mj. but i WOULD ask HER about that one tho? you just need to know the 'whys' in whay certain tests are being ordered and so does your ins company too? unless you had some pretty advanced DDD there, which would have at the very LEAST been worded more profoundly upon that initial MRI you had, i do not get this either. a good contrasted CT 'should' be just fine there?? can i ask just how old you are ? it would help alot given her decision to just know that?

    just wanted to let you know something about your appts with these ongoing specialists mj? do youy feel at ALL the least bit intimidated by them to the point you do not really ask certain quuestions like the 'whys' in now doing the bone scan vs the CT(which i would think, just given what it would show with constrast just IS the better choice since the MRI has already been done here?). believe me, the tons of surgeons i have had to see and the transplant surgeons and the many "teams" of specialists my son had to see when he was in liver failure, i HAD to learn to not be intimidated around some of there absolute jerks too(trust me, what you may not always DO as far as advocating for ourselves, you just HAVE to for your child, so that WAS a huge learning experience for me right there too)? what really helped me with my sons nightmare and then mine that followed right after his was ALWAYS bringing with me either my mom or my hubby or both, for the spinal cord surgery consult eval? just so I would feel more comfortable in asking all the right questions, and my hubs and my mom could ask "their' own questions, but this is also extra sets of ears too for picking up certain things when WE, the actual patients get told something that our brains can just tend to get "hung up on' and we don't always really 'hear" everything that we are being told from these people? my mom always took notes too, lol. this is just something i would ALWAYS recommend to anyone getting a consult for possible surgery. it just really DOES help in many ways mj. i would also make lists of good questions i NEEDED the answers to that i would bring to my appts then just run down the old list o questions with the surgeon(they do NOT think you are crazy or doing anything other than trying to understand and get answers to what IS a surgery thats going to be done on you, and esp within that spinal area)? and make certain to also write down ALL the surgeons responses too? this does also help tons.

    the only person who really even CAN answer that bone scan vs the CT IS that particular surgeon who decided it unfortunetly. i would also LOVE to know that reasoning too myself. the CT with contrast at least made more sense, ya know what i mean? but THAT question NEEDS to be asked as to the "whys' and what DOES she actually want to see considering what a limited amount of overall info would even be possible in a bone scan vs the CT, when simply considering the "overall" and much bigger picture here? just looking at only 'bone",other than looking for very specific things like bone strength, its not going to show your cord area, and the surrounding structures either. THAT particular question you simply DO need and desreve an answer to there hon.

    did you actually obtain your own copy of that latest MRI yet? please get that if you have not done so already mj,so you can simply post that crucial summary here for us? it helps with the comparritive ones esp to know how truely progessed things have become to this point and to just see if that stupid traction (just WHO actually even ordered THAT to begin with?) really DID or did not 'do" something to your spinal too? that right there could also explain at least 'some' of that abnormal "spacing' since it simply did pull upon those vertebrae there? and the changes in your reflexes too.

    but just knowing what is in that new MRI summary would help alot mj. AND make certain to actually ASK that doc just why she wanted the CT at all in the first place, and more importantly, why in the heck she NOW wants to change THAT to just a mere bone scan? that much you just DO deserve some answers to. and you have every right to ASK her why ANY test is simply being done on you at any time. marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 06-24-2010, 10:53 AM   #7
    MJml
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    Re: Help - I'm the 10%

    They want to go in w / a c4 c5- c5 c6 disc fusion both anterior - w/ the cages & then flip me & do posterior w/ the screws & titanium plates he said based upon my neuro exam when he flicks my fingers my thumb goes in& my reflexes r more abrupt then when examined immediately After mva in late feb. he also stated I have severe torn ligaments that did not show on the MRI - something about they show immediately / mine came later during pt .- something like that-- he said I have spinal cord impingement - & instability w- the disc the MRI in feb that I posted is the same as the one in June - a little more narrowing - I will give it to you so you can compare - yet he's basically going off of the flexion x Ray which shows severe spacing between my vertebre / which the other physician stated that could be something I wad born with - I asked him that he said no - I also asked him an
    abou the muscle trap pain in my shoulder - he stated that the muscle is compensating for the instability in my neck that's why I have not been getting better - he scheduled the surgery - July 7 th it's 3.- 4 hours long & they have to flip me - he talked about going thru the front & not being able to talk for a while / raspy but it would subside - he stated he did have one patient that did not get her full voice back - what to do what to do - I have a call in for a 3 rd opinion but I'm not sure I will get it in time - it would be at u of Michigan - - should I go to Cleveland spine ? Should I hold off on surgery - can my neuro symptoms get worse ? Once I find my new MRI read I will post it - oh & I'm 40

    Last edited by MJml; 06-24-2010 at 01:27 PM.

     
    Old 06-24-2010, 05:26 PM   #8
    jennybyc
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    Re: Help - I'm the 10%

    MJml....it was an unknown ligament injury that caused my first spine surgery(C3-6 laminoplasty and C7 decompression) to fall apart, breaking 3 vertebrae and almost killing me. The loose ligaments are what is causing the spreading in the bent neck x-rays. My neurosurgeon didn't do those x-rays as I had no memory of having my neck injured. It was from early child abuse and came back after the surgery(and family who knew finally said something). Had he known, he never would have done the surgery he did and I too would have ended up with front and back surgery or just back entry surgery as I did later.

    Your surgeon is going in from the front(as most have had done here) and removes the bad disks(they are at the front of the spine) but for a really solid fusion that would solve the problem of the torn ligaments, he needs to fuse from the back too. Torn ligaments that heal in the stretched position really can't be fixed. Ask my knees!

    Don't worry about being "flipped"....your surgery is done on a Stryker frame that rotates and takes you from front to back smoothly.

    Both of my surgeries have been from the back and I imagine if I find out next week I need #3, it will also be from the back. More painful than the front but better results. And I don't know of anyone here who hasn't gotten their voice back including a singer we had here.....(Pastor Robbie...you still around...how's the voice?). Luckily, the front entry is minimal pain.

    Your doc is doing what needs to be done to assure the stability of your spine. Unless your spinal cord is compressed to less than half thickness and you are showing signs of lower limb paralysis, it isn't a rush and it's important to do things in order to make sure you will get through everything okay. Even with my broken neck, he waited 8 days to fix it to make sure I was physically okay to go through it. Not unusual.

    We had someone else here who had both front and back simultaneous surgery but I think they have left....everything was okay.

    This is not unusual.....very scary...but not unusual.

    And seeing torn ligaments is not unusual either. Sometimes they don't show but the results do show later....laxity. Mine didn't show either and I didn't know....at least they knew to look for you. Good work!

    I know you are scared but I'd be spending my time getting dinners in the freezer, making sure you have help afterward and seeing what else you need post surgery. I got a shower seat just to make it easier. And I got a lot of easy to make food for myself. Get some of those frozen pre-made smoothies that are easy to drink on a sore throat.....thaw and drink. Get your pain meds in ahead of time and anything else you might need. Everyone here can share things they did to make surgery easier to get through.

    It's sudden and bad news but at least they now know what is what and have a plan to fix it.

    We are all here for you.

    hugs my friend................Jenny(fused C3 to T1 and possibly growing)

     
    Old 06-25-2010, 06:01 AM   #9
    MJml
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    Re: Help - I'm the 10%

    Jenny r you still on ? My 2 nd opinion dr wants me to have a bone scan - she stated something like if it comes back with white in it that would yell her that the pain is coming from the bone & that would indicate that surgery would be helpful - granted my second opinion also told me she sees no instability I could just be born w/ my vertebre in that position & she also stated that she sees no need for surgery - she said if I wad her patient she would have me take off the neck brace & try to strentghen my spine thru spinal pt & then try injections for my tingling & pain - I'm a little worried will that none scan hurt me in any way ? What do they inject in you ?

     
    Old 06-25-2010, 08:03 AM   #10
    feelbad
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    Re: Help - I'm the 10%

    jenny just gave you some really good tried and tru info mj about just how certain things can just happen within the spinal among other things. the one thing that truely bothers me here regarding NS number two is the mere fact she 'seems" to actually think that doing NOTHING as far as real surgical intervention when you actually just DO have some very REAL cord contact/compression going on is even a 'good idea here? seriously hon, besides the fact that you are having to wear a freaking hard c collar right now JUST to even 'have' staboility alone, and what you just have there NEEDS some level of real surgical intervention along with just making your spinal and the cord compression relieved and more stable for you to simply get on with your life, and not to 'try' ANYMORE PT which in YOUR case, i just seriously cannot see what she hopes to actually "gain" here for you at all with simply what your level of injuries just are at all right now? i just think, given everything here that 'doing' nothing surgical would be setting YOU up for potential major issues down the road? like i said before hon, not all NSs just ARE even CLOSE to be all being created equal? the initial NSs plan just does make much more basic common sense for what YOUR reral needs are here in even obtaining good solid stability without that collar eventually and relieving the most prominent symptoms/injury you just have too, that cord being impacted too? this "plan' for what he wants to do here, to me, it just makes soo much more real common sense and also seems much more logical. this WILL create the stability you just do NOT have right now too. and ANY muscle and the overall tone you would lose while you are more immobilized simply CAN be rehabbed back with a good PT and program and excercises you just keep on doing at home too. trust me on that one.

    and i STILL do NOT actually understand the really true NEED for ANY real bone scan vs the CT that would like i mentioned before, would simply give you one more view using radiation which per the flex and ext x rays you have already had that showed sooo much more than the MRI did using only magnetism, just really sounds like such a sooo much better idea to me anyways than what very limited info would be gained with doing that bone scan only?? i just do not 'get' her reasoning here on the change from CT which would so much more esp using the contrast, vs limited info that would be obtained during a mere bone scan? the thing is, radiation just DOES show the bone in a totally different way than MRI too as proven by the results of what even showed up with your flex and ext x rays?? which you just DID obtain alot of very useful info from that did not actually show itself upon MRI? and that just IS the main thing to keep in your mind? what did and did not show up on the MRI vs that x ray alone? radiation appears to actually 'show' your certain areas of injury(except of that cord level in jury) much more clearly than MRI in this case, so doing that contrasted CT that ALSO uses it to obtain pics, to me, just makes much more real sense overall?

    honestly MJ, i would actually stick with the very first NS you saw and also ask HIM about the CT with contrast since this was simply even brought up by NS number two and see what HE feels would be the best way to go here? you just very much DO NEED surgery hon unfortunetly, thats simply a given with the mostly your cord being even being heavily involved at all and to the point where it IS impacting the cord? and who even really knows for certain just how much true impact even HAVING that traction done on you could have done too even as far as spacing the verts out even more than they were only because that just IS what any traction actually is MENT to do, pull out the spinal column using pulling on your head with your body actually stationary or immovable and stuck in one spot while a machine actually applies alot of 'pull' upon the vertebrae in the spinal column? you just should NOT have even had that particular therepy at all mj, and your symptoms DID get much worse AFTER the traction was done too?? that simply tells 'something" right there. since you already had the endplates with spurring on them and already being pushed apart, this simply accelerated what you already HAD there hon? it was just a stupid therepy that never ever should have been ordered or done on you but was anyways.

    one HUGE thing here hon regarding the two totally seperate opinions you have gotten from the two NSs here? the merte fact that this woman cannot actually even 'see' the really unstable part of what you have there and WANTS you to actually even remove the ONLY thing that is giving that neck.c spine ANY real stability right now as well as keeping YOPU from doing something like a sudden turn of your neck at all which could make things soo much worse for you right now,actually scares the livin crap outa me,seriously mj. while i do KNOW she is telling you alot of different things that you seriously DO just wnat to hear right now, esp the no surgery? you really DO have to take a good hard look at what your situation just IS and the potential for not relieving the cord compression alone could end up even doing to you hon? that would be MY bigger worry for YOU mj, exascerbating an already proven to be un stable area.

    just reallly DO take a good hard look at what the first NS told you and how quickly he just wanted that c spine fully stabilized(right after you told him how much more profound the symptoms were getting, esp AFTER having your spinal pulled apart??, and what the others who have been down this icky road have alos told you here, and then MAKE your real decisions from the facts, not what you would really love to 'only' have to do that what appears to be from a not too overly experienced NS actually told you. THEN, make your real descision mj. and i woukld seriously skip that bone scan and go witn the original plan of the good contrasted CT instead? the more real 'views' you just get of that injury area and also using the very different forms of what actually"creates" any particular scan, really does simply show certain things much much better and in their very own unique ways too. the CT would show the bone VERY clearly, just not down to real in depth bone scan level? but it would show certain changes in that bone that any good rad read should be able to really pick up on?

    when you just get the time hon, simply typeing oput that full MRI summary here would help alot in really seeing what changes have occured and how that rad actually worded certain findings too really would help in just doing this word for word too? it will just give US a better idea when also comparing it to the initial MRI done post MVA that is in your other thread here too. hang in there mj, marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 06-25-2010, 04:26 PM   #11
    MJml
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    Re: Help - I'm the 10%

    here is my CT from feb.
    Findings: No vertebral fracture or paraspinal soft tissue abnormality is seen alignment is straightened.The current exam does not assess for ligamentous injury. The spinal canal contents are suboptimally visualized. There is a posterior disc protrusion at c5-c6 with mild central canal narrowing. The visualized portions of the aerodigetive tract, thyroid and larynx are unremarkable. There is a pleural-parenchymal scarring at the lung apices.
    Impression No cervical spine fracture or malaligment.
    2. Posterior disc protrusion at c5-c6 with mild central canal narrowing.
    Now MRI from Feb: Findings:

    Alignment is anatomic.
    The cervical spinal cord is normal in signal intensity.
    There is no evid. of lig injury within the cervical spine
    There is no prevertebral soft tissue swelling.
    The cervical vertebra are normal in marrow signal intensity. There is mild loss of intervertebral disc height at c4-c5 and c5-c6
    At c2-3 there is no posterior disc abnormality, cnetral canal stenosis, or neural foraminal narrowing.
    At c3-4 there is no posterior disc abnormality, central canal stenosis, or neural foraminal narowing.
    At c4-c5 there is a posterior disc protrusion with narrowing of the ventral thecal space, but no central canal stenosis or neuroforaminal narrowing.
    At c5-c6 there is a posteiror disc protrusion eccentric to the right with mass effect on the right aspect of the cervical spinal cored with mild central canal stenosis. There is mild left and no right neural foraminal narrowing.
    At c6-7 there is no posterior disc abnormality , central canal stenosis or nueral foraminal narrowing.
    Impression:
    1. No evidence of ligamentous injury
    2. Posterior disc protrusions at c4-c5 and c5-c6. Protrusion at c5-c6 exerts mass effect on the right aspect of the cervical spinal cord with mild central canal stenosis.

    Okay now June's MRI>
    The cervical spinal cord is normal in signal intensity.
    the cervical vertebrae are normal in marrow signal intensity. There is loss of intervertebral disc height and c4-c5 & c5-c6
    There is no evidence of ligamentous injury.
    At c2-3 there is no posterior disc abnormality, central canal stenosis or neural foramiinal narrowing.
    At c3-4 there is no posterior disc abnormality, central canal stenosis or neural foraminal narrowing.
    A5 C4-5 there is a posterior disc protrusion with effacement of ventral thecal space, but no central canal stenosis. There is a mild left and right neuroforaminal narrowing. Findings unchanged.
    At c5 -c6 there is a posterior disc protrusion eccentric t the right with mass effect on the right aspect of the cervical spine cord and mild central canal stenosis. There is mild left and no right neural foraminal narrowing. Findings are unchanged.
    At c6-c7 there is no posterior disc abnormaility, central canal stenosis or neural foraminal narrowing.


    Impression: right paracentral disc protrustion at c5-c6 with mass effect on the right aspect of the cervical cord and mild central canal stenosis. finding are unchanged.
    2. Posterior disc protrusion at c4-c5 with effacement of ventral thecal space.
    3. Mild left neuroforaminal narrowing at c4-c5 and c5 -c6.

    Now the # 3 under (impressions: )is new on this recent MRI. We asked our 2nd of opinion NS. she said she see's no change. Nothing dramatic that would need surgery. Yet my 1st opinion is showing instability based on the flexion xray along w/increased narrowing at levels and spinal cord impingement. along w/ several neurological changes.
    when my 2nd referral NS looked at the flexion xray she stated I could be born like that she see's no issue just need strengthening exercises. I heard that stand up mri's show instabiltiy ? could this be true?
    In pt they wanted to start strength training. They stated my muscles are still lig. sore torn ..I'm just wondering will not having the muscles around that area working up to 100% effect the growth or fusion...I noticed that in another thread that her disc did not fuse because of the loss of muscle and therefore blood flow to the area. ? Please help.
    I have surgery scheduled in 1 week..should I cancel should I go ..? should I get a 3rd opinon again....Once the 2nd neuro see's the bone scan she was going to consult w/colleagues regarding my case that she worked with when she was chief resident of nuerosurgery at UofMichigan...I'm thinking I should take that bone scan w/her & see what else she has to say.? This is a big step once surgery is done it's a long recovery....Is my body up to it...?

    Last edited by MJml; 06-25-2010 at 04:30 PM.

     
    Old 06-25-2010, 05:07 PM   #12
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    Re: Help - I'm the 10%

    Jenny...I hope your around. I know you mentioned go for the fusion...but, I'm a little reluctant. I see that you had an laminoplasty.? how did that go...& I noticed in a thread someone went thru an ADR (Arthroplasty) InNJ. I read his thread so far it seems he's doing well...Do you think based on my mri results this would be a good thing for me....I know it will take you some time to read my mri..but I would so greatly appreciate your input in this as well. Thanks Jenny

    Last edited by Administrator; 09-01-2010 at 11:51 AM.

     
    Old 06-26-2010, 09:07 AM   #13
    feelbad
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    Re: Help - I'm the 10%

    mj, thanks for placing alll that info in this thread so its just that much easier to compare to. the one HUGE reoccuring and very crucial finding IS that c 5-6 cord mass effect there? and that alone would be a huge motivating factor for 'me' personally to just want this fixed and decompressed hon, seriously. you also have some ventral flattening at the level above that finding too the at least needs to be evaluated from the "inside" at this point, as well as what those ligaments are just doing along with the muscle. some findings, even more dramatic ones just cannot even BE seen upon ANY actual scan at all? this IS 'only' a mere 'scan" of a given area and NOT like an actual picture, so some findings will probably be much worse than they show and some probably a bit better? its just the way this stuff actually apprears most times upon plain old scans, vs a surgeon actually finally visualizing whats going on once he gets inside and really 'sees" an area with issues?

    there is a poster here named sammy01 who honest to god, besides having some c spine issues that were creating bad headpain and alot
    of radiculopathic symptoms like yours have been and also changing on her, had NO real clue just how really extensive her overall damage was and neither did her surgeon, only becasue THIS particular finding for some insane reason simply did NOT actually show itself upon the contrasted MRI she had? what was found during the actual surgery that was just NOT even ON her films, right at her c 6-7 was a totally 'blown out' and very fragmented disc that was actually lying ON her spinal cord? this just the way any given 'scan" of an area can be vs actual visualization once any surgeon simply 'sees" that inside for him/her self can be? the mere fact that you HAVE had ongoing neuro symptoms/changes at all just shows there has been some level of real progression mj.

    honestly? if YOU alone would simply feel more comfortable in seeing what this second NS really has to say after she does her bone scan(although i still cannot realistically see that need, but i am not a NS either) then cancel that surgery til YOU simply have enough hard facts to justify it in YOUR head? i see something different than you are here only becasue i am NOT the scared out of my mind patient who will have to undergo the procedure? but you DO have to ask yourself whether or not you are putting off any surgery simply out of basic 'fear OF" the actual surgery here or you just truely do feel that waiting IS the best approach? that decision, when we simply do NOT want to even go there with surgery, can be a bit 'muddy/unclear' in our heads that does take some time to realistically 'see what just IS the best possible choice for 'us' when surgey enters the pictuer at all?

    BUT, between your films(and ligament/muscle damage does NOT always even show itself upon scans but WOULD be seen once they get inside) just showing what they do that have been very consistant thruout all scans, and YOUR bodys neuro changes and symptoms, well, those hands on evals and what you are now and have been displaying as YOUR radiculopathic symptoms, even in your feet here, simply DO tell their very own 'story" as to what just has been impacted and really cannot be stopped by you even if you tried, only becasue they just are a very basic CNS type reactions to the level of damage that you have and outside stimuli that DOES show changes in certain neuro functions too? so these areas most certainly ARE being impacted, and THAT just really IS what you have to always keep in the back of your mind with ANY decision you make here hon.

    the one bigger thing here hon is that this second NS is realistically telling you just what YOU really WANT to hear too? no surgery? when honestly mj, thwere just IS no realistic other way to get your c spine stable in all the very best ways for YOU. you simply do HAVE cord contact that is enough to create ongoing symptoms in your feet and the neuro symptoms and radiculopathic crap you are simply feeling in your arm? that really is NOT going to 'go away" without some levels of real surgical help unfortunetly.

    but, on the other hand here, just because you HAVE an actual date for ANY surgery set on some surgeons calender does NOT mean at all that you are 'locked in' to that surgical date at all? you still have the right to wait til YOU feel all bases have been well covered with this other NS or for any other reason, any surgery can simply BE cancelled by any patient for any real reason. so if YOU feel okay with waiting here for what this other NS sees in the bone scan or anything else, you most certainly HAVE the right to wait. but you also have to remember mj that it was YOU who felt this surgery was simply too far 'out' for you too kinda thing as well? so it really IS kind of in your hands here hon as far as waiting or going ahead with something that is just needed at least for certain very consistant findings that have NOT changed in description in any of the scans that are very critical findings that just ARE very much impacting you with the ongoing symptoms too?but DO NOT do what that second NS mentioned about removing that collar hon, right now,this just IS the only real thing keeping everything stabilized in there and well aligned too> you have also lsot 'some' solid mucscle tone too while wearing this so your c spine/neck will just be a bit more depenant on it til at least surgery gets done? THEN you can rehab all that muscle simply using basic strengthening excercises. but i would not remove this as she stated she wants you too. i sure as heck wouldn't at this point if this were me hon. its simply even having the types and depth of injuries and damage you ahve there right now hon that would need this level of ongoing stability. ANYTHING that just IS actually compressing upon your cord NEEDS that ongoing stability that this collar brings right now, its kind of that simple really.

    i really am so sorry that this just IS so very difficult to really even know what is the 'best thing' for you right now mj. but the one thing you DO just know is what YOU are actually feeling(along with ANY actual changes like from what you started out with) and the very consistant findings upon like every single scan you have had that really should dictate more of what is a 'needs to be done" thing, and what 'could' possibly wait here too? believe me, i do know what you are going thru right now with all of this crap, and i really DO feel for you mj. the way i have done things when it just has come to any of the six seperate surgeries i have had to have all since 2002?), and a wonderful aneurysm to deal with while i was actually waiting for my flippin knee surgery and it decided to pop in on me too(why not), is looking at all the really hard and known facts/symptoms and lets not forget pain here within your body and on any films, asking some advice from people who simply HAVE also been there, then going with what my gut just really is telling me is the 'right" or best option for ME given everything. that just IS the very best advice i can give you right now hon. it just IS a decision that can only really be made by you and the reality of what you just have there and are having to deal with too. i just really AM curious as heck to really find out just what the second NS hopes the actual bone scan will actually even begin to really 'tell' with the other crap you just have there too?

    just always remember mj that we ARE all here for you to try and help in whatever way we possibly can, K? marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 06-26-2010, 10:10 AM   #14
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    Re: Help - I'm the 10%

    Thanks Marcia, yes I'm unclear - I wake up sometimes w/ no pain - yet from wearing my neckbrace my muscles in my neck & arms are a little week .... Other than that I think the tingling in my feet is coming from my lower MRI scan - this could be - ? Or no? Do neurological changes only come from spinal cord Impingement ? When they say mass effect - is that major ? It's definetly not mild. - but what if the tingling in my feet is from the MRI lower level & because of the weight of the collar it has been bothering me ? Yet my feet do still tingle sometimes when I lay on my back - so then what ? & what if stregthening does help ? What if it paralizes me ? I can't deal w/ that decision - can I get a 3 rd does insurance cover that? Here is my MRI from the lumbar - alignment is straightened- the conus has a normal appearance and ends at the level of l1 - l2
    the lumbar vertebre are normal in marrow signal intensity. There is loss of intervertebral disc height at L 4- L5 and l 5 - s 1
    at t12-l1 therevis no posterior disc abnormality, ccstenosis or neural foraminal narrowing
    at l1- l2 there is a small difusevdisc bulge w/ out cental canal stenosis, or neural foraminal narrowing
    at l2-3 same as l1 l2
    at l3-4 there is a small difuse disc bulge and bilateral facet athropathy without central canal stenosis and neuralforaminal narrowing
    at l4-5 there is a difuse disc bulge bilateral facet artropsyhy w/ superimposed central disc protrusion and annular tear. Findings result in mild central canal stenosis. There is mild bilateral neuroforaminal narrowing.
    At l5-s1 there is moderate posterior disc protrusion which mildly narrows the central canal and mild to moderately narrows the keft lateral recess in close proximity to the traversing left s1 nerve root, correlate for left s 1 radiculopathy. There is no neuroforaminal narrowing.
    Impression; 1- central disc protrusion at l 4- l -5 with mild central canal stenosis.
    2- moderate posterior disc protrusion at l 5. - s 1 with mild narrowing of the central canal and mild moderate narrowing of the left lateral recess in close proximity to the traversing left - s 1 nerve root, correlate for left - s1 radiculopathy.

    Yet - why is everything on the left when I have tinfling in both my left and right foot , but no leg pains - would this be the spinal cord neurological changes or no ???

    Last edited by MJml; 06-26-2010 at 10:12 AM.

     
    Old 06-26-2010, 10:11 AM   #15
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    Re: Help - I'm the 10%

    Sorry MJ...was out on Cape Cod yesterday and didn't have time to even start the computer last night.

    First, a laminoplasty is primarily done for cord compression and while they are in there, can open up the foramina(the holes in the bone where the spinal nerves exit to the body. The laminoplasty rebuilds the back of the vertebrae for more space and allows the cord to move away from whatever it touching it. It means no fusion HOWEVER, it was the ligament damage that I had(and didn't know about) that caused it to destabilize and I broke 3 of 4 bone grafts put in and dislocated 5 vertebrae. Unless the ligaments are in good shape, it won't help and may make things much worse. But he did the laminoplasty in order to avoid fusing 5 vertebrae. When it all fell apart, I ended up with 6 vertebrae being fused. And that may be increasing.

    But what your neurosurgeon is talking about is fusing like 2-3 vertebrae from both front and back(don't remember which and too tired to go back and re-read for now...later once the eyes are open a little more)but I know it was only 2 or 3 vertebrae. The reason he wants to fuse from the back is to make sure the ligaments don't give away and you end up with a broken neck like I did. And the reason he wants to go in from the front too is to remove the bad disk...much easier to get it out from the front(in the laminoplasty they don't remove the disks, just make more room for the cord to move away from it).

    Bottom line, laminoplasties temporarily weaken the spine until everything heals and if your neck is already unstable, it is a bad thing to do. For ADR)artificial disks, they too can't be used of you have torn ligaments in your neck. They are strictly for a problem with a herniated disk and no other problems complicating the situation.

    BTW, that separating of the vertebrae is an indication of past torn ligaments because I did it in my lower back too and I've seen the x-rays that show that separating. If you were born with that problem, you would had neck problems long before now. They wouldn't suddenly show up because of an MVA but would have shown up doing summersaults in gym class as a kid. You'd have a history of neck pain from vertebrae rocking loosely and a lot of arthritis from it way before now.

    Your doc is talking about surgery on a fairly small area of your neck. It should not affect your ability to move your neck in just about any way. But....and listen up here.....if your neck is unstable and anything more happens, you are looking at paralysis from the waist down along with paralysis in your hands and wrist. At least you should be able to breathe on your own and if low enough, move your shoulders. That means paralysis of the bladder and rectum as well.

    As for doc #2, I had one of those too. Told me I could go much further without needing surgery despite my spinal cord having been crushed to half thickness. Why did he say this? He said my chances of my cord suddenly loosing it's blood supply due to a simple home injury was 3% and the chances of my coming out of surgery paralyzed was also 3% so I should wait until my chances of paralysis from an accident at home was greater than 3%.

    I interpreted this as he wasn't a very good surgeon so I sought out one who who personally had much better percentages(the 3% quote is a national average and I don't know what his average was but I suspect higher). I also know that I'm a klutz and my chances of falling and hurting my neck at home were much higher than 3%.

    When one doc is so concerned that he puts you in a hard collar to protect you and another laughs and says you are okay and just need PT.....that is 2 opinions that are way too divergent. Someone doesn't know what they are talking about. Oh, and bone scans use nuclear material to tag areas that have problems and then you are scanned to pick up where the biggest concentration of nuclear material is. It's an old, and not very specific exam that is not used too often for this kind of injury.

    But here is one thing I found in research. If you have a spine injury, if you can correct it within the first year after the injury occurs, you have a good chance of it doing well. If you wait more than 1 year to fix it, then you might as well wait as long as you want as the recovery will never be as good as if would be if done in that first year. And statistically, surgery to fix numbness and tingling has a 70% success rate(only 30% to stop pain) so it is very successful for your type of injury. My injuries to my neck were long standing and I was totally surprised as to how well I did after my first surgery. Once it was re-injured from the ligaments tearing again, it was fixed within a month and although I was paralyzed on the left side, I got 100% of movement back and about 95% of strength and I credit the fast surgery. I know have another injury developing that goes back to last fall and made worse this past spring. If it turns out to be another injury, I will have surgery as fast as possible to ensure a good recovery. I've learned my lesson....get it fixed as fast as possible for the best possible outcome.

    If It was me, I'd be fixing it now and not waiting to see if PT might help and then if it doesn't trying to fix it later....and maybe too late.

    Just my opinion from my personal experience.

    Hugs................Jenny

     
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