cervical spinal cord compression

ginnie · 06-10-2012, 09:24 AM

Hello, and just a thought. I would be very careful in your decision to proceed with the surgery. I had the first surgery, and didn't know that verterbre above and below the surgical site were damaged. I was not told, nor did I look at my medical records. You are getting a heads up notice, that the verterbre above and below arn't in such good shape. This is a concern, as they need to be strong enough to handle the brackets, plates, screws, cage or what have you. My fusion did NOT hold up and I experienced the domino effect. Was then fused, C3-7. I now have trouble at C1-2 and T 1-2-3. I will not have another surgery. Just get all the opinions you can regarding this issue. I know that sometimes you have to do the surgery. Ask your doctors more in depth about this subject, and continue to do some research if you can. I do wish you all the best in what every you decide to do. ginnie

Dubious · 06-10-2012, 10:11 PM

Quote:

Originally Posted by Dr. Smith

Investigate all of the alternatives. Many surgeons specialize in just one, or a very few, procedures. That makes sense if that's the procedure that's really best for you. In fact, it's the kind of surgeon you want because they have a lot of experience doing that procedure. The question then becomes, is that the right procedure for you, or is s/he seeing your problem as a nail because all s/he has is a hammer?

Early in my journey when I was told how bad my cervical discs were, I asked if they couldn't just replace the bad one(s). The surgeon told me it wasn't possible -- that cervical discs couldn't be replaced. Come to find out later that it indeed is possible, but that surgeon didn't do that procedure -- he was experienced in another.

It could be that the procedure your surgeon wants to do is best; OTOH, I'd want to know for sure. This is where becoming your own advocate, doing your own research, and getting multiple opinions come in. There are different kinds/types of fusion procedures. Some involve a cage, and some involve an artificial disc. Some are anterior (going through the front) and some are posterior (through the back) and I recently heard of one that went through both. Some are quite invasive and some are minimally invasive microsurgeries involving very tiny incisions and done via camera. Again, if it were me, I would want to know exactly what is going on in my neck, about every potential procedure to correct it, and be involved in deciding which one to go with. THEN I'd pick a surgeon.

Leesa, Ginnie, or others may have more info/input on this.

Doc

Yup...I would agree with Doc. If you think EMG's are invasive, will then just try an ACDF on for size!

Electrodiagnostics (EMG/NCV/SEP's) are really an important part of the diagnostic process and if it were me (and it has been on several occasions for different reasons), I would insist upon it especially if surgery was on the table of opportunities.

While it is not exactly fun to be stuck like a voodoo doll or chased around the room with an electric cattle prod, doing surgery without these studies done pre-surgically is certain insanity and asking for further abuse!

Voorhees · 07-08-2012, 03:33 PM

I have spinal stenosis. I was Diagnosed with it last year. I hurt my neck and went to the ER. They did a cat scan and it showed i was fine. About a week later i was getting tingling and burning sensations down my left arm and such. So i went to urgent care and the doc there order an emergency MRI.

I had a 2 day follow with my doc. He then diagnosed me with Cervical Spinal stenosis. He then referred me to a physical medicine specialist. He went over the MRI with me and explained that both my nerve roots and spinal cord is being compressed.

He tried all the conservative treatments. Some worked for a bit but now my symptoms is more constant. So I am in contact with him again and see what else I can do.

So they may try pain meds, physical therapy etc... on ya.

Dr. Smith · 07-08-2012, 04:03 PM

Quote:

Originally Posted by Voorhees

I have spinal stenosis. I was Diagnosed with it last year. I hurt my neck and went to the ER. They did a cat scan and it showed i was fine. About a week later i was getting tingling and burning sensations down my left arm and such. So i went to urgent care and the doc there order an emergency MRI.

This doesn't sound unusual. CT scans are better for imaging bone, while MRIs are better for imaging soft tissues. There's also a series of hoops that insurance companies require doctors (as well as patients) to jump through in specific orders due to cost. MRIs are many times the cost of a CT scan.

Doc

Dubious · 07-08-2012, 09:39 PM

Quote:

Originally Posted by Dr. Smith

This doesn't sound unusual. CT scans are better for imaging bone, while MRIs are better for imaging soft tissues. There's also a series of hoops that insurance companies require doctors (as well as patients) to jump through in specific orders due to cost. MRIs are many times the cost of a CT scan.

Doc

MRI costs on the front end are a lot....but there are deals around. I am told by another "Doc" that there is an MRI facility advertising $200 MRI's in North County San Diego. Personally, I have seen them as low as $350 by me. Everything is negotiable

Dr. Smith · 07-09-2012, 01:14 AM

Quote:

Originally Posted by Dubious

MRI costs on the front end are a lot....but there are deals around. I am told by another "Doc" that there is an MRI facility advertising $200 MRI's in North County San Diego. Personally, I have seen them as low as $350 by me. Everything is negotiable

Price ranges vary for most things, and while there are exceptions, IME you generally get what you pay for. Do those $200-$300 MRIs include interpretation by a radiologist, or do they just hand you a discfull of images? (With some discount places I checked, that's what they do.) Cut prices can sometimes mean cut corners.

Other factors that influence price can include whether it's done in-hospital or at an outpatient imaging center, contrasting, body part being imaged, and local competition/going rates (it's kinda hard to email your spine to Lower Slobbovia for discount imaging...

)

It may make sense for someone without insurance to do that kind of shopping, but I was talking specifically about when insurance companies are getting billed and doing the paying.

Google: MRI cost

Doc

Dubious · 07-09-2012, 08:47 AM

Quote:

Originally Posted by Dr. Smith

Price ranges vary for most things, and while there are exceptions, IME you generally get what you pay for. Do those $200-$300 MRIs include interpretation by a radiologist, or do they just hand you a discfull of images? (With some discount places I checked, that's what they do.) Cut prices can sometimes mean cut corners.

Other factors that influence price can include whether it's done in-hospital or at an outpatient imaging center, contrasting, body part being imaged, and local competition/going rates (it's kinda hard to email your spine to Lower Slobbovia for discount imaging...

)

It may make sense for someone without insurance to do that kind of shopping, but I was talking specifically about when insurance companies are getting billed and doing the paying.

Google: MRI cost

Doc

I don't know about the one in San Diego as I was only told about it by another doc down there, however the two up by me are cutting edge. One has a newer 3.0 T scanner (big magnet/greater detail), both only use in-house board-certified neuroradiologists (yes, you can pronounce their last names and just where is Slobbovia?) and include a written report. They are both in very close proximity to two major hospitals; one of which is rated in the top 100 hospitals in the nation. Both hospitals have their own scanners too.

If these outpatient facilities were of inferior image quality or their reads were substandard, then no local surgeons would risk their reputation or do surgery (without redoing the scan or obtaining overread) having obtained a scan from an imaging facility whose results were suspect especially since they have other options available. They would not survive in this regional market if they were not sound.

As far as reimbursement, I was told by the business manager several weeks ago that one of the largest major insurance carriers reimburses $362 for the MRI in which I was inquiring, deductables, co-pays and co-insurance aside. And yes, cutting prices CAN mean cutting corners. You've just made my case against HMO's, most work comp systems and national health care!

Dr. Smith · 07-09-2012, 09:01 AM

Quote:

Originally Posted by Dubious

just where is Slobbovia?

Sorry, thought you were old enough to remember Li'l Abner...
http://en.wikipedia.org/wiki/Lower_Slobbovia
http://www.lil-abner.com/slobovia.html

Doc

RLopez1975 · 07-09-2012, 10:10 AM

Hi! I have had Spinal cord was compressed in the T-1 to T-4 by 90% by what turned out to be a beguine mengeoma tumor. My Neuro Surgeon dr said this was the cause of my neuropathy symptoms all over my body. He also removed the tumor 1 and 1/2 year ago. I still have the neuropathy in both legs and feet and in my right arm. After my surgery I had to learn to walk again and now can do pretty good. I still use my walker out side of the house, mostly for my own security as I stumble and fall a lot. Due to the large percentage of the compression I could have been paralyzed from the neck down. I feel very blessed to just have to deal with the neuropathy. My only advice would be to have a good Neuro Surgeon. Where are you located? I would recommend my surgeon if you are in the Houston, Texas area or if you would be able to travel here. Good Luck and may God bless you.

Dubious · 07-09-2012, 02:30 PM

Quote:

Originally Posted by Dr. Smith

Sorry, thought you were old enough to remember Li'l Abner...
http://en.wikipedia.org/wiki/Lower_Slobbovia
http://www.lil-abner.com/slobovia.html

Doc

Nope....old enough to remember. I am but a simple soul and read "Peanuts."

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