Knee replacement surgery with TM diagnosis

I was diagnosed with idiopathic Transverse Myelitis 10/09 (only acute numbness) treated with 5 Solomedrol infusions and treated again after a recent exacerbation 12/09 and plan to have knee replacement surgery in the near future.  What kind of anesthesia would be recommended and is there a concern for an exacerbation from the stress of either the anesthesia or the surgery?

Thank you, Al

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Myelitis is inflammation of the spine. This can be infectious, demyelinating (as occurs in MS), or of a few other causes. Idiopathic transverse (meaning no identifiable cause was found) can be an isolated incident that does not recur and does not have long-standing consequences. While I can not make specific recommendations for your anesthesia (and this is beyond my area of expertise as a neurologist), in general, if there was an isolated episode of transverse myelitis with complete recovery in a person, and there is no evidence for an ongoing demyelinating disorder (such as MS), the risks of surgery would likely be low, possibly not even higher than the risk of complications in others, without a history of myelitis. There would likely not be any specific medications that should be avoided, though this would ultimately be deferred to the anesthesiologist. Even patients with significant demyelinating disorders such as MS can undergo general anesthesia without difficulty, though minimization of post-operative (after surgery) pain medications, to prevent excessive sleepiness/sedation is important in such cases.

It is important to discuss your questions and concerns with an anesthesiologist and/or surgeon prior to your procedure.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.