Dr. Jeffrey Gross, MD

A broken rod will not "stabilize" but you may have a solid spinal fusion, making a broken rod potentially not a big problem. That is an important question you should ask. The over-arching concern is failed fusion, which is more likely in the setting of having to take R.A. meds (powerful anti-inflammatories) which are known to inhbit the fusion process. It is best to understand the exact causes of your pain, and why your rods broke. There are also other options for your knees (such as regenerative medicine) but that is also potentially affected by your R.A. meds. I hope this helps.

I know people hate this answer, but it really applies: "it depends." The phrase "nerve damage" is quite broad and may be a lay person's term or a physician's term. The best way to figure out back pain is to sort out the EXACT source of the pain. Is is a disc issue? A joint issue? Is a NERVE ROOT involved? Is it compressed, irritated, other? Having said that, not all NERVE PAIN is permanent. There a different kinds of nerve fibers which have different sensitivities to damage. Ultimately, if you sort out the actual cause of your pain, you can better define nerve relate symptoms, and any actual type of "damage" and what that means BEFORE you can answer any questions of permanency! Your doctor should answer this for you. If not: obtain second opinions!!

This can be a very individualized analysis. The two most important factors are: is the oncology aspect of your condition fully treated and in remission? The second aspect is to confirm that there is no residual pressure on the brain from a bone defect or replacement skull component. Assuming these more serious aspects are handled, then we can address the functional and cosmetic components including missing skull, jaw muscle attachments and atrophy, etc. You can contact a trusted neurosurgeon, or seek second opinion with myself, or my colleagues in this field to address all your needs - hopefully that will also help reduce your stress too.

I do agree with you that there may be going on than is fully explained by the narrowing in your cervical spine (neck). The myelopathy (spinal cord involved) component related to the narrowing seen on your neck is not trivial. However, there is quite significant left sided narrowing of the specific foramen you have demonstrated on the cross section (axial) views which affects the exiting left sided nerves to the arms/shoulder blades, and surroudning areas. We can sometimes see facial symptoms coming from the neck, but I think you deserve a brain MRI for completeness. An MRI of the thoracic spine is not unreasonable. Physical therapy is a common first approach to painful symptoms involving the spine, but if your neurological impairtment is as bad as you say, then it may be time wasted, and could potentially contribute to more serious and/or more permanent nerve/spinal cord problems that can be possibly irreversible or at least less reversible. Medications may palliate the symptoms (but probably not your weakness/dropping things) on a temporary basis but are not a good strategy for long term amelioration of your problems. I don't think you are over-reacting. It is important to seek as many opinions as necessary to get the care you need, with someone you feel you can develop a healthy and trusting doctor-patient relationship.

If you are having significant symptoms as you describe, AFTER microdiscectomy, a repeat MRI is indicated to make sure that there is no re-herniation, or persistent herniated disc material that can be missed. The MRI should be of HIGH quality (i.e. not an open MRI) and preferably 3 Tesla.

The phrase "nerve damage" is not adequate to know how to approach recommendations for testing. This is why it is super important to provide much more details in regard to your symptoms. Your doctor should ask you questions based upon that list of complaints. Then a detailed physical examination is done. WITH THOSE clinical-medical data points collected, the proper tests can be advised.

Only if you have a risk of bleeding. However, many doctors are doing multiple tests at the same time to evaluate nerve-related symtoms. Thus, blood tests AND an EMG recommended at the same time are not unreasonable.

It is only possible and depends on the type of damage, the age and health of the person, and how bad the damage is. In looking at rehabilitating, repairing, or regenerating nerves, the word "damage" does not tell us enough to give a more detailed answer.

The answer completely depends on the specific nerve surgery and the severity of the damage. A nerve repair could take a year to reach its maximum benefit. A nerve decompression (like a carpal tunnel release) can start to provide benefits right away, and recover in weeks.

It is recommended that severe symptoms should be promptly evaluated by a physician with top possibilities being cervical radiculopathy vs. carpal tunnel syndrome, although the onset is not typical for carpal tunnel syndrome. Other possibilities exist, and it would be useful to know if it is just one hand vs. both.

Typically, unless something adverse occurred during the procedure, sharp intense surgical site (incisional/reconstructive) pain diminishes by about 5-10% after the third post-operative day, decreasing a few percentage points a day, thereafter. If the pain is neural (nerve related), there should not be sharp shooting pain if the nerve was adequately decompressed. There are other less common factors which can change these numbers, and they only exist as a general guide. By 12 days after surgery, most reasons for surgery (and pain related thereto) should be improving. Make sure to communicate this with your surgeon!

Neurons that do not completely die off after a stroke can improve and regenerate their function along their axonal path. Function of neurons that are completely lost by cell death can be taken up by other neurons through a process called "plasticity." Optimal healing requires aggressive and frequent cognitive and physical/occupational therapies for 12-18 months followed by maintenance care.

It is possible you may have hit your head on the bottom, but also shaking your head violently is not a good idea. If that was not willful, it could have been a seizure or something like a seizure. The brain does move a bit within the head, but it is unlikely that you feel it hitting the back of your head. The brain fog is a more concerning symptom and could be concussive. Please see your doctor, as a full neurological examination and possibly imaging of the brain would be considered reasonable.

There are multiple different nerves and various types of damage in the hand, but generally speaking, hand physical therapy ("occupational") is first. Certain medications can assist if there is nerve pain. There are also regenerative/stem cell approaches as well. If a nerve is cut / severed, surgery is usually required.

An untreated herniated disc, over time, may improve clinically (e.g. pain). The herniated portion may, in a small number of people, get smaller and "resorb" (not absorb). Other times, the herniation may remain, even if the symptoms improve. The flip side is that any symptoms may persist and become more chronic. If there is structural change over time, such as disc height loss, there can be additional sources of pain from the disc structure, the facet joints, and/ or involvement of the exiting nerve paths called the "foramine."

"Pinched nerves" in the neck are most often from "slipped discs," better known as herniated discs. These neck problems can often cause dizziness by also compressing the vertebral artery(s) in the neck and/or by reducing movement in the neck (which diminishes the ability of the equilibrium centers in the brain stem to detect position and, hence, cause dizziness). So, in short, YES is the answer.

Interestingly, the return of nerve function (including any related "regeneration") involves tingling, numbness, and sometimes a sense of discomfort, burning, itching, or pain. This can be similar to what many patients call "nerve pain" and is most commonly found with return of superficial sensory nerves (seen after a healing of a surgical incision, for example).

I am sorry to say that there is no answer that fits everyone. Strokes are highly variable as to which part of the brain is affected, how much of the brain is affected, which part of the body is "paralyzed," and whether or not such paralysis is complete. Other variables include age, health, plasticity, and treatment available. You are young, so that is a good sign. For the purposes of my answer, I am assuming "stroke" to mean a cerebrovascular occlusive event, and not a hemorrhage or something else. Good luck!

Limiting my answer to the spinal nerve (roots), these structures can be irritated, compressed, or bothered which can cause "damage" or sorts both temporarily or permanently. Symptoms may include such things as radiating pain (often from the neck to the shoulder blade, arm and hand, or up behind the ear and back of the skull), numbness, tingling, and/or weakness.

The short answer is many, but generally speaking, the nerves to the face and scalp, and involved muscles can be involved in tension headaches; nerves to the meninges (the lining of the brain) such as the Vagus nerve can cause headaches. Nerves from the brain stem area (cranial nerves) can also cause certain headache syndromes. Some headaches to not come from nerves.