I have a friend that recently reported she slipped an fell about the frist of April. She's 37 y/o otherwise in good health. She said she popped right up with no acute injury. She's been able to continue working and ADLs. She c/o bilateral hand numbness and left shoulder and low back pain. She's 5'2" and weights about 170. She went to the doctor and was sent for MRI C-spine. The report came back with "changes w/n the cervical cord at C3-4, c4-5, hypointensive on T1, no compression fracture or subluxatoin. C2-3, C3-4, C4-5, C5-6, C6-7, C7-T1 disc protursions. Enchroachment on c-cord at C3-4 w/generalized disc protrusion and bony proliferative changes. Abnormal signal changes w/n c-cord may represent ealry changes of myelomalacia.
The neurosurgeon wants to do surgery anterior cervical diskectomy w/fusion at C3-4 for HNP. She orgianally only went in for complaints of low back pain and left shoulder pain which have been mild at most. Is all this cervical stuff related to her fall or just a finding?
Myelomalacia is a term that refers to an area of softening of the spinal cord and usually more specifically to an area of the spinal cord that was injured, died, and has been reabsorbed by the body leaving a "hole" or cavity, or spinal fluid - filled space where the orginal healthy spinal cord tissue used to be. A contusion or bruise of the spinal cord from trauma is a very common way for this problem to happen
The spinal vertebrae are separated by disks filled with a soft, gelatinous substance, which provide cushioning to the spinal column. These disks may herniate (move out of place) or rupture from trauma or strain
The main treatment for a herniated disk is a short period of rest with pain and anti-inflammatory medications, followed by physical therapy.
.Non-steroidal anti-inflammatory medications (NSAIDs) and narcotic pain killers will be given to people with a sudden herniated disk caused by some sort of trauma (like a car accident or lifting a very heavy object) that is immediately followed by severe pain in the back and leg.
Steroid injections into the back in the area of the herniated disk can help control pain for several months. Such injections reduce swelling around the disk and relieve many symptoms Transcutaneous Electrical Nerve Stimulation (TENS) is a treatment in which a painless electrical current is sent to specific nerves through electrode patches that are placed on the skin. The mild electrical current generates heat that serves to relieve stiffness, improve mobility, and relieve pain
Treatment methods should be focused on pain relief and maintaining quality of life.
If these do not help then the only option is surgery.These symptoms are a result of the trauma sustained.You should consult another neurologist and take a second opinion regarding the pros and cons of the surgical procedure.
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