Historical Evidence
I have to say that at this point, ‘What is there that I haven’t seen neurosurgically?’ And my answer is that when you go somewhere else, you’ll find out. Even if you have no idea, understand that this is a side view of the neck and you are looking at the spinal cord. It has dents in it and there’s a white streak in the middle. That’s a bad thing to see. It’s an automatic recommendation for surgery when I see it. Others might disagree, but I have seen, even recently, what happens if you fail to act. So this woman comes in… and after I look at the scan and go through my recommendation for surgery, I look closer and see that this image was from 2008 – five years ago! Well, I have now learned that if you are indeed lucky, you might go on for years and never get worse.
Just when I was questioning my sanity and about to throw over what I believed, a 39 year man came to see me. he’s virtually paralyzed. He has contractures so bad that he can’t even straighten his arms or legs. He has had bed sores so bad that they required surgery to repair. And he has the same condition. His family wants to know how soon after the surgery he will begin to walk again. I can only say that I don’t do magic.
photobackstory 
Fascinating. How do you repair it?
March 29, 2013 at 9:58 am
It’s a fairly straightforward operation. Of course you need to have done it at least once or twice before. The problem here is that folks think that surgery will paralyze them and they would rather take their chances through inaction hoping that bad things predicted will not come to pass. Too often the worst thing is to put things off and to rely upon hope.
March 29, 2013 at 11:34 pm
Good to hear it is straight forward. I am always tentative when a doctor talks surgery, like most people I guess.
March 30, 2013 at 9:13 am
It’s not realistic if you’re not worried. The other side of the situation is to fail to act when serious consequences may follow. A woman came today, virtually paralyzed in the legs for four months. She might have had a chance to walk months ago, if surgery had been performed. Now it’s a matter of salvaging a little movement. That is sad. And it’s a poor choice given the risks of surgery today.
March 30, 2013 at 10:12 am
How could you possibly answer a question like THAT?
April 2, 2013 at 11:08 am
Some things have no answer. I find that bad things often happen as predicted and there is no satisfaction in being right when the patient is worse for it.
April 2, 2013 at 11:35 am