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  • leo42ray
    Member
    Post count: 3

    What could a person expect in the way of symptoms in the event of a long term dura deficency? Say 7 months or more. I had a spinal fusion surgery in 1997 (11 vertebrae 6 discs). Ten years later had some minor events occur. Found rods broken in the thoracic region. After an auto accident started suffering major muscle spasms & weakness, trunk to both legs numbness, falling down as well as other issues. MRI and CT scans showed normal. Only thing obvious was where the rods broke. Surgon decided he would repair the spot where the rods were broken. During the operation he discoverd the dura in fact was gone. He removed the vertebra to get where the dura was missing and placed a patch over it and reinstalled vertabrae using bone grafts and new hardware. I am now having MS symptoms with MRI of brain showing few hypointensities (very small)no white matter. EMG normal. Neurologist gave up after that and told me to go to the Mayo Clinic. Perscribed 6 months of physical theapy. Therapist (who works with a lot of MS patients took one look atme and I should be on disability becase I had MS. Help!!!!!!!!!!!!!

    leo42ray
    Member
    Post count: 3

    Failed to mention the Spinal MRI also showed an empty thecal sac with adhesive arachnoiditis in the Lumbar region

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    The dura is typically never deficient. The dura can be scarred to the walls of the canal from prior infection, surgery or immune disorders making the dura “look” deficient.

    You had a fusion of your spine 15 years ago but do not mention why. I assume you had a fusion for scoliosis with 11 vertebra and 10 discs fused (two vertebra typically share one disc). X-rays noted broken rods in the fusion region. I assume you had no symptoms prior to the auto accident you describe. You note “MRI and CT showed normal” but I also assume that there was an undiagnosed pseudoarthrosis (lack of fusion) as the normal reason rods break is a pseudoarthrosis.

    A surgeon typically would “not repair the spot where the rods were broken” unless there was a lack of fusion. If the surgeon was repairing the pseudoarthrosis, I am unclear why he or she performed a decompression of the canal at the same time as the fusion repair unless there was also a narrowing of the spinal canal (stenosis).

    You appear to have developed arachnoiditis from the initial surgery “Failed to mention the Spinal MRI also showed an empty thecal sac with adhesive arachnoiditis in the Lumbar region” This may well be why the second surgeon could not find the dura as it was adhered to the walls of the canal. This also may be why you had lower extremity symptoms prior to the second surgery.

    Your Multiple Sclerosis was not caused by either of the two prior surgeries. MS is an autoimmune phenomenon where your immune system attacks the myelin of the nerves.

    Dr. Corenman

    leo42ray
    Member
    Post count: 3

    Thank you for the quick response.

    The concern when going into the second surgery was a dura tear. The rods broke in the thoracic region. The surgeon found the dura was missing from the area where the rods broke. He had to remove the vertebrae from that area and place a “patch sealed with fibram adhesive over the area with the area. Used bone grafts to rebuild the area of the spine and installed new hardware. I now have MS symptoms with no definitive acknowledgement of such. I am wondering if the unprotected nerves could have suffered enough trauma to cause me to have these issuses. I am still working but this condition makes it very diffucult. The neurologist that I have seems to think that it is all in my mind. I really do not know what to do. I feel I may further injure myself try to maintain my work status pushing my body when it is not able to. They are telling me that it can not be MS beause I do not have sizable white matter on the current MRI of the brain and spine. EMG normal. Those were the only tests they have performed before telling me to do physical therapy and to go to the Mayo clinic. This is not an ordinary/ normal spinal issue. I just do not know what to do and what to do from here. I would be able to send you some of the records and the surgeons operative notes if need be.

    Again, Thanks for your input.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    If you have symptoms in your upper extremities as well as lower extremities, this could not have been caused by your pseudoarthrosis and “dural deficiency”. If however, your symptoms are only in your lower extremities, the severe arachnoiditis you noted can cause some of the symptoms to mimic MS.

    You need another very experienced neurologist for a second opinion to help you understand what disorder you have and the appropriate treatment necessary for this.

    Dr. Corenman

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