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cervical myelopathy treatment

mtrs  dr vaidya age 74 has cervical
cord compression at c4/c4/c6/ c7 ;evel treated conservatively improved was walking with walker oct 2005---2008june
in june 2008 indrea in bone pains stiffness in muscles
truned out to be multiple myeloma being the cause
treated with  dexamethasone and laningio latest for multiple myeloma
complete remisson from oct 2008
stopped treatmenytt asvuse from haemato oncologist
on 29th october suddenly she lost power of leg muscles  and hands both rt more than left
mri showed old cervical cord compression wedging of thorasic vertebrae at 3 --4 levels
neurological findings r
exaggerated reflexes upper motor neurone
babbinskis  po ve
thinking  ord odema methyl prednisolone 14 mg bd was given 5 days tapered off
she is loosing power can not sit can not stand
her immuno fliroonce studies for m m r numal how to treat this
what is the cause of sudden loss of power ?? she did not fall
with history of multiple myeloma can ve surgically decpmress her??
if so is there limited surgery ?? name -
if we dont operate just physio will she improve now?? before s he did
as a colleague a senior radilogist i request u appeal to u to please guide me i am so confused
how to treat her at this stage
we r giving her physio
yoir guidance is so much appreciated

dr manoj vaidya m d
senior radiologist
what surgery can be done looking to M M
weakness of muscles since one month  before she was good walking
visceral reflexes r  constipated passes one stool,per day wiyth efforts micturation
no incontinence
mri showing
cord compression c4/c5/c6/c7
after myeloma treatment
collapse of thosic vertebrae with high intensity sigmnals in bodies  of thorasic vertebrae no syrinx
neurology--weakness rt side planters extensors
jerks exagerated
triceps plus knee plus
power muscles rt 3 to 4
lw eft 4 plus
still she can not stand
fingers rt side claw shaped
tingling numbness both hands feet
hands since 2 years feet recent
how to manage this case with  remission state of myeloma
light chain
kidneys not invoved normal renal functions
there is fluctuation of muscle power and sense of well being
evening worst Dr  Manoj vaidya M D
1664/b2/1 SATYAM
sardarnagar -Bhavnagar
guujrat -0278-2562459

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