Original Injury C3 C4 unilateral facet dislocation Nov. 1975. Age 15 playing American Football (initial ASIA A. Recovered to ASIA D). No motor return for 34 days. Very Crude posterior column return 1 day post injury. Eventually ruled central cord syndrome. Initial management traction and closed reduction. Cervical myelogram with pantopaque day following injury. No block. Not stable. ASF January 1976. 7 months in hospital. Walked out with 2 canes. Went back to school. Graduated physical therapy school. Married 5 children. Could run, play recreational basketball, cut lawn, etc. 10 or more years ago started slowing down. Unable to play basketball. More problems walking, tripping. Progressive back pain consistent with spinal stenosis. C4 5 fused in 1994 due to HNP and loss of function right shoulder and elbow. Marked improvement post surgery. Also started to gain weight due to decreased activity. Now 6'1", 245 pounds. New weakness right arm 2009. MRIs showed no real change. Surgery not recommended. Walking kept on getting worse. Lumbar spine workup negative.
Eventually thoracic spine looked at in August 2014. Arachnoiditis Ossificans T 8- T 10- 11 with associated syringomyelia. Surgery Oct. 2014 in New York to remove adhesions. Syrinx left alone and did not go down at time of surgery. Some question that it may have decreased post surgery. Woke up with marked deterioration in motor and sensory function. Sensation with very modest improvement since then. Slow improvement for 6 weeks. Could walk 80-100' max with walker and w/c follow. Then things fell apart. No new trauma. MRI November 2014 ( 6 weeks post surgery). Status post posterior decompression at T8-T9 and T9-T10. 9.7 x 1.9 x 1.9 cm epidural fluid collection along the posterior aspect of the thecal sac, not seen on the prior study extending from T7 to the level of T10 with severe mass effect on the cord which is diffusely anteriorly displaced. There is an associated 2.4 x 0.5 x 0.4 cm simple appearing cystic lesion along the posterior surface of the cord extending from the level of T8 to the level of T9. Increased signal involving the cord extending from the level of T10 to the level of T12, increased compared to the prior study. This could represent dilatation of the central canal versus cord edema. No abnormal enhancement. No longer able to walk. Marked deterioration in motor function.
Slow improvement in motor function since February 2015. Now able to walk 60' max with walker and w/c follow with therapist. Marked spasticity. syrinx now as high as level T4. Recent workup in Miami. New CT and MRI. Scheduled to get shunt placed January 2016 (Central canal to peritoneal cavity). Adhesions to be left alone. Too severe. No CSF movement at first surgery. Per surgeon this was restored at time of surgery. Present status unknown but doubtful. Adhesions related to pantopaque? No history of trauma to thoracic spine. No history of infection, etc.
Anyone with any experiences with above problems. It is hoped that taking pressure off of cord will reduce pressure on nerves and decrease spasticity and improve motor function. Any other way to deal with this problem?
Thank you for your input.
John
Eventually thoracic spine looked at in August 2014. Arachnoiditis Ossificans T 8- T 10- 11 with associated syringomyelia. Surgery Oct. 2014 in New York to remove adhesions. Syrinx left alone and did not go down at time of surgery. Some question that it may have decreased post surgery. Woke up with marked deterioration in motor and sensory function. Sensation with very modest improvement since then. Slow improvement for 6 weeks. Could walk 80-100' max with walker and w/c follow. Then things fell apart. No new trauma. MRI November 2014 ( 6 weeks post surgery). Status post posterior decompression at T8-T9 and T9-T10. 9.7 x 1.9 x 1.9 cm epidural fluid collection along the posterior aspect of the thecal sac, not seen on the prior study extending from T7 to the level of T10 with severe mass effect on the cord which is diffusely anteriorly displaced. There is an associated 2.4 x 0.5 x 0.4 cm simple appearing cystic lesion along the posterior surface of the cord extending from the level of T8 to the level of T9. Increased signal involving the cord extending from the level of T10 to the level of T12, increased compared to the prior study. This could represent dilatation of the central canal versus cord edema. No abnormal enhancement. No longer able to walk. Marked deterioration in motor function.
Slow improvement in motor function since February 2015. Now able to walk 60' max with walker and w/c follow with therapist. Marked spasticity. syrinx now as high as level T4. Recent workup in Miami. New CT and MRI. Scheduled to get shunt placed January 2016 (Central canal to peritoneal cavity). Adhesions to be left alone. Too severe. No CSF movement at first surgery. Per surgeon this was restored at time of surgery. Present status unknown but doubtful. Adhesions related to pantopaque? No history of trauma to thoracic spine. No history of infection, etc.
Anyone with any experiences with above problems. It is hoped that taking pressure off of cord will reduce pressure on nerves and decrease spasticity and improve motor function. Any other way to deal with this problem?
Thank you for your input.
John
Syringomyelia and arachnoiditis
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