Radiology report..help me understand?

[qhcrazy]

Hey all, the good news is that at my 6 mos. MRI, it shows no tumors, however, the radiologist had this to say: "Postsurgical changes from previous myelotomy for tumor resection at cervicothoracic junction with persistent tethering of the thoracic spinal cord at the T1-T3 level into the surgical laminectomy margin. Residual small hemosiderin stained intramedullary cysts, likely syrinx cavities at C7 and T2 levels. These are unchanged from previous MRI yesterday. No other spinal cord, thoracic spine, or lumbar spine lesion. Annular tear without disc protrusion at L5-S1."

Okay, now in English please! They didn't mention to me whether or not I should be worried about the tethering of the cord and the cysts. Anyone offer any advice??? I am just worried sick now.

[chickiet]

Well, I can't offer any info on the tethering - sorry.

But I have 2 intramedullary syrinxes (aka cysts) - one at C6-C7 (original tumor site) and one around T3 (I think that was it). Anyway, my NS told me they would just watch these syrinxes and see what they do over time. If they grow they could put in a shunt to drain the fluid away.

I've had both of those syrinxes since my first MRI in August 2006. They actually shrunk after my first surgery but then re-filled shortly thereafter.

I just had my most recent MRI last Saturday, and follow up with my NS on Wed 4/23. I will be very curious to see what the syrinxes are looking like now - any changes, etc. (and of course hoping for no tumor re-appearance.) This is actually 5 months after my 2nd surgery, but 3 months after my most recent one.

So - I don't think I've offered any sage advice here, but we are kind of in the same boat, of that's of any comfort.

Hopefully someone else can offer advice re: the tethering.

Chris

[Joel]

When is your appointment with the NS to go over the report/films? Was there mention of tethering on the last MRI? I would also be concerned, and try to get some answers as soon as possible. Was there significant change from the last MRI? Is it the same radiologist? Do you FEEL different? These are things to talk over with the NS. It may be not worth worrying about, but get answers as soon as you can.
Joel

[tracy2001]

qhcrazy,

If you head back to the old forum archives you can find a lot of info on tethering. Search for an author named Kirsten, she is very knowledgeable and had personal experience with tethering problems.

Basically your cord is supposed to be free floating in fluid, except at where it's attached to the brain and root nerves. Just Imagine a ball attached to a rope, ball on top with the rope inside a flexible pipe. If you turn the ball, the rope will twist slightly. If you bend the pipe the rope will adjust to one side. Now imagine clamping the rope to one side of the pipe. Depending on how close to the ball you clamp, the rope will have to twist more in a shorter distance. It will also not adjust as easily as you bend the pipe. So if you've got a tethered cord, you are going to be more sensitive for body positioning. If you stretch the cord too much you can cause both temporary and possibly permanent damage. As you are adjusting to your new body, be careful, be safe as someone else said. You need to let your cord heal without stressing it. Stay away from quick sharp body position changes or extreme bending and twisting of your body.

If I remember correctly, Kirsten had a good initial recovery. But experienced problems afterward due to the tethering that she was unaware of having.

[went]

I'm no doctor, but it sounds to me that the tethering was there when you had your surgery. Your actual surgeon should be able to tell you about that.

[Ali-Brad]

Hi,

Well I have tethering high up at C1-C3 surgery site. It is very limiting together with a C1-C5 fusion. My cord is tethered to the back of the spinal column. I had 2 surgeries 4.5 months apart in 2004. I can relate to the tethering happening in that things became tighter as time pasted after surgery and scar tissue developed/hardened. I often relate it all similar to having one of those 'bulldog clips' on the back of my neck (not sure if called 'bulldog clips' over there in US but hope you know what I mean). I find walking hard in that after a short distance the pain is only what I can describe as the bottom of my brain banging against the bottom of my scull as it feels anchored by the cord at my neck. I feel there is no shock absorbancy in that area as the brain/cord is not free to float in fluid as I move. APART FROM THAT !! I don't think I know much else on it. My NS says he could try to free it up next time he operates, but he wouldn't do an operation simply to try to free it up due to all the usual risks.

Alison