Help for the treatment of post Cervical disectomy ..

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Hi There,

 

In 2001 a 40 years old male patient with H/O pain in the left side of

the neck and left arm associated with numbness of the left index

finger. There was a large left paracentral disc protrusion at C6-C6,

which causes severe compression of the left side of the thecal sac

and left exiting nerve root on axial images. No other significant

soft disc protrusion was identified no myelopathic changes were noted

in the spine Craniocervical junction was normal Marrow signals were

normal. Small spurs are noted anteriorly at C6-C7. A large left

paracentral disc protrusion at C6 C7 with significant tissue

compression was found.

 

He was operated under General Anesthesia in prone position. Part of

C6 C7 laminae were removed along with spinous process of C6-7

Inferior Facet C7 vertebrae and part of superior facet of C6 (mainly

the medial portion) were removed. Root was decompressed and ruptured

disc was removed after retraction of root medially. The wound was

closed in five layers.

 

Post operatively patient deteriorated due to Brown Sequard syndrome.

Left lower limb was o/5 with intact sensations and right side was 2-

3/5. Sphincter control was poor. He was treated with relaxants and

physiotherapy for his spasticity and weakness.

on sep 2002 post op sensory evoked potentials (Median and Tibial)

showed that potential from cervical cord were poorly formed on

stimulation from either of hands. The latencies of potentials from

Erbs point and cortex were normal. Left median nerve stimulation

showed smaller cortical potentials.

 

Post-Op MRI DEc 11 showed intramedullary focus of demyelination at C6-

7. He started to walk in 3 months and at present his power in all

four limbs is 5/5 with hypoaesthesia in right half of body. Sphincter

control is good but he feels heaviness in his rectum and spacticity

along with tightness around chest. He is on Tab Liaresol (Boclofen

Sod, 10 mg TID) for his spasticity.

 

His recent C - spine MRI shows myeltocondriasis & C6-7 osteophyte but

A physician said I do not thinks that ACD & E will provide any

significant benefit to his condition. He needs to repeat another MRI

if he deteriorates further. In that case surgical introvention may be

possible. At this juncture consercation urgent is the best option.

 

Kindly advise that can Acupuncture treatment improve his condition.

and also advise about any other treatment or further operations

needed.

 

I am looking forward to hear soon from you anxiously.

 

Regards

 

Rimsha