Random Thinking

Michel and I went to The Chiari Institute last week to talk to her surgeon, Dr. Paolo Bolognese. Michel hasn’t been able to work since she fell down the stairs back in June and she is having constant symptoms from her syrinx which has grown in size since the beginning of the year.

A syrinx is a fluid-filled cavity inside of the spinal cord. The white area inside the long dark channel running from top to bottom in the picture is a syrinx. Michel’s is actually much bigger. As the syrinx grows (a condition called Syringomyelia), it causes damage to the spinal cord which leads to many symptoms including pain, weakness, and stiffness in the back, shoulders, arms, or legs; headaches; loss of the ability to feel extremes of hot or cold, especially in the hands; instability; paralysis; and death.

Michel was the last patient to see Dr. Bolognese that night and since everyone else had left for the day, Dr. Bolognese came out to the waiting room (which is very nice and has several TV’s and computers with access to the internet) to exam Michel. We sat in comfort while he demonstrated a couple of things that he had found from Michel’s tests. He pulled up on her head and suddenly most of her symptoms including her headache and nausea disappeared. We were astounded, to say the least. He said that he could follow Michel around everywhere holding her head up but it could get expensive as he does like to eat. (He is from Italy!) So instead he suggested two surgeries to help relieve the symptoms and maybe let Michel go back to work.

The first surgery is called tethered cord detachment. Imagine the spinal cord as a long rubber band. It is attached at the top and at the bottom. If it is being stretched, it can cause symptoms. Since it can’t be detached at the top since that is where is connects into the brain, it is instead detethered at the bottom. There is a tether that pulls down on the spinal cord and the surgery will cut that tether to relieve the strain on the spinal cord. Like a rubber band being pulled down by a string, cutting the string will allow the rubber band to snap back into its normal shape. The surgery is fairly complex and requires several days in the hospital afterwards to recover.

The second surgery can be done three months after the first. This will allow enough time to heal from the first surgery. The second surgery is a neck elevation and fusion. Basically, they will open up Michel’s neck, pull her head up to optimum position, and then insert titanium bars in her vertebrae to hold her head at that spot. This provides the lift that Dr. Bolognese doesn’t want to provide by following Michel around everywhere. The end result will be a loss of neck flexibility but it should greatly relieve the symptoms of the syrinx.

We are aiming for February for the first surgery.