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In Remembrance
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Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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In Remembrance
Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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Hi miss irie and Artist,
Before talking about this procudere, let me introduce my bona fides on the subject: The 1995 assault that led to my RSD also produced several other diagnoses, including:
Epidural fibrosis at the foraminal space at both sides of S2; which means that scar tissue was compressing my nerve roots at the foraminal space; the point where S2 nerves enter the spinal cord.
Arachnoiditis; scar tissue at/on the arachnoid, the middle layer of three that surround the spinal cord and contain the cerebro-spinal fluid that allows the spinal cord to flex and move.
S2 radiculopathy; which is a measure of neuromuscular response diagnosed by electromyeogram (EMG).
Since these disorders define my pain and disability even more that the RSD, I began researching them first. I have not researched them recently, but my neurosurgeon cares and he closely keeps up with the literature about these disorders.
Meanwhile, ten years ago a surgical procedure called something like 'endoscopic surgical removal of epidural adhesions (memory fades), which used a tiny video-cam to focus on magnifying the scar tissue so the surgeon can sweep it away with a scalpel controlled through the endoscope.
Epidural can mean inside the spinal canal, but because lysis simply means rupturing of cell membranes and the procedure describes removing adhesions, I suspect it means outside of the spinal cord at the dura, the outer layer of the 3 spinal cord coverings. If it were intended to remove scar tissue from the arachnoid or the pia, the inner layer, I think these names would be used rather than epidural.
I suspect this means the surgeon has introduced a chemical to dissolve scar tissue at the foraminal space to replace the more invasive endoscopic surgery. I would not allow anyone to inject a chemical at or near my spinal cord unless the procedure had been demonstrated to be both safe and effective for at least 10 years.
I recall a few years ago when a similar procudure to dissolve the sympathetic nerve, replacing the surgical sympathectomy that was rapidly waning in popularity, created severe scarring and tissue damage in RSD patients.
Well, Dr Schwartzmann, once an advocate of surgical sympathectomies has now abandoned sympathetic nerve damage as a cause of RSD and has returned to peripheral nerve damage. In other words, big S should tell you that patients who underwent these chemical sympathectomies were sacraficed by attacking the wrong nerves and damaging nerve and tissue.
It gets worse; since I have exactly the diagnosis I suspect this patient has (hers caused by scar tissue over screws, mine by traumatic damage resulting in scar tissue, and there is absolutely no evidence that this scar tissue causes RSD; it causes radiculopathy and radicular pain.
Another reason epidural adhesions (scar tissue) can't explain RSD is that they are site specific: they can only affect nerves they actually touch, but secondary RSD symptoms can appear great distances from the original site. How in the world can scar tissue causing leg pain produce arm or hand pain?
If I am correct that this patient's diagnosis is the same as mine, epidural lysis might reduce radicular pain; but what of the risk? I just described RSD patients who suffered even more from the chemical damage that from the RSD it was intended to cure.
I am also extremely concerned over the fact that both medical providers appear to work for private pain clinics. Research into injecting any chemical intended to dissolve cells near the spine should be undertaken at a minimum of two university hospitals, not pain clinics.
Unfortunately, the FDA allows off-label use of any chemical or medication they approve for treatment of one disorder to treat any other non-related disorder, and many doctors and pain clinics put patient safety after profit. This lady may well learn some time in the future that losing this battle is in her best interest...Vic
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