Question Title: Neuroma

Forum: Neurology Forum
Topic: Neurology - General

Posted by CCF Neurosurgery MD on January 26, 1998 at 23:14:15:

In Reply to: neuroma posted by Nancy Nussbaum on January 26, 1998 at 21:48:49:

: I was recently diagosed with a large egg-sized
neuroma at L1/T12 that has probably been there
for at least 3 - 4 yrs. Surgery has been recommended
and is scheduled for 2/2. My questions are:
1. What is the probability of nerve damage
after surgery?
2. If there is damage, what is the likelihood
that it will be sensory vs. motor?
3. If damage is sensory, will it most likely be
numbness or chronic pain?
4. If damage is motor, what is the probability
of paralysis affecting the bladder or colon,
weakness in a very restricted area in the leg, or
much more general paralysis of leg muscles?

Thank-you very much!
NN

Dear Ms. Nussbaum:

I will attempt to answer your questions in the same order.

1. Anytime surgery is attempted near nerve roots or the spinal cord, there is a chance of injury to these structures. However, in the hands of an experienced surgeon this is highly unlikely.

2.The chances of predicting whether damage (if it occurs) is sensory or motor is extremely difficult to predict especially at a level where the spinal cord is present.

3.Numbness and/ ot pain may insue in the case of sensory component damage.

4.The chances of bowel/bladder dysfunction are also present although again very unlikely. The motor damage may also involve muscles of the leg (one or both because of the level of the lesion T12/L1.

It is however important to note that most neurosurgeons will recommend surgery for this type of lesion. The rationale for this is that these are typically benign lesions that should be cured once removed with small chances of recurring. If they are not removed, they may grow and cause permanent damage and at that particular level where the spinal cord is present, damage might be greater if left untreated. Overall the risks of surgery in the hands of an experienced surgeon are fairly low.

If you have further questions, please write back.

Good Luck !

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