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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Hi Folks,
I have a very interesting experience to share regarding the correct viewpoint, I think, that an MRI is only a part of the picture or package that determines treatment options. Brief personal review: 2006 cervical MRI shows stable herniation at C5-6 with mild flattening of the cord. 2009 MRI shows the same but EMG testing indicates nerve impingement. Also, symptoms are growing to include spasms, neck pain, arm pain, weakness and so on. Symptoms are getting worse. My PM clinic doc has no doubt it's time for a surgical consult. I resisted. He stressed, as have members of this board, that it's the whole picture that adds up to surgery. So, I am in process of getting surgical opinions and I call Dr. So and So's ofc today (spine specialist, highly regarded) to ask the basic questions about getting a referral. And I'm told, "All you need to bring is a CD of your recent MRI, he'll decide on the basis of, you don't need to send or bring the EMG report. If he wants anything else based on the MRI, he'll ask for it."

So, here I sit wondering why this keeps happening. Do I run from all these docs. These are highly trained spine specialist. Despite what I have experienced in the OR, and despite what so many patients and other medical people advise, the reality is...these surgeons only care about the MRI. I have 2 other consults lined up. I can't say for sure what they will tell me. But so far, based on what I've been told, their opinions will be based on the MRI. One doc will only agree to book the appt.....based on her review of ...the MRI. Truth to tell, I find it all quite frustrating and discouraging. SQ
Hi are you today...confused? It really is confusing but I think I can figure this out for you.

Your MRI showed that you had nerve impingement and the EMG confirmed that. But what is more important to the spine surgeon is the flattening of the cord and what symptoms that is producing. Yes, they will fix the impinged nerves if they are so badly impinged and they are in danger of permanent damage but cord damage is silent and shows up with reflex problems and other signs. I bet your pain management docs have noticed a change in your reflexes as well and other signs the cord impingement is getting worse. That is why they think surgery is warranted.

The docs will decide based on the MRI and the exam and the recommendation of you pain management docs who will probably be sending a referral report with their findings. It will have the EMG report in it.

But I know my doc used the MRI and my exam to decide if it was time to operate or not based on the amount of cord impingement...they take that very seriously. Nerve impingement was secondary.....very secondary.

So the confusion is really about nerve versus need to know what is happening to both, not just one. Why? Because you have a risk of coming out of surgery paralyzed so if you don't really need it, they don't do it. These docs pay enough in mal-practice insurance and they don't want to do anything to make it higher.

Does that help? What else can I try to answer or research for you?

gentle hugs..............Jenny

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