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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Nerve Root Damage I have also had back pain and trouble walking which I attributed to Chiari. I have recently had an EMG which shows nerve root damage/compression in the lumbar area. I do not necessarily want to go through more surgery.....but am in excrutiating pain and am having more and more trouble walking. Would pain blocking shots be a viable idea...with a rhizotomy as an end result...or could blocking the pain also block possible later serious damage....putting my walking in jeopardy? My surgeon looking at my MRI does not see LSS, but this could be the beginning...correct? I also know that tethered cords go along with ACM. One is not apparant...but there is a thickening. I would just like 1 year without pain....I have been this way for 14 years!! Can you please give me some advice? Thank you very much for you time and consideration. I greatly appreciate it. Very truly yours, Nancee Tomassoni
Dear Ms. Tomassoni: By definition, Chiari II or ACM malformation patient have a (>95 percent) meningomyelocele and thus a predisposition for a tethered cord. You should be able to see the tethered cord on the spinal MRI. If there is a doubt, then have a neuroradiologist take a look at the films. If part of the problem is a tethered cord then maybe you will require surgery. It sounds like the etiology pain is from something other than you walking. Although walking is very painful, it probably does not make the etiology of the pain worse, only the pain. It may be an idea to try therapy and vigorous medical management for the pain to see if surgery can be avoided. Sincerely, CCF Neuro[P] MD
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