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Neurology (Expert Forum)
spinal epidural hemorrhage?
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spinal epidural hemorrhage?
by bugs, Nov 06, 2001 12:00AM
Hello, I had back surgery by a neuro-surgeon while over a year ago. He removed the 4th disc and placed a cage in its place and then used rods and pentacle screws at that level to stabilize it. Unfortunately, I didn’t have a normal recovery. The day after my surgery while standing I fell landing hard onto the hospital bed while my legs were yet over the side of the bed twisting my spine. I was still wearing 4 drain plugs and was not in a brace. My back pain immediately became severe all I could do was cry out in pain and blacked out. X-rays were taken, then 3months later another mylagram/CT was performed. On the CT scan the radiologist indicated he saw blood in the epidural space. My neuro-surgeon said he felt instead the hardware was casting shadows but indicated that there was evidencethat acanthocytosis had developed at the 4th level. Upon reviewing this he indicated the pentacle screws seem to be really close to the nerves but assured me they were not in the spinal column. I've developed nerve pain in buttocks, hips, and throughout both legs, feet. This is my question: If the acanthocytosis is at the 4th level then how can the symptoms be coming from above and below that level? Is it possible that I developed acanthocytosis after the twist? Is it also possible I had a spinal epidural hemorrhage due to the twist and fall and this is what is yet causing my the symptoms? Can old blood be removed? What additons test could be performed to determine this due to shadows on CT? Lastly, if the pentacle screws are irriatating the nerves what can be done? Thanks in advance. VJL
Doctor's Answer
by CCF-Neuro-M.D.-JT, Nov 06, 2001 12:00AM
Sorry to hear about your complicated post-op course. The best test for you would be an MRI of the spine to evaluate the blood/shadows. The difference should be picked up without any problems by an experienced spine neuroradiologist. Also, it can tell the staging and amount of the blood, meaning if it's new or old, significant hemorrhage or simply postop changes that everyone has. The MRI would also help with looking at the pedicle screws, because if they're pushing on your cord or the nerves - it has to be readjusted without question.
Unfortunately, I'm not quite sure what you mean when you say "acanthocytosis" which actually refers to a condition of the blood that describes different sized red blood cells. I wonder if you're mis-spelling something else. ALso, the 4th disc of what part of the spine??? There's the cervical which is in the neck, thoracic-midback, and lumbar-which is lower back. If the problem is in the lumbar region, then definitely you can have symptoms from that. Otherwise, I would be alittle surpised if you were having mainly leg symptoms from a neck problem. Get the MRI and talk to your surgeon again. If they are unwilling to change anything, go for a second opinion with another surgeon or neurologist. An EMG may also be helpful to see where the pain is coming from.
Best of luck.
Unfortunately, I'm not quite sure what you mean when you say "acanthocytosis" which actually refers to a condition of the blood that describes different sized red blood cells. I wonder if you're mis-spelling something else. ALso, the 4th disc of what part of the spine??? There's the cervical which is in the neck, thoracic-midback, and lumbar-which is lower back. If the problem is in the lumbar region, then definitely you can have symptoms from that. Otherwise, I would be alittle surpised if you were having mainly leg symptoms from a neck problem. Get the MRI and talk to your surgeon again. If they are unwilling to change anything, go for a second opinion with another surgeon or neurologist. An EMG may also be helpful to see where the pain is coming from.
Best of luck.
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