Are Neurosurgeons only limited to the Brain/Spine?

[xmelax35]

Does anyone know if Neurosurgeons are only limited to the Brain and Spine? I mean can they work on discs, spinal stenosis, bone spurs, etc...? My brain MRI showed that I had Chiari Surgery, but it does not say anything else about it. The one who does reads them all the time (I seem to have the same radiologist all the time read them) is always very short and doesn't state sizes or anything.  My Cervical states the same and it just goes on and on about the bone spurs and other stuff. There is one thing on it that I have questioned before and all drs except an ER dr have ignored my question. The ER dr said I should have this one thing checked. Long Story.

[selmaS]

  ((hugs)) I know just what u mean sweety and I pray this Dr is able to give u that ...keep us posted.

Keep in mind we r here for u <3

[xmelax35]

I am hoping this local (in Cols) surgeon will be able to help me. He has one copy each of 2 different MRI's but since I had this last one, I will have to mail to him. I hope he can help me out.  I am tired. I can't keep fighting this alone.  All I want is to feel a little better.  I want to feel all the way better, but you know what I mean...if I can just feel a little better, that would make a huge difference, in my opinion.  I just don't want to continue to feel worse.

[selmaS]

  I understand ur frustration.....just like those that acknowledge we have Chiari and then try to say if it is mild  or severe by the length of the tonsils instead of how it is affecting us.....they leave us out of the picture and it is us that are affected ....very odd if I may say so.

So many things get missed and this is y I always say get copies of the MRI and the report for ALL tests so u have them for a 2nd opinion and so u know what was in them.

I can understand that a radiologist is not going to view all the pics or get the DX right...as that is not really their job, most times it is to report on a specific thing....but it is the NS's job to view the MRI pics and come to his own conclusions and not go by the reports. JMHO

[xmelax35]

Thanks Selma and Desertstorm.  I tried the last time when something was not on the MRI that is always on there (something that I needed for another neuro who specializes in the area to see).  They for the 1st time ever did not report it and claimed they did not see it. I wanted to talk to them personally but the hospital just called them instead and reported back to me that they claimed they didn't see it...hmmm. Strange! This time it was on there, so this time they did not miss it. Amazing. So I guess they certainly miss things too.  They had told me at the hospital that they have so many images to look at that they don't look at all of them. Why all of the images then if they are not going to look at them? I just don't understand it.  My nerves are on edge. Plus how can it be that when I looked somethings up it shows that it can be extremely painful (or just painful) for many people and then yet the doctors say that it won't cause symptoms. (just like the chiari I guess, they tried telling me that it does not cause symptoms stating it was asymptomatic).  They stated I was asymptomatic. I was experiencing symptoms, so it kind of made me mad.

[desertstorm2009]

Because the radiologist are giving strictly an anatomical opinion of what the see on film based solely from a structural prospective. That is what they are trained to do and its what they do best. The neurologist on the other hand takes that opinion in conjunction with your other test results, symptoms and medical history to form the complete clinical impression, the diagnosis and treatment plan. Sometimes, and many times other Dr's are consulted as well. Ideally, it all plays in together (the good, bad, correct and even incorrect information which help to rule out things) in the end to help us reach a final answer. It takes a lot of thinking, researching and ruling out on our part because the final decision is up to us! (the least trained, lol)

One recommendation I would make and I know it may sound silly to you... but you should google the anatomy of any part you question and here is why. Sometimes you can look at it and suddenly it makes sense as to why you have the pain in that area! At a minimum it helps to understand what is going on in your own body. For me, when I reviewed the anatomy of the occipital nerves, I was able to pin point each point of pain in my scalp and it was at every single junction of those nerves! Makes me feel a little more confident in that diagnosis and in trying the treatment for it....  Your questioning mind is a GOOD thing in my opinion, take it to the next level until you find the answers which make sense up to and including talking with the radiologist if need be, many are glad to (after your Dr reads report of course). It's their thing and they love it. If you want or need any help let me know. Good luck to you and to all of us :-) Lisa

[selmaS]

  Radiologists are not NS's and many times report only on what they are asked to report....I had one NS tell me the radiologist that found my Chiari was being over zealous in reporting it...and I did not have it....

We have to remember Chiari is in it's infancy as far as what has been taught in med schools....so there are not a lot of medical staff be they a NL, NS or radiologist that will know Chiari or if surgery was complete....JMHO

[xmelax35]

Lisa, on  the impression, the final words it doesn't mention my tumor (like other MRI's or CT's do when it comes to the final remarks or the Hemigomia in the T4 region either), not my chiairi, it just says: "Disc and osteophytes throughout the cervical region resulting in mild stenosis (other's state moderate) of the thecal sac and narrowing of the neural foramina as discussed above." She never goes into detail about it as other radiologists (esp Cleveland Clinic do). Cleveland Clinic always goes into more detail.  Also, why is it that some neurologists and neurosurgeons see something different than the radiologists? For instance 3 neuros (2 surgeons & one regular neuro) saw that my decompression was only done half way and then stopped in a certain point (they explained to me more where) and meanwhile the radiologists mention nothing of the sort <<< this was before my last surgery.  

[selmaS]

  U r right tethered cord does not always show on a MRI and for that reason it is sometimes referred to as Occulta Tethered Cord Occulta meaning hidden.....

And u would not want an exploratory surgery of the spine...it is too risky,,,,,but there are other indicators of TCS if it does not show on a MRI...such as  an elongated brain stem, sacral dimples, hairy patches , lower back and leg issues as well as bowel and bladder issues, A urodynamics test done on the bladder can help with this too,

I was lucky in that my TCS did show on a MRI but I did not learn of it until yrs later,,...

When I first looked to the EDS hyper mobility skin issues I said the only thing that fits me is the easy bruising and slow to heal....but I was wrong, I do have hyper mobile joints, I never would have imagined even reading the info,....so I have to stress u have someone that knows EDS check u as there r many types and not all have hypermobile joints.

[xmelax35]

Thanks both of ya. Also, they have never looked into EDS. I think in their minds it is not even possible.

Though I looked at the symptoms and I don't have many of them, such as: Hyper-flexible joints, Stretchy ligaments and tendons, Swan neck deformity of the fingers, Stretchy skin with a velvety texture or many of the skin symptoms. So I think they probably would never suspect it. I have always (along with my sister) suspected Tethered Cord and of course Dr. Di suspected it too. (boy I wish he was still a surgeon).  The ortho neuro did a thorasic mri and said that he didn't see it, he said,"No, you don't have Tethered Cord, it would show on the MRI".  <<< my sister said and dr di said that it doesn't always show on the MRI.  Don't they have exploratory surgeries for the back too? I had an exploratory surgery for my female issues when I was very young. They didn't see my endometriosis and tumors until they did.

[selmaS]

No this is referring to something different....this is the space between every pair of vertebrae The foramen allows for the passage of the spinal nerve root, dorsal root ganglion, the spinal artery of the segmental artery, communicating veins between the internal and external plexuses, recurrent meningeal (sinu-vertebral) nerves, and transforaminal ligaments.

U r not an idiot, u just have more going on then u have educated urself on....so, to get back to the NS and ur current issues.....Some Chiari specialists do have an ortho that works with them or they refer u to....some may help with some of the disk issues, but not all of them do/will.

Keep asking questions, that is how u will find out.,...

I have to ask, did they rule out EDS for u?

[desertstorm2009]

Hello....
You have had two decompression surgeries for your Chiari? A neuro surgeon can deal with anything related to your neurological system and like Selma said, can specialize in many areas. Some of these issues overlap. Do you have a copy of your MRI report? If so, what does it state at the end under the final impression section? That is the radiologist  I would think yes they are referring to your foreamen magnum, but without reading your report can't say for sure. Lastly, have you discussed this with your Dr.? I know they don't always listen so consider writing your questions down and asking him. Mean while you can google search as well. Good luck! Lisa :-$

[xmelax35]

see above remark and this: The reason I ask is as I said my cervical MRI mentions my chiari surgery too, but goes on and on about other stuff. It says something on there somewhere about left neural foramen greater than right. I don't know what that means. That's why I asked where it is located and if it is the same thing as the foramen magnum.

[xmelax35]

Okay. I wondered, because I was hoping to find one who dealt with all of it.  Also, where is the Foramen located? Is there more than one thing called a foramen? <<< I aplogize, I am an idiot.  I've had 2 decompressions and dealt with issues for awhile and I don't know about the foramen. It's not the same as the foramen magnum, right?

[selmaS]

  A NS can specialize that they only deal with Chiari and related conditions....so u may need a diff Dr at this point....

Ask ur Chiari NS point blank who do they suggest u see for these other spinal issues.