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    Old 02-24-2012, 09:46 PM   #1
    Chitown2012
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    Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Posterior Cevical Laminectomy C3 through C7 with fusion/rods/screws from C3 through T2. Staples were out on 02/07/2012 and have followup with NS on March 1st... Still concerned about right arm weakness that showed up postop. I appreciated ant input as to the reports below.... Thank you so very much to you all!!!


    Procedure Report CHITOWN2012
    Result Type: Procedure Report
    Result Date: 01 February 2012 0:00
    Result Status: Unauthenticated
    Result Title: Procedure Report
    Performed By: Contributor_system, SOFTMED on 01 February 2012 0:00
    Encounter info: Inpatient, 2/1/2012 - 2/9/2012
    Procedure Report
    **************************************** ************************************
    *The following report is provisional, pending final review by the physician*
    **************************************** ************************************
    PROCEDURE REPORT DATE: 02/01/2012
    NAME: CHITOWN2012 HOSPITAL #:
    PHYSICIAN: BILLING #:
    PAT. TYPE: I PATIENT LOC
    ADMIT DATE: 02/01/2012 DISCH DATE:

    PREOPERATIVE DIAGNOSIS: Cervical spondylotic myelopathy.

    POSTOPERATIVE DIAGNOSIS: Cervical spondylotic myelopathy.

    OPERATIVE PROCEDURES: CERVICAL LAMINECTOMY C3 THROUGH C7, POSTERIOR SPINAL FUSION C3 TO T2, ARTHRODESIS AND SEGMENTAL FIXATION OF C3, C4, C5, C6, C7, T1, T2, DECOMPRESSION OF SPINAL CORD, USE OF BONE MORPHOGENETIC PROTEIN, AUTOGRAFT, ALLOGRAFT, NEURO MONITORING, C-ARM, STEALTH.

    INDIVIDUAL CONSIDERATIONS: None. PREPARATION: Routine.

    INDICATIONS: Patient is a 54-year-old right-handed gentleman with
    several-month history of left upper extremity pain and weakness. Imaging studies revealed the presence of multilevel spondylosis causing significant spinal cord compression. Risks and benefits of performing a decompression and stabilization were discussed with the patient. After all questions were answered, consent for surgery was obtained. Because we were working in proximity to neural elements, neuro monitoring was utilized.
    PROCEDURE: The patient was brought to the operating room and, after uneventful administration of general anesthesia; he was positioned on the Jackson table in a prone manner. All pressure points were padded and secured. Head was held in 3-point fixation via the Mayfield head holder.
    Printed by: Page 1 of 3
    Printed on:

    The dorsal cervicothoracic area was shaved, prepped and draped in usual sterile fashion. Following infiltration of local anesthetic, a midline skin incision was created. Using the Bovie, we performed subperiosteal dissection of the paraspinous musculature. AP intraoperative radiograph was obtained verifying our level. As such, we optimally exposed from C3 down to T2. Care was taken not disrupt C2-3 or T2-T3. We then, following optimal exposure of the spinal column, drilled the lateral muscles for C3 through C7. A starting point approximately 1 mm medial to the center of the joint was selected and trajectory of 30 degrees cephalad, 30 degrees lateral was drilled. These holes were probed, tapped, probed again prior to placement of the right sized screw which was 3.5 x 12. We used a Midas Rex to demarcate the starting point for thoracic pedicle screws and, using a Lenke, we accessed pedicle down to 20, probing before accessing again down to 30 mm. As such, these holes were probed, tapped and probed again prior to placement of the right sized screw as determined by the Stealth. We now performed our laminectomy by drilling two vertical troughs at the laminar facette junction. Using a nerve hook, we developed an epidural plane and then carefully took down the osteal ligamentous structures of left and right sides as well as superiorly and inferiorly. As such, with doing this we were able to remove the lamina en bloc. We were now able to use the nerve hook to palpate the underside of the remaining lamina and facette edges. We now used a combination of Kerrisons to remove this last bit of bone circumferentially. Following this, irrigation of the wound was performed, arthrodesis of all bony surfaces was performed, BMP sponges were packed in the facette joints bilaterally. Two rods were cut, contoured and secured by means of blockers. We then put the rest of the autograft and allograft over all exposed bony surfaces. The rods were secured by means of blockers. In addition, a crosslink was placed. Radiograph showed good placement of all screws and rods. Accordingly final tightening of all blockers was performed, 0.25% Marcaine plain was used for infiltration of the muscles. Two drains were placed in the wound and made to exit out a separate stab skin incision. Closure was undertaken by means of 0, 2-0, 3-0 Vicryl followed by staples on the skin. At the end of procedure, all needle and sponge counts were correct. The patient was transported to recovery room without incident. Of note, all neural monitoring was stable as well.
    Unreviewed
    Printed by: Page 2 of 3
    Printed on: 2/17/2012 14:04

    Completed Action List:
    * Perform by Contributor_system, SOFTMED on 01 February 2012 0:00
    * Transcribe by Contributor_system, SOFTMED on 01 February 2012 0:00
    Printed by: Page 3 of 3
    Printed on: 2/17/2012 14:04 (End of Report)

    -----------------------------------------------------------

    * Final Report *
    Result Type: XR Spine Cervical (AP/Lateral)
    Result Date: 02 February 2012 12:21
    Result Status: Authenticated
    Result Title: XR Spine Cervical (AP/Lateral)
    Performed By: on 02 February 2012 13:53
    Verified By: on 02 February 2012 13:53
    Encounter info: Inpatient, 2/1/2012 - 2/9/2012
    * Final Report *
    Reason For Exam s/p fusion
    Report
    XR Spine Cervical (AP/Lateral) 2/2/2012 12:05 PM
    Cl to (27) can be seen on the lateral view. There has been posterior surgical fusion
    from C3 to T2 held in place with 2 rods and multiple screws. A laminectomy defect
    is noted from C3 to C7. Bony graft is seen between the transverse processes at least from C4 to T1 bilaterally. Surgical skin clips are present in the midline over the cervical and upper thoracic spine. The prevertebral soft tissues are normal. There is straightening of the normal lordotic curve of the cervical spine.
    IMPRESSION:
    POSTERIOR SURGICAL FUSION FROM C3 TO T2
    Signature Line
    ***Final Report***
    Attending Radiologist:
    Date Signed Off: 02/02/2012 13:53 Transc. by: TR 02/02/2012 13:53
    Dictated by: 02/02/2012 13:53
    Completed Action List:
    * Order by on 01 February 2012 14:31
    * Perform by on 02 February 2012 12:21
    * VERIFY by on 02 February 2012 13:53
    Printed by: Page 1 of 1
    Printed on: 2/17/2012 14:04 (End of Report)

    ------------------------------------------------------


    * Final Report *
    Result Type: MR Spine Cervical WWO Contrast
    Result Date: 07 February 2012 21:43
    Result Status: Authenticated
    Result Title: MR Spine Cervical WWO Contrast
    Encounter info: Inpatient, 2/1/2012 - 2/9/2012
    * Final Report *
    Reason For Exam WEAKNESS

    Report

    PROCEDURE: MR Spine Cervical WWO Contrast

    HISTORY: Status-post posterior spinal fusion. Weakness. Evaluate for myelopathy.

    TECHNIQUE: Pre-infusion T1 and T2 weighted spin echo, STIR, and post-infusion T1 weighted images were obtained.

    COMPARISON: MR cervical spine, 10/18/11

    FINDINGS: Postsurgical changes status post C3 to T2 posterior spinal fusion are identified. Laminectomies are seen from C4 through C7. Metal artifact from the hardware limits evaluation of the adjacent structures. A fluid collection is seen spanning the laminectomy defects, most pronounced from C7 through T2 and extending to the subcutaneous tissues.
    There is mild residual narrowing at the C3 vertebral body level. The ill-defined T2/STIR hyperintense cord signal at this level likely represents artifact from adjacent hardware. Evaluation for cord signal abnormality is limited secondary to metal artifact; however, no definitive abnormality is identified. Additionally, the known myelomalacia at C5-6 is not well seen.
    There is straightening of the normal cervical lordosis. The alignment is unremarkable. The vertebral body heights are well-maintained. Mild loss of intervertebral disk height is seen at C3-4, C5-6, and C7-T1.
    The atlanto-occipital and atlantoaxial joints are unremarkable. Mild endplate degenerative changes are seen at C3-4 and C5-6.
    C2-3: There is no significant central spinal canal or foraminal stenosis.
    C3-4: There is a small posterior disk/osteophyte complex and moderate right and mild left uncovertebral hypertrophy resulting in mild central spinal canal stenosis. There is moderate right and mild left foraminal stenosis.
    C4-5: There is moderate right facet hypertrophy, resulting in moderate right

    Printed by: Page 1 of 2
    Printed on: 2/17/2012 14:05 (Continued)

    * Final Report *
    foraminal stenosis. There is no significant central spinal canal or left foraminal stenosis.
    C5-6: There is a broad-based posterior disk/osteophyte complex and moderate bilateral uncovertebral hypertrophy, without significant central spinal canal stenosis. There is mild left foraminal stenosis. There is no significant right foraminal stenosis.
    C6-7: Evaluation is limited by the metal artifact.
    C7-T1: There is no significant central spinal canal or foraminal stenosis.

    IMPRESSION:
    1. Status post C3 to T2 posterior spinal fusion. Postoperative fluid is seen spanning the surgical bed.
    2. Residual narrowing at the C3 vertebral body level. Ill-defined T2/STIR hyperintense cord signal at this level likely is felt to likely represent artifact from adjacent hardware, but recommend correlation with associated weakness.
    3. Please refer to the CT cervical spine performed on the same day for further characterization.
    Signature Line
    ***Final Report***
    THE ATTENDING RADIOLOGIST INTERPRETED THIS STUDY WITH THE RESIDENT
    WHOSE NAME APPEARS BELOW, AND FULLY AGREES WITH THE REPORT
    AND HAS AMENDED THE REPORT WHEN NECESSARY:
    Printed by: Page 2 of 2
    Printed on: 2/17/2012 14:05 (End of Report)

    --------------------------------------------------------


    * Final Report *
    Result Type: CT Spine Cervical WO Contrast
    Result Date: 08 February 2012 8:28
    Result Status: Authenticated
    Result Title: CT Spine Cervical WO Contrast
    Performed By:
    Verified By:
    Encounter info: Inpatient, 2/1/2012 - 2/9/2012
    * Final Report *
    Reason For Exam eval postop construct
    Report
    PROCEDURE: CT Spine Cervical WO Contrast

    INDICATION: Evaluate postoperative construction. Cervical myelopathy. According to the electronic medical record, the patient is status post cervical laminectomies from C3 through C7, posterior spinal fusion from C3 through T2 with instrumentation and graft material, on 2/1/2012.

    TECHNIQUE: CT cervical spine, without contrast. Coronal and sagittal reconstructions.

    COMPARISON: Numerous prior studies, most recently the MRI cervical spine from 2/7/2012 and the CT cervical spine from 1/17/2012, as well as the intraoperative spine plain films from 2/1/2012.

    FINDINGS: Postoperative changes are identified status post decompressive laminectomies from C3 through C7 and posterior spinal fusion from C3 through T2. The posterior spinal instrumentation includes bilateral lateral mass screws at each level from C3 through T2. A horizontal cross bar is identified at the C6 level. Metallic streak artifact related to the instrumentation degrades the surrounding detail. The right C7 pedicle screw extends inferiorly into the right C7-T1 facet joint (series 5, image 54). No evidence of hardware fracture or failure is identified. Bone graft material surrounding the lower aspect of the posterior spinal fusion, inferiorly as far as the T3 level, has been lifted away from the osseous structures on the basis of an underlying fluid collection that extends from the lower aspect of the decompressive laminectomy surgical bed (series 2, image 103; series 5b, image 45). Within the limits of CT, the dominant portion of this collection measures approximately 2.9-cm (AP) x 1.6-cm (TV) x 6.8-cm (CC), at the T2-3 level. Additional, smaller areas of fluid are identified extending more superficially to the skin. These collections are also demonstrated in the MRI cervical spine from 2/7/2012. Please see the report of that study for further details. Numerous gas foci are also identified along the surgical bed.
    Straightening of the normal cervical lordosis is noted with slight focal reversal centered at the C4-5 level. The alignment and vertebral body heights are normal.
    Printed by: Page 1 of 3
    Printed on: 2/17/2012 14:04 (Continued)

    " Final Report *
    Sclerosis along the endplates at the C3-4, C5-6 and 07-Ti levels most likely corresponds to discogenic degenerative change. No acute fracture is identified.
    Multilevel degenerative disk disease is identified on the basis of posterior disk osteophyte complexes, decreased disk heights and vacuum disk phenomenon, most prominent at the C3-4, C5-6 and C7-T1 levels.
    At the C2-3 level, there is a mild posterior disk osteophyte complex, bilateral uncovertebral and facet arthrosis, without resulting in significant central canal stenosis or neural foraminal narrowing.
    At the C3-4 level, there are postoperative decompressive changes, moderate posterior disk osteophyte complex, bilateral uncovertebral and facet arthrosis, resulting in moderate right and mild left neural foraminal narrowing.
    At the 04-5 level, there are postoperative decompressive changes, mild posterior disk osteophyte complex, severe right uncovertebral and facet arthrosis and mild left uncovertebral and facet arthrosis, resulting in severe right and no left neural foraminal narrowing.
    At the C5-6 level, there are postoperative decompressive changes, severe bilateral uncovertebral arthrosis and mild bilateral facet arthrosis, together resulting in severe left and mild right neural foraminal narrowing.
    At the C6-7 level, there are postoperative decompressive changes, a moderate posterior disk osteophyte complex, bilateral uncovertebral and facet arthrosis, resulting in stable severe right and moderate left neural foraminal narrowing.
    At the C7-T1 level, there are postoperative decompressive changes, a moderate posterior disk osteophyte complex, resulting in moderate right and mild left neural foraminal narrowing.
    Moderate right mastoid air cell opacification is noted.

    IMPRESSION:
    1.Postoperative changes status post decompressive laminectomies from C3 through C7 and posterior spinal fusion from C3 through T2, as described. No evidence of hardware fracture or failure.

    2. Postoperative fluid collections along the surgical bed extend as far inferiorly as T3, with the dominant portion of the collection measuring 2.9 x 1.6 x 6.8-cm at the T2-3 level. The differential diagnosis for the fluid collections includes postoperative seroma, hematoma, cerebrospinal fluid, with the possibility of superinfection not excluded. Clinical correlation and follow-up, including with consideration for fluid sampling are suggested, as clinically warranted.

    3. Please see the recent MRI cervical spine report from 2/7/2012 for further details.

    Printed by: Page 2 of 3
    Printed on: 2/17/2012 14:04 (Continued)

    * Final Report *
    Signature Line
    ***Final Report***
    Attending Radiologist:
    Date Signed Off: 02/08/2012 13:12 Transc. by: TR 02/08/2012 13:12
    Dictated by: 02/08/2012 12:38
    Completed Action List:
    * Order by on 08 February 2012 6:44
    * Perform by on 08 February 2012 8:28
    * VERIFY by on 08 February 2012 13:12
    Printed by: Page 3 of 3
    Printed on: 2/17/2012 14:04 (End of Report)
    ----------------------------------------------------------

    Last edited by Chitown2012; 02-25-2012 at 04:59 AM. Reason: Pls delete this duplicate post...sorry I clicked twice. Thanks!

     
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    Old 02-25-2012, 12:41 PM   #2
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Which muscles in your right arm are weak? Any other symptoms - pain, tingling, etc - in arms and hands.

    You do STILL have "severe" foraminal narrowing at C4-5, C5-6 and C6-7... could be that your spinal cord is moving backward (as it should) due to the decompression, and tugging on one or more nerve roots that are "tethered" by the foraminal narrowing.

     
    Old 02-25-2012, 01:38 PM   #3
    Chitown2012
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Not sure which right arm muscles they are other than upper. For instance when i'm lying in bed and have my right arm along side my body I cannot lift it unless my left hand assists. I do have right upper, what I'd call muscle soreness. My left hand is still pretty useless as the NS said it probably would be.....

    Postoperatively, I also have:

    Outer thigh numbness in both thighs.

    Little toes in both my feet.

    In the morning when I get out of bed, my legs sometimes feel a bit weak, but generally speaking I can walk fine, actually just walked 1 mile.

    I'm trying to cut back on the valiums to 5mg/day... I still at times have a lot of muscle tightness in between my shoulder blades.

    You think this right arm cramp is that C5 Palsy postoperative complication that will go away?

    To refresh my memory what are your issues? At you still on meds? Also do most folks survive this or is it disability?

    Thank you for your input!

     
    Old 02-25-2012, 04:15 PM   #4
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Keeping in mind that the following is from an amateur and should not substitute for consultation with competent medical personnel...

    If it's your bicep that's affected (and deltoid, as well) then it's likely C5. Whether or not it is C5, all that foraminal narrowing is suspect. Your current right-arm symptoms may well subside, but the narrowing is still there, and eventually will cause any number of symptoms, if it isn't doing so already.

    What's going on in your legs - if coming from the neck - would be due to the cord itself. Your cord is moving backward and also probably expanding, so this IMPROVEMENT is likely to express itself in some new symptoms. After my C4-5-6 laminoplasty, I developed a whole new set of symptoms - chills in arms and legs - that came and went over a period of months.

    As for the likely extent of permanent disability, Jenny can answer better than I, because her situation is much closer to yours.

    Last edited by WebDozer; 02-25-2012 at 04:16 PM.

     
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    Old 02-26-2012, 12:15 PM   #5
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Chitown....you are not even 3 weeks post-op with a surgery who's recovery time is measured in years, not weeks. Your neck must adjust to the surgery, the rods and screws being but in, the swelling alone takes weeks to go down and the room made for your cord will takes weeks for the nerves to adjust.

    I had the C3 to T1 fusion and it took me almost 3 years to finally know what would stay numb, what would get feeling back and how much and what muscles would recover function and which ones wouldn't. This is as major a surgery as you can have...it takes time. If you had a heart transplant, you wouldn't expect everything to be back to normal in 3 weeks would you? This is just as big.

    And here's a newsflash that we tell so many people and they don't believe us until it happens to them........THERE IS NEVER ANY GUARANTEE THAT YOU'LL HAVE LESS PAIN OR RECOVER MUSCLE FUNCTION AFTER SURGERY. All surgery is designed to do it stop the progression of damage, not return you to normal. Basically, all it is designed to do it stop everything in it's place and not let it go further.

    Give it some time....you are still in the very earliest stages of recovery. Once you hit 6 months post-op, then you can start to wonder but from my perspective, give it 1-2 years.

    Jenny

     
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    Old 02-26-2012, 02:14 PM   #6
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    To add to what Jenny said - and to reiterate what I said - your post-op image still shows a LOT of severe foraminal narrowing. This - by itself - would be of concern in someone who had not yet had surgery, and no less so even for you. While you should be very patient with symptoms coming from your spinal cord (probably anything in your legs/feet), you should also be alert to symptoms that might be caused by foraminal narrowing, as you won't be able to wait those out.

    I would suggest a serious and detailed talk with your surgeon about the foraminal narrowing, including what symptoms might be caused by it (now and in the future) and what surgical intervention might be called for (now and in the future).

    I had expected your laminectomy surgery to include foraminotomies. Maybe it did at some levels and not at others? Maybe the bone overgrowths that are narrowing the foramina were not accessible at the time? Either way, you really should talk to the surgeon about it and be sure to come away understanding the situation.

    Last edited by WebDozer; 02-26-2012 at 02:15 PM.

     
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    Old 02-27-2012, 09:56 PM   #7
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Jenny or Web: is any of this anything to be concerned about? Have you ever had trouble with NS when you confront them with various reports and ask for clarification or in my case what about the forminal narrrowing and things like this clip from one of the above reports....

    The right C7 pedicle screw extends inferiorly into the right C7-T1 facet joint (series 5, image 54). No evidence of hardware fracture or failure is identified. Bone graft material surrounding the lower aspect of the posterior spinal fusion, inferiorly as far as the T3 level, has been lifted away from the osseous structures on the basis of an underlying fluid collection that extends from the lower aspect of the decompressive laminectomy surgical bed (series 2, image 103; series 5b, image 45). Within the limits of CT, the dominant portion of this collection measures approximately 2.9-cm (AP) x 1.6-cm (TV) x 6.8-cm (CC), at the T2-3 level. Additional, smaller areas of fluid are identified extending more superficially to the skin. These collections are also demonstrated in the MRI cervical spine from 2/7/2012. Please see the report of that study for further details. Numerous gas foci are also identified along the surgical bed.
    Straightening of the normal cervical lordosis is noted with slight focal reversal centered at the C4-5 level. The alignment and vertebral body heights are normal.


    I'm a little concerned about some of the verbage...It sounds to me as if a screw went in wrong?

    Also, just curious what meds you've been on and for how long.... Lastly, what's the most levels of fusion have you heard that has been done? Thanks again for the onput.

     
    Old 02-28-2012, 05:36 AM   #8
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    My fusion - 16 years ago - was only one level. My laminoplasty last year was three levels.

    As for the apparent fluid/gas buildups, that's way over my head. Certainly something to ask your surgeon about. Could be that the radiologist is describing something that is abnormal in a neck that hasn't been operated on, but would be considered normal after an operation like yours.

    Some surgeons are REALLY BAD when it comes to answering questions, as though it's an imposition for them to even be asked. Do not let your surgeon get away w/o explaining EVERY WORD to your satisfaction. Don't worry, it will be good practice for him...

     
    Old 02-28-2012, 09:12 AM   #9
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Okay...I'll add my 2 cents...I'm a 5 level laminoplasty with a 6 level fusion...both from the back.

    Collections of gas and fluid in the tissues are normal after surgery. What they say about the screw is to reassure the doc that the screw did not break anything while being put in...they often don't have much room and just like screwing into a piece of wood, sometimes the wood breaks or splinters....same for bone. But it your case, it did not. I had one vertebra that was so compromised, he couldn't but any screws into it and had to jam it in between 2 others and then pack it with bone putty and prayed it stayed there.

    When they put in screws, they are doing it somewhat blind so they have to do multiple checks to make sure it got in without hitting a nerve or breaking anything....yours didn't do either. We had someone here who woke up in horrendous pain as it turned out the doc screwed right into a nerve and it was wrapped around the threads of the screw. Your C7 screw is in okay.

    There is mention of some BMP being lifted off the surface of T3 but that is dissolving as evidenced from the fluid collection and you weren't having anything done with T3 anyhow.

    But what I would be concerned with is that you still have a straightened neck with a slight reversal of normal lordosis at C4-5. I've seen my pre-op and then post-op x-rays(at 3 weeks) and I went from a revered lordosis to a good looking normal curve in my neck after surgery. Maybe she waiting to see if the rods will move the neck back into the normal curve. Since I didn't have x-rays until 3 weeks post-op...maybe it's something that takes time? I don't know. Or maybe your neck was so bad it couldn't be reversed, just stabilized against further reversal. But why she didn't do the forminotomies...I'll never know...that is the biggest question for her.

    We aren't surgeons and when it comes to the little stuff like this, unless we have obvious signs of a major problem that lasts well beyond the normal healing period, then let it go and wait to see what happens as you heal.I did talk to a malpractice lawyer(he's a friend) both prior to and after my surgery and as he pointed out, you can only sue if whatever was done lasts past the normal healing process and becomes permanent...which with spine surgery means waiting a couple of years.

    You have to remember, surgery stops further worsening...not necessarily reverses what was done. As for the C5 problem you have...give it time. I woke up with almost no use of my left arm whereas I could use it prior to surgery. My doc warned me prior to surgery that he felt I would end up with left arm paralysis due to what he had to do to in there. But around 9 months post-op, I began to get some strength back into the shoulder and arm muscles and then worked the heck out of it in PT. I now have at least 95% back but have found I have to exercise them everyday or they weaken again.

    Seems to me you are looking for faults. That is one major reason to get a second and third opinions prior to surgery.....gives you a chance to get to know your docs, their expectations and feel more confident in the outcome. I had a lot of doubts about my doc despite the extra opinions until I went to NYC to the Hospital for Special Surgery and the top spine doc there said I was very lucky to have done as well as I did. Based on what I was able to tell him and the pre-op and post-op MRIs, he said he couldn't have fixed me that well. Now I know docs cover for each other but in this case, this guy didn't like my doc in Boston. So I realized that I actually did well...and why I am now having a 3rd surgery with him.

    Give it time and stop obsessing over every little report.

    Jenny

     
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    Old 03-01-2012, 01:28 PM   #10
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    I just got home from my NS appointment at Northwestern University Hospital in Chicago. Northwestern is also where I had my laminectomy. I had some X-rays before my appointment this morning then I saw my surgeon, Aruna Ganju. She showed me the X-ray and said I'm coming along fine. I asked her about the severe forminal narrowing at the various levels and she basically said not to worry about it and she/I left it at that. I think she is a decent surgeon, I mean she is has been at Northwestern for like 7years. She is one of those NS that aren't big on explaining things to you, it's more of the "trust me" attitude. I feel like I let myself down for not being a bit more demanding for an explanation. I do see her again on March 29th and will try to pin her down more. It's just I assume she is much smarter than I and I don't want to have her upset with me. I suppose I should also mention that I do not have insurance at the moment and am considered a charity case for this surgery on both the hospital and doctors side of things. I would hope that would not make a difference. I mean there are only like 7 NS at Northwestern and one of them is world renowned, just not the one I had. I know assumptions can be dangerous but she seems to be part of a brilliant NS team. She said today my right arm will get better. I have a Neurologist at Northwestern as well who explains things much better and am trying to get an appt soon with her. Sorry, I guess I'm just venting at my own disappiontment for not being more bold in getting answers from my NS today. I will post my report from today's X-ray as soon as I get a copy. Thank you to all for your input, it has defiantly helped me in my struggle with this issue I'm going through right now.

     
    Old 03-01-2012, 01:43 PM   #11
    WebDozer
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Chitown - It's all a matter of practice. That surgeon has had years of practice in lording it over patients. She's gotten very good at it. You, on the other hand, have almost no practice forcing a surgeon to have a real conversation with you.

    As for her being "smarter" than you, that's very unlikely. Real intelligence would give someone in her position the ability to see from her patients' perspectives and to communicate with them accordingly.

    I know you won't do this, but I would love it if you would. Next time you see her, ask her what part of the word "severe" she's having trouble understanding....

    Last edited by WebDozer; 03-01-2012 at 01:45 PM.

     
    Old 03-01-2012, 01:51 PM   #12
    Chitown2012
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    I should also mention that the Neurologist, who also recommended that I have the Laminectomy, is also doc at Northwestern University Hospital here in Chicago. Thanks for your listening ears.

     
    Old 03-01-2012, 09:04 PM   #13
    Chitown2012
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    I guess part of my paranoia is the fact that all these NS & Neurologists are at the same hospital in their own little club with offices even on the same floor....Anyway it's been a long day, time for rest.... Blessings to all....

     
    Old 03-02-2012, 09:19 AM   #14
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    I wish you had told us earlier that you didn't have insurance...then we'd understand why you couldn't get more opinions. You are kind of "stuck". You have to trust she did her best. Beggars can't be choosers.

    Let's hope you do recover and the pain in your arm goes away...as I always say...give it time. This is a 1-2 year recovery time.

    jenny

     
    Old 03-02-2012, 09:42 PM   #15
    Chitown2012
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    Re: Laminectomy Surgical & Postop, MRI,CT Report Help Requestd

    Yeah being in a 1099 job with no insurance and to young for Medicare and make too much for Medicaid sucks. Northwestern hospital ranks very high in general and in neurosurgery. My doc is the one that said I needed surgery. I just don't understand her on the forminal narrowing. I'll just have to pin her down on that issue. The hospital bill alone ran $188,000. With costs that high for these surgeries do any of you max out on your insurance coverage caps?

     
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