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Thread: dear dr.young,pls help me with your suggestions,

  1. #1
    Junior Member drparthi's Avatar
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    dear dr.young,pls help me with your suggestions,

    Dear Dr.Young,

    My brother Karthikeyan Ramasamy,26yrs old met with an accident and had spinalcord injury. Here's his Injury details.

    He met with an accident on july 3rd 2004. He had a C6 burst fracture and had immediate Tetraplegia. He was treated with iv Solu-medral and lifeflighted to washoe medical center,reno,where they performed a C6 CORPECTOMY & removal of epidural hematoma. They placed a Perma Mesh Cage and a Landis Plate for Anterior Fusion from C5 to C7. He had a follow up MRI on 9th july which demonstated increased cord signal from C5 to C7 as well as abnormal fluid signal from C7 to T1 question consistent with Myelomalacia. There was some artifact from anterior plate and the doctor said it was just a Bruise of Spinal cord.

    He is currently in rehabilitation institute of chicago undergoing therapy. Right now his condition is stable except for few episodes of Urinary tract infection. From the begining he has normal movements in both his upper arm till his wrist joint and his sensation till his chest. He is able to show minute movement in both his foot.

    MRI to evaluate osteomyelitis(he had fever) on 27th august showed,
    * No evidence of osteomyelitis or Epidural abscess.
    *Cord edema/Myelomalacia which extends from the level of C5 through C7.

    Recently he got his movement in his Right index figer and has some sensation over his Sacral region and Anus. He is able to feel the movements in his legs but not the Sensation.

    I will be glad to know your views on his present conditions and further course of treatment he might need if any.


    Thanks,
    parthiban.

  2. #2
    It sounds like he has had good care. Unfortunately some do develop significant myelomalacia (atrophy of the cord) fairly early after injury. There is really no treatment for this at this time.

    RIC is an excellent rehabilitation center. Who is his doctor there? It sounds like he now has an ASIA B injury, which is encouraging as early return like this may predict some further return, although no one can tell how much or for how long.

    (KLD)

  3. #3
    Parthi,

    I agree with KLD. It sounds as if your brother received methylprednisolone (Solumedrol), early rapid decompression and stabilization, and is beginning to get some function below the injury site. I am particularly heartened by the suggest that he has sensation in his anal region and is able to detect movement of his legs, and is able to move an index finger, suggesting that he has progressed to ASIA C from ASIA A. RIC is a good rehabilitation center and I think that your brother has a strong likelihood of recovering additional function in the coming months. Regarding treatments, as you know, there is still no proven therapies that restore function but a number of therapies are now being tested in clinical trial. Some of these therapies are beginning to show definite sensory improvements and some motor improvements in people with chronic spinal cord injury. These of course need to be confirmed and improved.

    wise.

  4. #4
    Junior Member drparthi's Avatar
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    dear dr.young,
    thank you for your valuable suggestion and i appreciate you for your immediate response and carring out this great work.now we are confident that he is having chance of getting back his locomotion.i will keep you updated on his progress.

    sci-nurse,
    Thank you for your opinion on my brother's condition. the doctor who is treating him is Dr.James A.Sliwa D.O. my brother's visa expires in january and we are planning to take him back to india,so do you have any idea about the doctors or institution specialised in spinalcord injuries in india.

  5. #5
    Dr. Sliwa has a good reputation. He was a resident there when I was at RIC as a graduate student many years ago.

    We have several members on these forums from India. You may want to do a search using that word. I know that Dr. Young has traveled in India and knows about some centers and physicians there. Perhaps he can provide you with some contacts.

    (KLD)

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