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Spinal cord compression. Surgery helps or not? (Read 3236 times)
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Spinal cord compression. Surgery helps or not?
Jan 5th, 2014 at 3:57pm
 
Hello Everybody,

I am seeking an advise on this patient. The patient is my close relative. I kindly ask experts to consult. What i want to know wheter it is possible to redo a surgery and get possible positive results. Actually, we did surgery in Uzbekistan at the earlier stage of the disease but we want much better results if the second surgery helps.

Here are the patient history and other details.

Patient History

Name: Murodjon Oripov
Age: 25
Anamnesis Morbi: He had a severe car accident in 2009 and had surgery at one of the local hospital in Uzbekistan.

Current State

Complaints:
-      had rare ache on neck area
-      weakness at both hands
-      legs have no sense and movement and are paralysis
-      urinary and stool have delay/faeses

Neurostatus:

-      has a normal consciousness
-      I Pair – normal
-      II Pair – normal
-      III, IV, VI Pair– normal
-      V Pair – pain on trigeminal points
-      VII Pair – symmetric face
-      VIII Pair – normal
-      IX, X Pair – swallowing and phonation are normal
-      XI Pair – Normal
-      XII Pair – Normal

Physiological Tendon Reflex:

-      Upper extremity is weak, deep Para paresis
-      Lower extremity is absent, Paraplegia
-      Sense: lower than C5 anesthesia
-      Disorder of Pelvis organs on delay type

Instrumental Examination

Computed Tomography:

-      C4, C5 – burst compression fracture
-      C4 – frontal dislocation
-      Vertebral axis is non-distorted
-      Vertebral Canal is deformed
-      C5 - form of wedge deformation
-      Height of discus is shortened

MRI Examination:

-      Kyphotic deformation
-      Width of spinal canal: sagittal 1.2 cm, frontal 1.5 cm
-      Posterior longitudinal ligament is saved
-      Ligomentium flava VC3, VC4 and VC5 are distorted
-      Spinal cord is compressed and infiltrated
-      Spinal cord is at level VC4-6: multi-focal cysts formation 2.2 cm and full occupancy of canal at this level

Laboratory:

-      Blood: Hb - 100, ER - 3.7, Lu – 5.5, ESR – 18,
-      Urine: transparent, protein – 0.165
-      ECG: sinus tachycardia

Surgery:

-      De compressive laminectomy C5, C4 at the right side, puncture and emptying cysts of spinal cord, sewing electrodes to dura mater
Clinical Diagnosis
-      traumatalogical disease of spinal cord, fracture and dislocation of C4, C5 vertebra with compression spinal cord
-      subdural cysts at the level C4, C5

----
Thank a lot beforehand!!
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