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Myelomalacia: Let's connect

Spine Health | Last Active: Sep 14 10:01pm | Replies (62)

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@dacraig

I have the same story, experiencing the same symptoms along with muscle stiffness, spasms, internal tremors and mild fasciculations after exertion. My right arm becomes very weak if I use it too much. Neuromuscular doctor says it is from malacia at c-4. Neurosurgeon disagrees, says there are no changes in the MRI since the symptoms have developed. I have never been told about the malacia until my recent MRI April this year. Please post after seeing surgeon I am stuck between physicians opinions with no help.

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Replies to "I have the same story, experiencing the same symptoms along with muscle stiffness, spasms, internal tremors..."

@dacraig Welcome to Connect. I am presuming that at this stage, you have not had surgery, but may be considering it. When a radiologist issues a report on imaging, they often will list a lot of possible diagnoses that need to be confirmed by a clinical exam. Surgeons can have a differing opinion. Did your surgeon show you the imaging and explain it to you?

Myelomalacia can show up as a white mottled fuzzy looking area within the spinal cord where there is compression and typically represents the loss of nerves that have died. In your case, you need to get the diagnosis from your specialist's opinion. Myelopathy represents spinal cord dysfunction, but not necessarily permanent damage. Surgeons may also be watching for changes over time before offering surgery. At some point, you need to decide if you want surgery. An onion from another surgeon may be different, and you may get an offer for surgery sooner. Generally speaking, it's best to decompress before permanent damage occurs, but even surgeons can't tell you exactly when that happens on your timeline of your spine condition. If you already have permanent damage, they may hesitate since they can't improve that function.

I am a cervical spine surgery patient, and my surgery was done before any permanent damage happened. I had good results and spine surgery resolved all the spine generated pain. Sometimes surgeons may decline to help if they don't think you will improve, for example, if there already is some permanent damage that will leave lasting symptoms, weakness or another condition that can produce overlapping pain symptoms, and they may think a patient will blame that result on them. They should tell you that surgery will help prevent a spine condition from worsening, and not necessarily promise improvement or pain reduction as a result. There are a lot of variables, and all patients are different.

This link has some images of Myelomalacia showing the white mottling or streaked areas.
https://radiopaedia.org/cases/compressive-myelomalacia-snake-eyes-appearance?lang=us
Do you have an appointment for follow up? You might ask questions on your hospital portal. Are you considering a second opinion elsewhere?