This is a very interesting case. I've had dozens of conversations with many different neurologists and surgeons. There is clear cord compression and associated changes to the myelon. Some surgeons look at it and are certain that surgery should be done to minimize risk. We hear things like, "if you get in a fender bender or slip and fall, you may be paralyzed." Others say, with no symptoms, why do surgery? Everyone seems to agree that if neuro symptoms are advancing, surgery post-haste in indicated. One thing I know for certain is that there is no one size fits all in spine. Nobody knows the best path. Nobody knows the timeline.
If she were to have surgery and it makes her worse, she'd never know how many years she could have continued with little or no symptoms.
If she waits and is ultimately left with neuro issues related to the spinal cord compression, she'll never know if doing the surgery earlier would have made a difference in the outcome.
If she waits and has surgery at the onset of advancing symptoms and has a great outcome, then she'll know that she chose the best path in her individual case.
I hope that she gets to wait, then never needs surgery!
I'm not sure which path I'd choose. I'm waiting for my surgery, but I do NOT have spinal cord compression like she does... I get to make the quality of life decision without worrying about myelomalacia and permanent spinal cord damage. (He said as he is waiting for NEW cervical MRI... last one almost 1.5 years ago.)
Interesting discussion... interesting case... hits close to home for many of us.
Mark
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