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Opinion on Spinal Cord cyst
I would appreciate medical opinion on below MRI report of my 38 years old brother, having symptoms such as weakness and pain in knees, tightening of stomach muscles, spasticity and mild worsening of gait. At times he faces bowel control problems.

"Noted a well-defined non-enhancing T2 hyper and T1 hypointense intramedullary lesion with adjacent extramedullary component in the thoracic cord at D5-D6 levels - measuring 7x8x10mm (APxTRxCC). Extramedullary component measures 0.65x1.3cm (APxCC) with no significant change in size (from earlier MRI scan done 3 months ago). Features concern for astrocytoma. Recommend HPE correlation."

The Neurosurgeon has recommended a surgery to decompress the hourglass cyst and biopsy.

How bad is it? And what kind of recovery can one expect post surgery? Is full recovery a possibility in such cases?

Thanks for your support.
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4 Answers
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620923 tn?1452919248

  Hi and welcome to the Spinal Cord C/D forum.

I am sorry, but this is a support community, u will want one of the expert communities to get a medical opinion and even then it may be a general answer and not particular to u as it is difficult for a Dr to give advise with out seeing u.....

A non medical reply is this...from my own experience with surgery...we r all different as to how long it may take and we can not rush getting back to our lives and "normal" since nerves are involved causing all the symptoms he needs to be patient, as nerves can take up to 2 yrs to heal completely....

His Drs should be able to give a better idea as to how they feel he may do....

Sending well wishes and please let us know how he is doing : )
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Thank you for your wishes and suggestion.
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So sorry to hear of your brother's suffering.  I know EXACTLY how he feels, because I have almost the same problem - a cyst now measuring around 5 cm long at T5-T7.  It was 1.5 cm long when it was first detected 23 years ago.  Until few years ago, my problems were just some numbness and lower back pain (almost all the time, ranging from mild to sever, but bearable) and then the bowel and urinary problems started.  But now for the last few months, I am having muscle weakness in one leg and muscle cramps in the other, accompanied by spasticity and gait problems, which are now causing difficulty to maintain balance while walking.  I am using a stick.  All the neurosurgeons I saw recommended decompression surgery as well, which involves inserting a plural shunt into the cyst and leaving it there with a drainage pipe inserted into a body cavity to continuously drain out the fluid. I was also told that too much CSF (cerebra spinal fluid) drainage can also cause headaches and dizziness. Only in the last 2-3 weeks I started developing pain in the knee on the weaker leg, which I suspected was because of uneven pressure on that knee due to the muscle weakness, which my doctor agreed with.  Now my neurosurgeon suspected and confirmed another problem through a CT scan.  I have spina befida, which apparently is a birth defect.  This he suspects is causing a downward pull on my spinal cord, i.e., a tethered cord.  Thus he suggested that first I go through a more simple and less risky surgery untether the spinal cord, which involves cutting the filum, which is stringy part at the very end of the spinal cord, which apparently is useless.  He said I should start to feel better, but if my condition does not improve significantly over a month or two, then he suggests the more difficult/risky plural shunt operation.  He gave me a video of such an operation he had performed on another patient, who could not urinate, and cyst became smaller (narrower) after the surgery and he could urinate again and he was apparently bicycling 2 weeks later.  Hope this helps.  Any comments or any further info you wish to share?
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I forgot to mention that I wear latex knee braces when I have to walk some distance and that seems to have helped, because my knee pain has gone away, possibly because the knee is being kept straight by the braces, thus reducing uneven pressure.
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