Inspired Spinal Cord Injury Support Forum

dlevy
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Why did they delay surgery? Sept 29, 2014 17:51:59 GMT -8

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Post by dlevy on Sept 29, 2014 17:51:59 GMT -8

I am 13 months into a T12 burst fracture. I am going over my medical records preparing to find a surgeon to remove my hardware. I had a burst fracture with some transverse displacement narrowing the cord to 5mm at T12. They delayed surgery one day. I don't know why. If a normal cord is say 10 mm, it would stand to reason that I might have 50% function below the injury. I would guess I have 5-10% function below the injury. Hell, they even plated my arm *before* they stabilized my spine.

Does anyone have any suggestion as to why a neurosurgeon would delay surgery on a T12 burst fracture? It is a very dark thought to think he delayed surgery on Sunday because it was more convenient to wait until Monday. Please tell me there is a plausible reason!

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Why did they delay surgery? Sept 29, 2014 20:53:58 GMT -8

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Post by Lαrα on Sept 29, 2014 20:53:58 GMT -8

dlevy, I dont believe there can ever be a good reason to delay surgery. What needs to be looked at is what difference the surgery would have made if they operated sooner and if there was any other issue that would have caused a complication at the time of surgery that they needed to stabilise.

You have questions that need answers because if surgery was delayed for no good reason then that is a serious matter.

Do you know what ASIA grade they assesses you at prior to surgery?

DJ Administrator STAFF Posts: 8,162 Post Likes Received: 2,829 Date Joined: July 2013 Injury: C6 - ASIA B Date Injured: June 2011 Member is: Offline Send PM	Why did they delay surgery? Sept 30, 2014 3:22:40 GMT -8 Quote Select Post Deselect Post Link to Post Back to Top Post by DJ on Sept 30, 2014 3:22:40 GMT -8 I've read that it's not good to work on an inflamed spinal cord because it's sensative and could cause more damage. I don't think waiting a day was a problem, it's bad if they do it too soon or when you're waiting days!

dlevy
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Why did they delay surgery? Sept 30, 2014 7:56:38 GMT -8

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Post by dlevy on Sept 30, 2014 7:56:38 GMT -8

Sept 29, 2014 20:53:58 GMT -8 Lαrα said:

dlevy, I dont believe there can ever be a good reason to delay surgery. What needs to be looked at is what difference the surgery would have made if they operated sooner and if there was any other issue that would have caused a complication at the time of surgery that they needed to stabilise.

You have questions that need answers because if surgery was delayed for no good reason then that is a serious matter.

Do you know what ASIA grade they assesses you at prior to surgery?

I was Asia A with no rectal tone. 13 months later it is obvious that I am not complete. I think if the decision not to immediately operate was based on me being "complete", the delay caused more damage. I base that conclusion on the measured diameter of the cord at 5mm at the injury.

If they had given me the option to immediately operate where the risk was death or more paralysis, I absolutely would have chosen immediate surgery. The surgeon seems to have an aloof personality so I wouldn't dismiss the possibility that he didn't want to bother performing surgery on a Sunday night.

dlevy
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Why did they delay surgery? Sept 30, 2014 8:00:00 GMT -8

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Post by dlevy on Sept 30, 2014 8:00:00 GMT -8

Sept 30, 2014 3:22:40 GMT -8 DJ said:

I've read that it's not good to work on an inflamed spinal cord because it's sensative and could cause more damage. I don't think waiting a day was a problem, it's bad if they do it too soon or when you're waiting days!

Can you cite a source? I fail to understand, based on the fact that the spinal cord is essentially brain matter, why immediate intervention to stabilize and relieve pressure would be a bad way forward.

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Why did they delay surgery? Oct 1, 2014 9:18:00 GMT -8

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Post by Lαrα on Oct 1, 2014 9:18:00 GMT -8

Either way you need answers dlevy as to why it was delayed. I did a little reading on this some time ago...and if i remember rightly the spinal cord is approx 6mm at Thoracic level..and i have a feeling that surgery is most urgent if its compressed approx 50% when there is a burst fracture.

I will try to find the article on this for you..but it does sound like there are questions you need answering.If it were me, i would want to know and find out..no doubt.

If this affected your recovery then its serious and if not then at least you know..

dlevy Member Posts: 126 Post Likes Received: 91 Date Joined: January 2014 Injury: T12 incomplete Date Injured: 8/18/2013 Member is: Offline Send PM	Why did they delay surgery? Oct 1, 2014 17:56:04 GMT -8 Quote Select Post Deselect Post Link to Post Back to Top Post by dlevy on Oct 1, 2014 17:56:04 GMT -8 The MRI report four hours after the accident states the presence of an "evolving edema". I was operated on 24 hours later. That delay most certainly contributed to my loss of function and I am taking action.

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Why did they delay surgery? Oct 1, 2014 18:55:25 GMT -8

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Post by DJ on Oct 1, 2014 18:55:25 GMT -8

Sept 30, 2014 8:00:00 GMT -8 dlevy said:

Sept 30, 2014 3:22:40 GMT -8 DJ said:

I've read that it's not good to work on an inflamed spinal cord because it's sensative and could cause more damage. I don't think waiting a day was a problem, it's bad if they do it too soon or when you're waiting days!

Can you cite a source? I fail to understand, based on the fact that the spinal cord is essentially brain matter, why immediate intervention to stabilize and relieve pressure would be a bad way forward.

Sorry, don't have an immediate source since I've been told that by "professionals" and briefly read about it some time ago. My surgery was also delayed for many hours later than it could have been done for undisclosible reasons and I'd like to say/claim that it has caused me more damage but apparently my case isn't strong enough since it's possible to do more damage by doing surgery early.

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Why did they delay surgery?

Post by dlevy on Sept 29, 2014 17:51:59 GMT -8

Post by Lαrα on Sept 29, 2014 20:53:58 GMT -8

Post by DJ on Sept 30, 2014 3:22:40 GMT -8

Post by dlevy on Sept 30, 2014 7:56:38 GMT -8

Post by dlevy on Sept 30, 2014 8:00:00 GMT -8

Post by Lαrα on Oct 1, 2014 9:18:00 GMT -8

Post by dlevy on Oct 1, 2014 17:56:04 GMT -8

Post by DJ on Oct 1, 2014 18:55:25 GMT -8

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