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Does my mom need surgery?

cql
As of now she still have numbness in her both legs and can't walk. She had catheter on as she also lost her bladder sensation. I just need to know if physical therapy and medication can get her back to normal.
This was the MRI result
clinical information;
history of fall landing on her back. Weakness of the lower extermities.TC transverse myelopathy secondary to spinal cord compression.
Finding;
the examination demonstrate a severe acute compression fracture involving t4.vertebral body,associated with retropusion of the posterior vertebral margin. There is a subacute intraspinal hematoma [probably epidural in location] within the left side of the t4 spinal canal. The combination of these finding causes rightward displacement and moderate compression of the spinal cord at t4 level
The adjacent t5 vertebral body demonstrates bone marrow edema, which may be secondary to bone contusion. No evidence of spondylolisthesis or facet dislocation is noted. No other areas of cord compression are identified in the thoracic spinal column.
The thoracic intervertebral disc are unremarkable. Without evidence of the disc herniation at any level, the post-gadolinium study shows no abnormal areas of contrast enhancement.  Limited sagittal t2-w images of the cervical spine. Obtained for localization purposes, show mild bulging at c6-7 level
Impression;
1. Severe acute t4 compression fracture with retropulsion,associated with a 2.0 cm subrate intraspinal hematoma[which appears epidural in location] within the left side of the t4 spinal canal, causing moderate cord compression..
2. Bone marrow edema involving t5 vertebral body, probably secondary to bone confusion
3. Partial visualization of the mild C6-7 bulge.
4 Responses
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Avatar universal
Hi. It is better oyu consult a neurosurgeon as soon as possible. If once the symptoms increase, it is difficult to regain her health. If you can goto banglore, goto BGS GLOBAL hospital and meet Dr.ARUN L NAIK. he is very good and successfull in these kind of cases.
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Avatar universal
MEDICAL PROFESSIONAL
Hi there. Spinal epidural hematoma may have occurred following the trauma that your mother sustained though it may be spontaneous or may follow lumbar puncture or epidural anesthesia. Spontaneous hematomas may be associated with anticoagulation, thrombolysis, coagulopathies etc. spinal epidural hematomas causes severe localized back pain with delayed radicular radiation mimicking disc herniation. Associated symptoms include weakness, numbness urinary incontinence and fecal incontinence. Transverse myelitis is a neurological disorder arising from an inflammatory process of the spinal cord. Degree of sensory loss will depend upon the extent of the involvement of various sensory tracts. Bladder paralysis and urinary retention is an early manifestation. Lesion of thoracic cord produces spastic diplegia or spastic lower limb paralysis. Consult your neurosurgeon who is the best guide for intervention.  Surgical decompression would be necessary for epidural hematoma management for preventing the permanent neurological complications. Hope this helps. Take care.
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1580828 tn?1322128022
I totally agree with mcamp.

The condition seems beyond medications and physical therapy.  I am not a doctor, but I have been having a condition taking care of via meds and therapy, and have now reached a point of needing surgery because of a fall.

I hope all works out well.
Helpful - 0
947040 tn?1300685387
have you taken her to a neurosurgeon? I would, because it sure sounds like she could benefit from surgery, I mean with all the info on the MRI, and the loss of bladder function too. I would think this could all or most of it be resolved with surgery, definitely I would go see a good neurosurgeon and take the MRI with you...

lots of luck and I hope you find some help
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