I'm New: ependymoma removal with dynamic stabilisation

[ytkanos]

Hello,

After fracturing a vertebra running I was sent for an MRI where in addition to a T10 fracture, they discovered an L4-L5 intra dural tumour (suspected ependymoma).
My neurosurgeon said that my MRI also shows Modic changes at L4-L5.
Since part of the removal process of the tumour involves a laminectomy, my neurosurgeon is proposing to stabilise my spine with a dynamic stabilisation mechanism.

I am resigned to the fact that the tumour has to be removed but I am not really very keen to have this addition of dynamic stabilisation which I gather is like a spinal fusion but a "flexible" version. 

When they do the laminectomy, is the removed bone replaced or not?

Does anyone have any experience with this?

thanks for sharing!

[mcguyverdan]

I was diagnosed with an intradural tumor at L-5 in April of this year and had L-5 and S-1 laminectomy on May 19. Initially the NS thought it was an ependymoma, but post-op pathology indicated it was a schwannoma. Even though I have a fair amount of disc degeneration at L-5, no stabilization was initiated. They stuck the bones back in with what I believe was superglue. No screws or hardware, just a handful of staples to keep it all in till it heals up completely. Those came out at 3 weeks. I am 50 and in relatively good shape with no other health problems (that I know of). I am on light duty, no bending lifting (10 pounds) or twisting for 3 months. In August I can start physical therapy to build back up the muscles and hopefully regain a "normal" life...whatever that is. I would recommend tossing out reading about modic changes on Wikipedia, and read page 19 in the Clinical Intervention and Prognosis section of the paper titled "Modic changes: a systematic review of the literature" at www.ncbi.nlm.nih.gov/pmc/articles/PMC2556462/ The way I read it stabilization might slow the progression of MC or even help move from type 1 to type 0. I would however get a second opinion by another NS, just in case. My neurosurgeon saved my life. Best of luck, let us know how it goes.

[ytkanos]

Thanks for sharing your experience and that link.

The superglue solution (laminotomy?) sounds less aggressive and possibly requires less maintenance (no potential for loose screws etc...).
My bones seem to be in reasonable shape although there is some edema from the damage I did running...
In any case, I'm looking for a second NS opinion as we speak.

I'll be 50 in a couple of weeks time and have scheduled my operation for 1st Sep.

I am looking forward to getting over the surgery /pathology hurdle, getting into recovery and getting back to normal life.

How do you feel now that the op/pathology is over?

[mcguyverdan]

Other than missing out on my summer because I am not supposed to bend, lift more than 10 pounds, or twist, I would say that everything is fine. I still have a patch on my right leg that is numb and tingly/burny, but the debilitating pain on my left side that was causing me to not be able to sleep, walk, or do just about anything unless I was on narcotic pain killers, is GONE. I still have a fair amount of pain as a result of the surgery, but I am hoping that as soon as I can start some physical therapy to get the muscles stretched out and start building them back up, the surgical site aches will get better. I stopped taking narcotics the second day that I got home from the hospital and only take a couple acetaminophen once in a while if I get a headache or something like that. I also have a good group of church ladies that pray for me, and I believe that Faith makes a significant difference.