2016 FAQ questions

Good day. Our problem is related to pain in the tailbone. We would like to contact your clinic in Georgia. Are there specialists dealing with this problem there? We associate pain in the tailbone with trauma in childhood; there is no inflammatory phenomenon in this area. CT, MRI, they say everything is fine. The pains still bother me, we want to come to you. Is coccygodynia promptly treated?

Hello. Surgical treatment of coccygodynia consists of the surgical removal of the coccyx. As an alternative conservative treatment, we offer local application of therapeutic injections, physiotherapy, and reflexology. In the initial period of the disease, in the presence of subluxation, manual reduction of the coccyx is performed.

 

Hello! My father has a herniated intervertebral disc and instability of the vertebrae in the lumbar spine (5 mm displacement of the 5th vertebra), I wanted to know what treatment methods you can offer and is a B-twin implant suitable for us?

Hello. To confirm / exclude instability of the revealed spondylolisthesis of the L5-S1 segment, the patient needs to undergo an additional X-ray of the lumbosacral spine with functional (dynamic) tests (3 images are taken in the lateral projection: straightened spine, forward bend, back extension). After that, the advisability of installing the B-twin fixation system can be judged. At this stage (according to the MRI data received from you), it will be enough just to perform an endoscopic discectomy operation with decompression of the spinal canal at the L5-S1 level.

 

Good day! I would like to receive advice from you regarding the operation of my father (54 years old). In 1998, he had complaints of partial loss of sensation (2 arms and the right leg), unsteadiness of gait, back pain, very rarely choking, and many others, after which he was diagnosed at the hospital: syringomyelobulbia, cervicothoracic form, bulbar syndrome, mixed tetraparesis, cerebellar syndrome. Discopathy, protrusion of C3-C4, C4-C5, C5-C6 discs. Since then, he underwent treatment annually, after several years of treatment, positive dynamics appeared, sensitivity recovered a little, gait was less shaky, choking almost disappeared. But on July 1, 2016, due to a long absence of treatment (1.5 years), against the background of his illness, bilateral pneumonia appeared, he spent 2 weeks in intensive care under mechanical ventilation, now his condition has improved. But I would like to clarify whether it is possible to operate on my father so that his illness at least does not develop and does not give such complications?

Hello. With syringomyelia, decompression is carried out at the level of the foramen magnum and those segments of the spinal canal where compression of the spinal cord by the syringomyelia cavity is most pronounced, without or with the evacuation of its contents. For indications for possible surgical treatment, check with the attending physician, neurosurgeon, anesthesiologist, and therapist.

MRI of the cervical spinal cord shows two syringomyelic cavities filled with CSF (indicated by arrows).

 

Good day, here I have a compression fracture of the thoracic spine Th7 Th8 Th9 vertebrae of the 2nd degree with a decrease in height in the anterior-middle sections to 13.8 mm. It has been five years since the injury, please tell me you can do vertebroplasty or kyphoplasty.

Hello. Kyphoplasty is performed in the acute period (the first few days) of a compression fracture of the vertebral body. Vertebroplasty is justified when the compression of the vertebral body increases in dynamics (compare the old and new data of X-ray or tomography of the spine) or with severe pain syndrome (local or girdle pain on the level of a vertebral fracture).

 

Hello. This summer, my wife, when we were visiting Moscow, had an attack. The condition was as follows: severe dizziness, vomiting, panic attack, severe burning in the back of the neck. The ambulance doctor gave me a pre-stroke condition, gave mexidol and an antiemetic injection. It became a little easier and we refused hospitalization. We slowly drove home (Tomsk region) and the next day again by ambulance, the wife was hospitalized. (discharge epicrisis in the attachment). It was a little easier after the hospital, but after a couple of weeks everything began to recur - blood pressure rose, panic attack, and severe nausea with dizziness developed. No medication helps, only makes the attacks less pronounced and lasting. The wife is an active young woman, and now she cannot live a full life. In the spring we did an MRI (description in the attachment) There were first signs of the disease (numbness in both hands, dizziness). Help me, please. Our doctors shrug their shoulders.

Hello. In the case of the cervico-cranial syndrome, an active effect on the cervico-occipital joint is necessary, as the main source of the formation of the described symptoms. Treatment must necessarily include manual therapy, which can be supplemented with physiotherapy (stimulation currents, thermal procedures). After normalizing muscle tone, the patient will be able to regularly engage in spinal stabilization exercises.

 

Hello. I have a question for you. 5 years ago I received an injury to the anterior right abdominal wall, in the form of a strong clamping with two fingers of the right anterior abdominal muscle. Since then, I have been tormented by severe pain in this place during physical exertion, especially when the abdominal wall is stretched. Also, since then I have noticed a decrease in erectile function. CT and ultrasound of the anterior abdominal wall revealed nothing. No hernia either. what nerve can be pinched from this injury and will surgery help me. Thank.

Hello. By description, it is similar to the syndrome of anterior cutaneous nerve entrapment. As a treatment, a therapeutic injections of the identified trigger point with a local anesthetic is performed, which relieves pain and relaxes the muscle.

Localization of the painful trigger point (the patient is lying on his back) is detected by palpation. The pain increases with raising the head (Carnet test). Impaired skin sensitivity over the projection of the trigger point is detected with a cotton swab (tactile sensitivity) and a napkin moistened with alcohol (temperature sensitivity). Squeezing the skin folds with your fingers will be painful compared to the opposite side.

 

Hello, Mom is 78 years old, open hernias l3-4, l4-5. In December 2014, a microstroke. Without impairment of motor and speech functions. Can she have a nucleotomy? Do you do Oms? If paid, what is the approximate cost? Are there any statistics on old age on the duration of recovery? What are the main problems with recovery? How much does a person drop out of an active life? Will he be crawling for six months or will he be running briskly in 5 days, as before? Best regards, Julia

Hello. This surgical intervention is possible in the absence of other contraindications that can be excluded at the stage of preoperative preparation of the patient. Treatment is possible both under compulsory medical insurance and at your own expense. Statistics on old age and the duration of recovery after discectomy do not differ from patients in other age groups, because to date, all these interventions are performed using modern low-traumatic methods using microscopy and endoscopy. After the operation, on the second day, the patient can be discharged from the hospital to his home for his subsequent rehabilitation at the place of residence under the supervision of a neurologist and physiotherapist. The average rehabilitation period is about 1 month.

 

Good day! Our child had an open craniocerebral injury in August 2015. Brain contusion of moderate degree. Open penetrating depressed comminuted fracture of the frontal bone. Question: Do we need to perform cranioplasty on a child with such a defect (18*17 mm)? How much will the operation cost? Your consultation is very necessary. Thank you in advance.

Hello. The purpose of cranioplasty is to remove a bone defect in the skull. This is necessary to restore the most optimal protection of intracranial structures (the brain, its membranes, blood vessels, and sinuses), to prevent possible post-traumatic headaches, meningitis, and liquorrhea (in case of damage to the frontal sinuses), lability of intracranial pressure and elimination of a cosmetic defect, etc. To obtain a cost estimate for the treatment planned with us, you will need to contact our manager.

 

I received a course of treatment: 07/19/2014 - Zoladex 10.8mg; 10/27/2015 - Differen 11.25 mg and 01/23/2016 - Eligard 45 mg. Their effect should have ended somewhere in August, but strong sweating and fluctuations in blood pressure still oppress them. Maybe there is something that can take it off? I am 70 years old. Thank you in advance. Vladimir

Hello. Your symptoms can be both a residual phenomenon from previously received drug treatment, and independent manifestations of the underlying disease. Contact your attending physician on this issue or our manager to schedule a consultation with us.