Jellyhall

I assume that there was nothing worrying on the scan.
The neurosurgeon that I saw was very vague. He didn’t do any neurological examination at all.
He didsn’t talk about my symptoms although I did ask about bowel and bladder problems and if I was correct that they would come on very quickly and be extreme, he said yes they would, so I assume it is not Cauda Equina.

He did look at the scan of my neck, thoracic and lumbar spine.
He said that my neck doesn’t need anything done because there is still just enough room for the spinal fluid to flow around my cord. He didn’t comment on this appointment on the discs below the fused levels, where they are practically gone and the vertebrae almost bone on bone and with lots of osteophyes changing the shape of the vertebrae.

He looked at my thoracic scan and pointed out some herniated discs that are compressing my subarachnoid level of my cord. He talked about doing surgery on the two worst levels at T7/8 and T9/10 and said he would have to deflate my lung and remove a rib to access them.

He then looked at my lumbar scan and pointed out how the two levels above my fusion of L4/5 have now herniated and that the facet joints are hypertrophied and pressing into the spinal canal meaning there is little room there. He said that if he did surgery there he would have to fuse both these levels and extend the existing fusion which would be very invasive. He didn’t explain why this would be very invasive.
Could you please explain this to me Dr Corenman.

He then said that he was reluctant to do another surgery on my spine because I have so much degeneration throughout all levels. He said it was highly likely to cause other levels to also go and cause a domino effect throughout my spine.

All in all, the appointment was very disappointing and not helpful.

The follow up letter to my GP didn’t represent what he had described on the scans. His letter said that I have ‘some mild disc degeneration’ in my neck.

He said that in my thoracic spine, ‘as previously, there are 2 small left sided lateral throacic disc prolapses not compressing the spinal cord which could account for some radicular pain.’

He then said that ‘at the L3/4 level which is the level above the site of her previous fusion there has been some degeneration with some facet joint hypertrophy.’ This could account for some of her back pain.

He also said that I have ‘widespread spondylolisthesis affecting her neck, lumbar spine and thoracic spine.’ I am sure that this is an error made by his secretary and that he actually means spondylosis.

I feel very let down and wonder why on earth he ever mentioned surgery if things were as he described in his letter to my GP.

This surgeon has had a case in the high court against him by a patient who had thoracic spine surgery by him and is now in a wheelchair. The patient has won the case on the grounds that the posterior access that this surgeon took is outdated now because of the danger to the spinal cord. The General Medical Council however, haven’t taken action so they must not feel he had done anything wrong. I wonder if he doesn’t want to be my surgeon because of my problems in the thoracic level of my spine and was just trying to put me off when he described the surgery on my thoracic discs. If that is the case, I wish he would just refer me to someone else. I feel very confused about all this.

Thank you for your reply.
I do suffer with spastic spasms every day. Generally they are in the morning while I am still in bed. As I start to move, both my legs will go stiff and my abdomen goes tight causing my back to arch up off the bed and my neck to bend backwards. I have been getting this for years. I saw a neurologist to rule out MS and some other neurological diseases they didn’t name, who said I had damage to my cord that occurred before my ACDF, which was in 2012.

I think the doctors are assuming that is what is causing the spasms. A neurosurgeon saw me last month very briefly on the NHS, but he was rather vague and didn’t do a neurological examination or talk about my symptoms with me. The hospital has got very behind with appoointments and my referral was over a year ago. I did have a recent MRI scan for him to view, so I suppose what I can see is not high signal. Having been left for so long before my ACDF that I have cord damage, makes me rather worried about the symptoms I have and this light area on the cord. (It was on your advice that my neck needed attention that we decided to get another opinion and I had ACDF surgery about 3 weeks later!) The lighter area on the cord isn’t bright white, but a definate lighter area that runs for about three vertebral levels. Perhaps it is due to something else. Is that possible?

Thank you again Dr Corenman,

Your description of IDR does sound like it could be what I have. Although my vertebrae don’t show quite such a large area as white. I do find running and even stepping of a kerb can be painful.
I don’t think that I have STIR or FS images of my scans.

On a recent report, it mentioned that I have osteosclerosis of the vertebrae in the thoracic spine. That is not where the white on the vertebrae is though. That is at L2, 3 and 4.

Thank you for your reassuring comment about epidural injections.

I do appreciate all your time and help.