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Thread: Removal of a section of spinal cord - affect on a future cure?

  1. #11
    Quote Originally Posted by Johnnie Walker View Post
    Hello Dr. Wise Young

    I am a T4, T5 complete injury, caused by a bullet, but the bullet did not go through my spinal canal, he went through between my T4, T5. from side to side. and push the disc a bit in to the spinal canal and causes a contution injury

    What you say about the arteries around T6 can this be also in my case ? since my injury is around T6

    Because i also have not spasticity in my legs, but i have a good tone in my legs, (they are not so thin) they are almost normal. but when I stretch my upper body, I also (only than) get spasticity, and I get very stiff and hard, so hard that i almost can not sit down on my bed, and almost can not displace my legs from one pleace to another

    Thank's in advance
    Please replay !
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  2. #12
    Quote Originally Posted by Johnnie Walker View Post
    Please replay !
    Johnnie, this is one possibility. As I think that I have commented to you in a privte message, I am puzzled by why you have a spinal cord injury if there is no bony injury. The bullet may have disrupted the artery of Adamkievicz which may enter the spinal cord at T5, T6, or T7. However, I am also skeptical that the bullet can do that without damaging the aorta itself. Did you have surgery in that area and was the bullet removed?

    Wise.

  3. #13
    Dr. Young, we often see GSW-caused SCI where there was no cord penetration, while the bullet passed very close to the cord. We are told that the combination of tissue shock wave and bullet heat can damage the cord tissue without having to penetrate the cord tissue. Is that not the case?

    (KLD)

  4. #14
    Dr. young,
    hi, I hope you are doing fine. My case is exactly the same from the gun shot wound . the bullet went in from a little below the front of my right sholder , then it damaged my right lung (i had a big surgery on right lung and they removed one of my rib near the right lung) and then it kept going (I assume it did hit vetebrea, although i am not even sure of that) without hitting the soft tissue of the spinal cord what so ever( bullet never went inside the cord) and ended up behind my back skin at about t2 -t3 level and they took the bullet from my back skin (my level of injury is T2 complet asia A with neurogenic bowel and bladder) . I always have strong spacticity in my legs and a in my stomach and bladder. but one thing i know the bullet never hit the the cord intself(soft tissue) and even the vertebrea at that area looks normal and straight. and i had a test while ago (i forgot the name of the test) that says neurons below the level of injury are fine and active. my last MRI says that there was an atrophy at the level of injury etc. what do you think of my injury ? could it be that the peripheral nerves that come out of the t2 level(outside of the cord) was damaged from the gun shot and that send some shock wave inside the cord , etc. that caused the paralysis. ? could my spinal cord injury be the result of the tissue shock wave and the heat from the bullet , etc.? they always told me from the beginning that the bullet never peneterated inside the cord (soft tissue) .and since bullet never peneterated inside the cord ,why my injury is ASIA A , and not ASIA B or even ASIA C ? One more thing , any time i use FES in any part of my body below the level of injury ,it works fine and all the muscles respond to FES . what do you think caused my injury to be ASIA A ?
    Thanks for your reply and you have a great day
    Last edited by kz; 03-17-2012 at 09:52 AM.

  5. #15
    Hello Dr. young,

    First I want to thank you for the interest that you have shown and for taking the time to answer my questions.

    We have never discuss about my case through private messages, as far as I can remember. but we have about it over here, but it was more about the surgery that I had by Dr. Reis (in Portugal 5 months after my injury) and the benefits from it (which is none until now) I am still an Asia A. http://www.biomedcentral.com/content/pdf/1471-2482-6-12.pdf
    You've told me then that 5 months is too late for descompression and that maybe I might not see any benefits from it, and you were right

    When I got injury, the bullet did not go through my spinal canal, it went through my T4, T5. disc, between my T4, T5. vertebrea, from side to side. and pushed the disc a bit in to the spinal canal and caused a compression and a contusion injury. the bullet went through my body and went out by itself. that's one of the resons why the Dr's. did not surgery than, and because the fracture of my vertebrae T4 and T5 (caused by the bullet) were so stable that they decided not to surgery, that's why I dont have any metal hardwear in my spinal, but i kept a small compression in my spinal canal that i decided to remove 5 months later by Dr. Reis with his procedure that you already know.
    He told me that there were no bone fragments in my cord, and even the dura mater itself was not damaged, he did remove a piece of disc that was pressing a bit the dura mater and the cord, I have pictures of my own surgery with the dura mater open and the spinal cord expose. I post some of them here for you, please take a look

    Perhaps KLD is right ?

    Or do you think maybe de bullet or the sugery by Dr. Reis (5 monts later) may have disrupted the artery of Adamkievicz ?

    Because i am still an Asia A.

    Thank you so very much, and God bless you and your family
    Last edited by Johnnie Walked; 03-18-2012 at 11:52 PM.
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  6. #16
    Here are a few more
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  7. #17
    Senior Member 0xSquidy's Avatar
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    One question, the aim of the surgery was to remove bone fragments? The picture 24...that doesn't seem very good idea, to press the cord like that, isn't it?

    Thanks for showing the pictures btw.
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  8. #18
    Hi Ox,

    You are welkom, No the aim of the surgery was (pure hope) to remain some funtions back, maybe from an Asia A to B, or C, but it was not the case. The surgery was not necesary because my compression was not that big. thas why they did not do it in the first pleace. later i wendt to Dr.Reis by my self. he did not remove any bone fragment from my cord, but a piece of the disc that was pressing the cord a little bit as I said, and he did he's procedure to remove everyting abnormal like Arachnoid cysts, Arachnoiditis and syringomyelia etc,

    And yeah, you're right about the picture 24... it looks pretty scary to me to, I wonder what Dr., young has to say about that

    Thas why maybe he disrupted the artery of Adamkievicz with the surgery. I dont know, just a guess

    Saludos y un abrazo
    Last edited by Johnnie Walked; 03-19-2012 at 08:07 PM.
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  9. #19
    Senior Member 0xSquidy's Avatar
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    Ahora no estaba seguro de si eras el mismo del otro foro o no

    Gracias por la respuesta y un fuerte abrazo.
    Don't ask what clinical trials can do for you, ask what you can do for clinical trials.

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  10. #20
    Quote Originally Posted by SCI-Nurse View Post
    Dr. Young, we often see GSW-caused SCI where there was no cord penetration, while the bullet passed very close to the cord. We are told that the combination of tissue shock wave and bullet heat can damage the cord tissue without having to penetrate the cord tissue. Is that not the case?

    (KLD)
    KLD,

    This is a very controversial area. Unfortunately, the only U.S. study on this subject by the Department of Defense (DOD) was stopped by the General Accounting Office because it involved the shooting of anesthetized dogs. The DOD has funded a number of studies on the subject of how improvised explosive devices can cause shock waves to damage the spinal cord and the data is confusing or not convincing.

    Nobody, in my opinion, has provided convincing evidence that a bullet passing through the body can create shock wave that would penetrate vertebral column to affect the spinal cord. Most of the studies indicate that spinal cord injury in the presence of even very powerful blasts occur because the whole body is accelerated and hits something. Three decades of experience of contusion models of rat spinal cords have shown a minimum velocity of about 0.5 m/sec and the indentation is at least 10-20 mm at this velocity is necessary to cause severe spinal cord injury. Higher velocities may be effective with less indentation.

    I don't know about bullet heat but I do know that heat does not penetrate from in tissues. For example, when we do electrocoagulation of tissues (for hemostasis), we know that application of heat to create temperatures sufficient to coagulate tissues will not cause damage to cells 5 mm away. So, the likelihood is very low that even a very hot bullet would cause sufficient heat to penetrate the vertebral column to the spinal cord.

    Finally, one Chinese study of gunshot induced spinal cord injury was done by the Chinese military in pigs. That study showed that when the bullet did not touch the spinal column and did not cause a fracture of the spinal cord, they found no damage of the spinal cord.

    This of course leaves unexplained cases of gunshot induced spinal cord injuries where there is no evidence of any bony damage. One possibility is that a bullet passing through tissue in front of the thoracic spinal cord may disrupt blood vessels that feed the spinal cord. The artery of Adamkivicz is an example of a crucial artery that bring blood from the aorta to the spinal cord. The bullet may cause a stroke of the spinal cord.

    Wise.

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