HappyPoet wrote:
Hi Dr. Sclafani,
Hope you're feeling well and haven't caught the flu.
Your questionnaire attachment that I have in email can't be opened. Could one be snail-mailed to me so you can have a thorough update?
I've decided to have the AO chiro Atlas/Axis adjustment tomorrow because: (1) I think it's best if my head is on straight for when the orthopedic neurosurgeon takes his own MRI and X-ray images next week, (2) It's the fastest way to get some CSF and blood to flow more properly, and (3) The adjustment won't worsen any other cervical problems, e.g., bone spurs, stenoses, etc.
What procedure do you think I should do after the adjustment: Cervical spinal surgery or CCSVI PTA?
Thx again!
There is no right answer based on evidence so
i will give some pros and cons of having cervical spine surgery first
PRO
alterations of blood flow that are corrected by the surgery will be eliminated as a concern during ccsvi treatment
assuming surgery goes well, then getting structural abnormalities permanently fixed first will eliminate them as a concern during the ccsvi treatment
get the higher risk procedure out of the way before the safer ccsvi treatment
CONS
if metal hardware is used, it may obstruct the visualization of the veins
if you have muscular spasms as a result, it may compress the veins
if you are on anticoagulation for a long time afterwards, it will delay ccsvi treatment for a long time
you may be unable to rotate your neck or flex it as part of the ccsvi procedure
and i will give some pros and cons of having ccsvi procedure first
PRO
ccsvi may show muscular and osseous caused stenoses before the surgery. might that help plan the surgery?
ccsvi treatment will improve venous outflow, improve circulation that may reduce cerebral hypoperfusion risks of surgery and anesthesia
ccsvi recovery period is shorter (one month of anticoagulation and a week wait for first ultrasound) and both procedures will be finished sooner than if surgery is done first
CON
complications of ccsvi (uncommon but certainly a possibility) may delay surgery
surgeon unfamiliar with ccsvi may not want to do the surgery
if i think about it longer i will likely come up with more but this for now
DrS