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Brown Sequard - after 3 level ACF???
My wife, 51, began experiencing tingling/numbness in RT hand and arm ... MRI showed stenosis at c4-5, c5-6, c6-7 ... neurosurgeon performed "anterior cervical diskectomy and interbody fusion, c4-5, c5-6, c6-7 with bone grafts from the right iliac crest." Immediately when she awoke in recovery she couldn't feel her legs. Stat x-ray and CT scan were normal per surgeon. Within a couple hours she was diagnosed with Brown Sequard Syndrome because of RT side motor deficit (arm, hand, leg) and numbness in left side (almost entire body left side). She has made some recovery with intensiive PT (leg is better, but hand and burning/tingling/numbness in arms, hands, and legs is worse).
Two weeks post-op we went to another neurosurgeon for another MRI with contrast. This MRI showed c4-5 (AP diameter of 8.5mm and moderately narrowing of RT lateral foramen) , c5-6 (AP diameter of 7.0 with severly narrowed nerve root exits bilaterally) , c6-7 (AP diameter of 8.5mm, moderately narrowed lateral foramen bilaterally). There was also what appears to be a spinal cord bruise at the surgical site.
I have many questions but I'll start with these: does a bruised spinal cord heal? If so, will her recovery still be limited by the stenosis? Should we consider another surgery and when?
I appreciate your help and insight.
Answer:
Brown Sequard - after 3 level ACF???
Such a major complication of cervical spine surgery is very rare - I'm very sorry to hear about this.
Have you posed these questions to the attending neurosurgeon? He/she should be able to answer all these questions and specifically as they apply to your wife - I am only able to make comments of general nature.
Here's my answer to your questions: