Increased burninng sensation and stiffness in the Neck post Laminectomy C4/5/6

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aosman
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Joined: 06/28/2013 - 11:25am
Increased burninng sensation and stiffness in the Neck post Laminectomy C4/5/6

Dears I need your advise and recommendations.

One year and half before, my dad started to complain about burning sensation beneath his feet and then he started to have a difficulty in walking and weakness in the hand and legs muscles.
Since we are in Somalia with no effective medical systems, several doctors diagnosed wrongly that he was infected with Typhoid and the gave him antibiotic injections in his buts and made it even worse until he reaches a stage of paralysis and was not able to stand up by himself.
We immediately drove him to a neighbouring country of Ethiopia 1500 Km away , he was hospitalized and after an MRI scan, they found that there is a spine cervical and lumbar compression

Please click here to see the MRI report attached
*** EDITED to remove the link to MRI report**** this is NOT allowed at Spine Health

After consulting with serveral spine surgeons worldwide from Turkey,Philipines, Malaysia, Saudi Arabia ...etc

The agreed that spinal decompression is required at 3 Levels in the cervical spine C4/C5/C6 while others said that both cervical and lumber decompression is required,a the lube they said two levels are required.
Some doctors said that the lumbar compression is present in mostly all the old people and decompression ill not bring much improvement.

Two other doctor said that diffuse brain atrophy is the main cause of the symptoms which is a partial stroke.

First Doctor comments
=========================================
issues:
He is worried about the MRI report that states there is some chronic
infarct changes in the brain, coupled with the fact that patient is
diabetic. There is always a chance, that there are a few acute on chronic
brain changes.

The pathology in the brain could explain some if not most of the
patient's
disability, especially the described symptoms in the right upper & lower
limbs. This is very suggestive of a 'stroke' resulting in symptoms &
signs
in a 'hemi' distribution.

Patient will require a detailed clinical examination to determine the
clinical contributions of the brain, cervical & lumbar pathologies. This
will greatly help in explaining the final outcome (prognosis), if a
cervical spine procedure is to be done.

In conclusion, Dr. (edited to remove doctor's name) is worried that most of the patient's disability
may be due to the changes in the brain (stroke / infarct). Thus, a
procedure to the cervical spine, may not produce much improvement(s).
========================================================
2nd Doctor comment
=========================================================
...
Unfortunately, your father's condition, I believe, is not caused by the
slipped discs or even the narrowing of the spinal canal but rather the
diffuse brain atrophy caused by an infarct (stroke). This, in my opinion,
is what is causing the rapid decline of your father's health and
...

==============================================================

Eventually we decided to go for the cervical ignoring the response of the two doctors above as the majority of the doctors said it is the decompression which causes the symptomps
Due to financial limitations we were able to perform both the lumber and cervical, and only the cervical part was done and we ignored the lumber decompression because some doctors also said that it is not necessary .

Many doctors insisted said that implants are necessary to avoid Kyphosis, while a few said that no implants is required for a patient with the age of 77 years old, saying that if he is young then implants are required, for such an old person no implants are rnecessary

We selected a doctor at a Cheap univeristy hospital and My dad underwent a cervical laminectomy with c3/4, c4/5, c5/6 with screws and rods fixation. and according to the spine surgeon he says it went successfull.

The Spine surgeon mentioned that he used a Neuromonitoring device during the surgery called Intraoperative monitoring for Motor Evoked Potential which is a device that monitors the neurological morbdity during the manipulations in the spine,
Most of the signals before the surgery were in red color, after the surgery it showed that all the motor cortex signals of the limbs are full restored.

It is now 1 year and 2 months and our expectation was to see improvement but there is a deterioration, my dad still complains increased burning sensation and pain over his both hands, increased stiffness in the in hands and neck which insist is caused by the implants.
He regularly goes to physiotherapy and there is a small improvement in his walking.

He is currently on Lyrica 75 mg to reduce the nerve pain but this did not bring much relief.

His biggest problem is the burning session and stiffness in his hands and neck, this kind of pain gets worse in the afternoons and evenings makes it unbearable.

==> Do you suggest to increase the dosage of the lyrica from 7mg upto 200-400 per day, to reduce the nerve pain
==> Lyrica seems to be very expensive one pill is like 3 dollar in the Africa? how about Neurontin and other nerve pain medications?

==> Can we expect any improvement or the main purpose of laminectomy surgery is was to avoid deterioration ?
==> What do you guys think about the two doctors who associated my dad's symptoms with Stroke?(Diffuse Brain atrophy)

YOur responses are highly appreciated.

Thanks

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sandi
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Last seen: 13 hours 47 min ago
Title: Moderator
Joined: 06/20/2008 - 12:53am
Unfortunately,

the symptoms can come from either the strokes or from the cervical issues. Increasing the Lyrica might be worthwhile but only do that under the guidance of his treating doctors. Do NOT ever increase dosages on your own.
If I were you, I would take him back to the neurologist and find out for sure, what exact problems are caused due to the strokes, or what is caused by the cervical problems.
The doctor can change him over to a different nerve type of pain medication, but they will again want to change any medications only under the guidance of the doctors treating your father. Doing any of it on your own could be deadly for him for you don't want that responsibility.