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is it normal

is it normal for a neurosurgeon to operate on the cervical spine based only on mri imaging, or would he do more tests to confirm correct level, and is he required to run certain tests before performing surgery,,, HELP ME
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Comments

  • dilaurodilauro ConnecticutPosts: 10,049
    especially, if the MRI results came back so loud and clear about the disc problem and what needs to get done.
    Before the actual surgery, I am sure the doctor would do some additional tests just to make 100% sure and the exact levels the are dealing with.

    But then again, before I would go in for any surgery, I would want to have another pair of eyes review those same mages and come up with the same conclusion.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • It depends on the findings of his exam of you, your symptoms and of course, what he sees on the radiologists films and studies. Sometimes, the problem matches perfectly the findings on the test, and the symptoms match up exactly, so it is easy to determine what the cause of the problem is and the solution is also clear.
    In others, it is not quite so clear and requires more testing and imaging to find out where the problem is stemming from.
  • for my cervical fusion, surgery was done with only MRIs prior. in my case, problem was obivous, to very herniated discs. nerve root compression was seen on 3 nerves, and one of those matched the location of the pain in my arm. there was never any suggestion or requirement for more testing.

    for my lumbar fusion, i had both and MRI and a CT scan. but in that case, i had already had 2 surgeries in the same location, so doc felt having the CT scan as an addition was beneficial, plus they could use that imaging to make sure the rods and screws used were the correct size for the location.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • it is unethical to do this, if the patients symptoms neuro eval and mri dont match, then what??
  • dilaurodilauro ConnecticutPosts: 10,049
    edited 01/09/2014 - 2:35 AM
    then it is up to you to question the doctor as to why... The doctor has to have some rationale as to why they want to do surgery even when the tests dont come up with the same conclusion.

    If you are not satisfied with the answer, then you would need to go for a second opinion.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • i tried he wont talk to me, and i am seeing new neurosurgeon because of the wrong level surgery, emg and ncs confirm c7 impingement, but he operated on c7-t1 level, or c8 nerve as they say, based on mri only, symptoms and his eval point to c7 nerve, im not neuro or radiologist but i can read and interpret what they say, internet is a wonderful tool, c7 nerve controls triceps, plain and simple.
  • dilaurodilauro ConnecticutPosts: 10,049
    edited 01/09/2014 - 4:37 AM
    Now reading your last post, you did have SURGERY1. Nothing before gave us (at least me) any indication that it was after the fact
    I dont think I can offer any more information
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • in first post it asks if its normal, why would i ask this unless surgery was performed??
  • We get asked questions like yours all of the time, not all of them are by persons who have had surgery already.. I also didn't realize that you had had surgery either.
    The dermatomes show areas of innervation of the spine, however, there is some cross over for lack of a better description between areas that are served by a particular nerve.
    Your surgeon only uses the findings on MRI or CT scan as a small part of his decision making process when it comes to making decisions about surgery. The major part of the decision making process is the patients' physical exam, any findings that come from that, and the complaints of the patient.
  • robotbobrrobotbob Posts: 14
    edited 01/09/2014 - 1:57 PM
    then why would the symptoms and the neuro eval be ignored and surgery performed on the level that the mri radiologist reading pointed to, but did not correlate to symptoms that i presented, i found this dermatome and mylatome info after this surgery, so you see what im trying to find out is if certain nerves are responsible for certain muscles, as in my case to have extreme triceps weakness, and find out so easily that the c7 nerve controls this but neuro operates on c8,with that, what would you do.like i did went to new neuro and well what do you know emg/ncs both point and confirm new neuros level of problem, one can see this easily while the other cant
  • dilaurodilauro ConnecticutPosts: 10,049
    really questions that only your surgeon can answer.

    We can only speculate.

    Since you said surgery was performed, then it should be much easier to get those answers. I have to assume that before you had the surgery, your surgeon and you discussed the situation, the surgery , recovery and long term outlook.

    This is something pretty common with all doctors today.

    If there was something that you did not feel was correct, you would have been the only one to stand up and say STOP.

    After the fact, I really dont know what to tell you. You can dig up all the medical records before and during surgery and have them reviewed by another set of medical eyes. But at that point, what is your objective? Are you looking just to get some answers? or are you looking for a course of action to take?
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • well i wish i had had a medical degree, then i would have questioned, are we not to be able to trust doctors, not anymore evidently
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