Opinion requested regarding: surgical decompression of C3-C4

Opinion requested regarding: surgical decompression of C3-C4 with
anterior decompression using arthrodesis and cervical plating, then
perhaps additional surgical intervention for a posterior
decompression.

I have been able to obtain satisfactory answers to almost all my
questions, I am still concerned however about the possibility of
aposterior decompression after surgical intervention using anterior
decompression and the fusing of these vertebrae antbrioraly.

I find it difficult to understand how the second procedure, which made
become required, could be accomplished in order to decompress, after
the aposterior vertebrae have been fused, without causing seriously
increased stress on some other point of the spinal column, or perhaps
breaking the fusion of the vertebrae corrected during the first
suggested surgery.

I have been informed that working on the spinal column to perform a
posterior decompression is much more risky especially with regard to
working around the arteries. I wish to understand more clearly the
risk benefit trade-offs, the likelihood of success in the first
process so that the second process is never required, and the
possibility of doing both the anterior and a posterior decompression
and fusion simultaneously.

I am also somewhat troubled by the apparent asymmetrical nature of my
spine with respect to its abnormalities. There are slight
abnormalities at the very top and the very bottom of the spine, which
are dismissed as unimportant, and also there appears to be an
asymmetrical nature correlating the cervical and lumbar abnormalities.
It worries me that reducing the mobility of C3-4 especially during
might precipitously exacerbate the lumbar areas in ways which I do not
yet understand well enough.

He does have evidence of myelopathy and the abnormal signal within the
cord at C3-C4. I would recommend surgical decompression of the area
and in his case would probably favor an anterior decompression with
arthrodesis and cervical plating. The main goal of the surgery would
be to prevent his symptoms from increasing. Hopefully, however, he
would gain some improvement in his complaints. I did extensively
review the actual operation including the operative indications,
expectations, alternatives and extensively reviewed the risks. I
discussed the use of allograft versus autologous bone. He would need
to be in a firm cervical collar for at least six to eight weeks after
surgery. I did discuss with him also that he may need a posterior
decompression at some point in time if he continues to have stenosis
from posteriorly. Jack H. Deckard, M.D.

For comprehensive details including both the detailed journal, and all
my medical opinions, please see the following two links:

http://givehealthachance.org/Vince/Status/History.htm
http://givehealthachance.org/Vince/Opinions/default.htm

Most Respectfully and Gratefully, 
Vincent J..Cataldi -- [EMAIL PROTECTED]