Dear Cindy, CCF and readers -
I was in a bad car wreck 11/98 which left me temporarily paralyzed in fingers,arms and hands. I was hospitalized 10 days. On the 4th day, my limbs moved and I was downgraded from ICU to inpt rehab for 7 days. My neurosurgeon says my recovery has been "nothing short of remarkable" yet he remains concerned about paralysis and I find myself in chronic pain and continue disabled. i remain in PT which gives some relief and has increased my ROM to normal limits, yet the feeling of pressure in my neck limits me greatly. My diagnosis is myelomalacia and spondylitic disease. Apparently, there are bone spurs around C4/5 and C5/6 which, when rear-ended at 70mph, pushed them into the cord. My Dr. is suggesting fusion which he believes offers an 80% chance of pain relief and will address the stenosis/spondylosis caused by the spurs. I have had opinions from surgeons at Emory and Saint Joseph's hospital. Both suggesting avoiding surgery if possible. One feels the diagnosis as to what is actually causing the pain, e.g. a diskography, should be done before proceeding with operative treatment. My main question is: I understand that less invasive procedures are now available - have heard from a surgeon that something (maybe laser?) is being done for decompression at UCLA and Cedars Sinai in L.A. Are you aware of anything that would be able to remove the spurs encroaching on the cord without causing the ROM limitation and risks which a fusion would impose? Sincere thanks, Karen
Dear Elaine:
As you know, myelomalacia is a pathological term used for pathological softening of the spinal cord. So, the etiology of the MRI finding is extremely important, if it is to explain your pain symptoms. Whether it is the spinal cord abnormality or the epidural, I can't tell from your posting. Since the problem is in your arm, I am assuming that it is in the cervical cord, on the left side. Since you were given epidural injections, I will also assume that your problem was pain. The recent increase in the pain then maybe from the pre-existing problem that has worsened. There is always the possibility that the epidural injection exacerbated the problem, if so, the pain should resolve in due time. So, I'm not sure what to tell you. There is a CCF Florida, (Naples) that has two very good neurologist who might be able to address your problems.
Sincerely,
CCF Neuro MD