Back from NSs, pretty confused

[Guest guest]

Hello.

Still Paola here...

We now have two different opinions and are pretty confused:

FIRST Neurosurgeon:

- A pediatric centre: the NS Chef, talked to us as soon as we

arrived. He had a look at the RMI and said 'we need to do a surgery

here. The cord is tethered and we have to do it before damages arise.

Also there is a bit of hydromelia so this shows that although the

baby is asymptomatic, he begins to suffer. It is a very simple

surgery cause there is just a little lipoma and no LMC or SBO, we

have seen lot of more complicated cases'.

- We stayed 2 days and they did lot of controls (XRay for the

kidneys etc…) BUT he just said that BEFORE all the analysis.

- He looked very knowledgeable BUT I had the impression that

for him the ONLY solution is to have surgery and he did not even

consider to wait and watch.

- He said they have LOTS of cases of tethered cord, it is a

specilistic centre so they ONLY take care or SB and SBO and

complications lice TCS.

- About the retethering danger he said that generally there is

a 10% of people who do get retethered. Then I talked with the nurse

and she said that in the cases like my son they did not get any

retethering (I wonder if it is possible!!!) , on the contrary they do

get some retethering for LMC, but so far she did not see any case of

retethering for similar cases, and she has been working there for 20

years.

CONCLUSION: they look very knowleadgeable and if we go for surgery I

feel it is the right places. BUT I feel he rushed into surgery.

SECOND Neurosurgeon:

He looked at the RMI took few minutes to analyse and said:

I honestly don't know if there is a TCS or not! I don't think we can

say that for sure given this RMI. Yes, there is a bit of hydromelia

but it can be physiological rather than pathological.

Also, the lipoma…I can barely see it, it is so small I don't bother

for that.

It looks like the cone is between L3 and L4, true, but we have to

think that a newborn has the cone at L3 so it is a grey area here for

your son, I frankly don't think we should intervene. I am against it.

I suggest to repeat anIRM after 6 months and see if something has

changed. I strongly advice you not to intervene because preventive

surgery has not been demonstrated to be effective and if there is not

symptom the risk/advantage is not worthy.

Plus the lately we as NS have been reconsidering preventive surgery

cause it is not sure it is the best.

I feel very optimistic, because I from this RMI we cannot tell it is

a pathologic and I would never touch a cord if I am not sure it is

pathological.

CONCLUSION: very optimistic. I had the impression is has a more

objective view cause he dos NOT ONLY TCS but also other spinal

pathologies, he is an university professor (so I don't think he is

idiot) . On the other hand he doesn't have, maybe, the same

experience as the first guy cause the first one does TCS on daily

bases.

We are very confused…what do you think?

I am trying to take another appointment in another specilized center…

Paola