Compression in cervical and L3 L4 Inflamation due to accident

Posted by proteus @proteus, May 18, 2022

My mom (age 63) had a slip and fall accident on Feb 2022. currently she is bed ridden and doing physio therapy.

As of now her symptoms are below
Symptoms around Feb 2022
1) Not able to move and bend both hands
2) Not able to bend the fingers
3) No sensation in both legs and thighs
4) No trunk / hip control
5) Not able to stand for more than 5 mins in total lift bed

Current symptoms May 2022
1) Able to move and bend both hands
2) Not able to bend fingers
3) Sensation in left leg but no sensation in right leg
4) 60% better trunk / hip control
5) able to stand for around 1.5 hr in total lift bed

we took MRI and PET scan and below are details
1) No major observation in brain MRI
2) Compression in cervical MRI (report attached)
3) Inflamation in L3 L4 ( PET report attached)

currently she is undergoing physio therapy. Neurologist suggested no surgery at this point of time.

Question
1) Will this lead to life long paralysis / not able to walk?
2) what is the typical recovery time for this type of injury?
3) What we need to keep in mind or any suggestion in this situation?

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@proteus I see that you are new here, so welcome to Connect. I understand your concerns for your mom. There probably are no easy answers and only time will tell how much healing and improvement your mom will have. Her report notes severe kyphosis of her cervical spine as well as bone spurs. I am presuming that this was her condition before the fall? What was her mobility like before the accident?

I do know that an injury to a nerve can take a very long time to heal, and spinal cord injuries have limited ability to heal. I remember how much progress actor, Christopher Reeve, made after his spine fracture and serious disability. Your mom has made some real progress. All spine patients are different and have different health issues in addition to being spine patients. We all heal at different rates, and if there is diabetes present it can affect the ability to heal and how well a patient heals. Osteoporosis and age would be another factor. Smoking affects how well spine patients can heal after spine surgery. There are just too many variables to answer how long healing should take and what is the best that can be achieved. So we work at it the best we can and stay focused on celebrating the improvements we do make. Surgeons don't want to promise a recovery that may not happen, so they give us the worst case scenario to try to give us an honest answer. As patients, we take a stand and set a goal to try to do better and achieve more than a doctor will promise to us. It gives us hope to take on this mission. Sometimes patients do achieve more healing and recovery and I truly believe in listening to my inner voice to give strength to my own recovery.

I do know that Mayo Clinic has been doing research on spinal cord injuries in using assistive technology to bridge the signals past an injury so it travels to the limbs helping a person to walk. Here is a link where you can find more information.
https://www.mayo.edu/research/centers-programs/spinal-cord-injury-research-program
What I can tell you from my own experience as a spine surgery patient is that it took 3 months after a cervical fusion until I wasn't noticing my weakness all the time. I was in a neck brace for 3 months, so I had to do some rehab to get my strength back. I had spinal cord compression, but I didn't have trauma to the spinal cord. Many patients say it takes a year to recover from spine surgery. I would think that after the spine trauma from an accident, it may take a lot longer. I am sure that your mom appreciates your support and I am sure this is very difficult for her and your family. You can always get copies of her imaging and send that to a neurosurgeon for another opinion. She may not be a surgical candidate. A neurologist is not a surgeon, so you may want a surgeon's opinion. A surgeon can't fix damage that has already happened to the spinal cord. They can assess the current condition and if any improvements could be made if surgery was able to decompress something. The severe kyphosis in the cervical spine might be something a surgeon would address. Holding a position like that might be stretching the spinal cord across bone spurs that could be pressing into the spinal cord and that might affect arm mobility. That could be adding to the disability, but without knowing how much disability was caused by the spinal cord trauma that is a hard question to try to answer.

The best you can do for her is to advocate with her medical providers and keep asking questions about what can improve her quality of life. Find the best experts that you can. There are a lot of spine surgeons out there who want to do simple cases of fusions or disc replacements, but who would not take on a complex case, so you need to search for the Spine deformity surgeons at the top of their profession who like the challenges of a complex case. It may be that surgery could be beneficial in the future. Surgery isn't always an answer and can leave a patient worse off and in more long lasting pain. There is so much to consider and you take it one day at a time.

REPLY

@jenniferhunter Firstly thanks much for your detailed response getting into all details. Much Much appreciated!!

Yes i myself had cervical issues and suffered for 3 months. Continuous physio therapy helped to recover in my case. As your rightly mentioned time is the only factor that tells as i felt in my case.

My mom in terms of physical active scale of 1 (bad) to 10 (good), would rate her around 5. so that's another factor causing her to recover slow. Also since she is in catheter, UTI is affecting her progress to recover too. we consulted neurosurgeon too and they gave a ball park of around 4 months as recovery time. She has been progressing better as i mentioned in my earlier thread as some of her symptoms starting to get better. Bigger thing is ability to walk as her leg is showing slow progress. we need to wait and see.
Also she had colorectal cancer and was going through chemo before accident. we stopped the chemo for last 3 months considering her situation as UTI is taking long time to go away. Too many bad things falling at same time. Just waiting for some miracle to happen.

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