tethered cervicle spine

i have a tethered spine as a result of scar tissue growth from a surgery 20 yrs ago in the c4 to c7. the pain in my cervicle spine and in my left arm and hand have gone from a manageable pain level of 5 on scale of 10 to 8-9 and somehours of the day a solid 10 since i was rear ended while stopped at a traffic signal 2 yrs ago. i have told i need dethering surgery and also to avoid that surgery. also it's been recommended i have a spinal cord stimulator implant but in my case it can only be implanted from the top around c3. both procedures are difficult and i am struggling with choosing one over the other. i would prefer to do nothing but i believe i will soon be forced to choose one or the other due to the pain level and some changes in both motor and sensory skills. can you please advise me on the risk vs reward for these two choices and if you have any idea as to what might have happened to increase my pain so much as a result of the rear end collision. dr's all agree i was tethered at the time and have suggested some tugging could have taken place but are all vague in responding to that question. thank you.

[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 your doctor.

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

Non-surgical options include medications (non-steroidals such as advil), sometimes steroids if there is swelling (edema), temperature therapy (hot or cold packs), stretching and controlled physical therapy, muslce relaxants, and so on, these are best prescribed by an experienced physician, each has its own indications. Evaluation by a pain management specialis may be of benefit as well.

This forum is for neurology rather than neurosurgery questions, and the question may be better posed to a surgeon. However, based on my limited knowledge, the goals of the two procedures (dethering vs. spinal cord stimulation, or SCS) would be different. Detethering would be indicated if there are progressive neurologic symptoms such as weakness and/or sensory symptoms, and may help with the pain as well. SCS would help with the pain, but if there is some sort of traction on the spine or pressure on the nerve roots, this would not be of benefit to that.

One means of assessing whether or not there are nerve roots being pressed on is a test called an EMG/NCS which assesses how fast the nerve conducts electricity and how the muscle responds. This type of test is done by neurologists in most centers. This may help guide the surgical options: if there are nerve roots being pushed on, or if the MRI shows evidence that the spinal cord itself is being injured, then the detethering surgery may be more indicated.

However I again emphasize that I am not a surgeon, and continued discussion of your treatment options with your spine surgeon and pain management specialist is recommended.

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

[selmaS]

For support we do have a chiari forum here on MedHelp and members with TC are also members there.

I hope u join us : )

"selma"