Vince Cataldi
2003-09-20 09:25:24 UTC
Opinion requested regarding: surgical decompression of C3-C4 with anterior
decompression using arthrodesis and cervical plating, then perhaps
additional surgical intervention for a posterior decompression.
I have been able to obtain satisfactory answers to almost all my questions,
I am still concerned however about the possibility of a posterior
decompression after surgical intervention using anterior decompression and
the fusing of these vertebrae.
I find it difficult to understand how the second procedure, which made
become required, could be accomplished in order to decompress. After the
vertebrae have been anteriorly fused, would a posterior decompression cause
seriously increased stress on some other point of the spinal column, or
perhaps break the fusion of the vertebrae corrected during the first
suggested surgery.
I have been informed that working on the spinal column to perform a
posterior decompression is much more risky especially with regard to working
around the arteries. I wish to understand more clearly the risk/benefit
trade-offs, the likelihood of success in the first process so that the
second process is never required, and the possibility of doing both the
anterior and a posterior decompression and fusion simultaneously.
I am also somewhat troubled by the apparent asymmetrical nature of my spine
with respect to its abnormalities. There are slight abnormalities at the
very top and the very bottom of the spine. There is also an apparent
asymmetrical nature correlating the cervical and lumbar abnormalities, and
stress fractures in the center, in the thoracic vertebra. It worries me that
decompression of C3-4 especially during the second posterior process, might
precipitously exacerbate problems in the lumbar areas in ways, which I do
not yet understand well enough.
He does have evidence of myelopathy and the abnormal signal within the cord
at C3-C4. I would recommend surgical decompression of the area and in his
case would probably favor an anterior decompression with arthrodesis and
cervical plating. The main goal of the surgery would be to prevent his
symptoms from increasing.. I did discuss with him also that he may need a
posterior decompression at some point in time if he continues to have
stenosis from posteriorly. Jack H. Deckard, M.D.
The assessment from Dr Deckard's original appointment with me is available:
- see ( June 16, 2003 report ) it includes future test-scripts he
requested.
Also, the initial MRI image most interesting to Dr Deckard is:
- C2c (center). I made a negative version also.
http://givehealthachance.org/scans/cervical/C02c
For comprehensive details including both the detailed journal, and all my
medical opinions,
please see the following two links:
http://givehealthachance.org/Vince/Status/History.htm
http://givehealthachance.org/Vince/Opinions/default.htm
Most Respectfully and Gratefully,
Vincent J. Cataldi -- ***@Cataldi.com
decompression using arthrodesis and cervical plating, then perhaps
additional surgical intervention for a posterior decompression.
I have been able to obtain satisfactory answers to almost all my questions,
I am still concerned however about the possibility of a posterior
decompression after surgical intervention using anterior decompression and
the fusing of these vertebrae.
I find it difficult to understand how the second procedure, which made
become required, could be accomplished in order to decompress. After the
vertebrae have been anteriorly fused, would a posterior decompression cause
seriously increased stress on some other point of the spinal column, or
perhaps break the fusion of the vertebrae corrected during the first
suggested surgery.
I have been informed that working on the spinal column to perform a
posterior decompression is much more risky especially with regard to working
around the arteries. I wish to understand more clearly the risk/benefit
trade-offs, the likelihood of success in the first process so that the
second process is never required, and the possibility of doing both the
anterior and a posterior decompression and fusion simultaneously.
I am also somewhat troubled by the apparent asymmetrical nature of my spine
with respect to its abnormalities. There are slight abnormalities at the
very top and the very bottom of the spine. There is also an apparent
asymmetrical nature correlating the cervical and lumbar abnormalities, and
stress fractures in the center, in the thoracic vertebra. It worries me that
decompression of C3-4 especially during the second posterior process, might
precipitously exacerbate problems in the lumbar areas in ways, which I do
not yet understand well enough.
He does have evidence of myelopathy and the abnormal signal within the cord
at C3-C4. I would recommend surgical decompression of the area and in his
case would probably favor an anterior decompression with arthrodesis and
cervical plating. The main goal of the surgery would be to prevent his
symptoms from increasing.. I did discuss with him also that he may need a
posterior decompression at some point in time if he continues to have
stenosis from posteriorly. Jack H. Deckard, M.D.
The assessment from Dr Deckard's original appointment with me is available:
- see ( June 16, 2003 report ) it includes future test-scripts he
requested.
Also, the initial MRI image most interesting to Dr Deckard is:
- C2c (center). I made a negative version also.
http://givehealthachance.org/scans/cervical/C02c
For comprehensive details including both the detailed journal, and all my
medical opinions,
please see the following two links:
http://givehealthachance.org/Vince/Status/History.htm
http://givehealthachance.org/Vince/Opinions/default.htm
Most Respectfully and Gratefully,
Vincent J. Cataldi -- ***@Cataldi.com