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Carl Kao's Surgical Procedures in Ecuador

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    Dr. Young...

    How does a person find out if there may be compression in the cord? Would a MRI help? Finally any time limitations on the proceedure? Thankyou,



      I would imagine that the MRI shows if the cord is compressed or tethered. Dr. Kao asks all(new)or(prospective) patients to have a recent MRI done. Jim also had a CT scan while in Ecuador, another MRI, x-rays, and a spinal tap. (all of these were done before the actual operation) He also had another MRI was done after the operation as was x-rays and a bone density type x-rays done after the operation. This was because Jim asked for one to make sure that his back was actualy strong enough without all the hardware. His past surgeon told him that if he ever had the hardware removed that his back would start to slump...that he NEEDED the hardware and that he should not let anyone tell him otherwise.


        BirdeR is right. The MRI is the best way to tell whether the spinal cord is compressed. The only problem is that neurosurgeons do not universally agree upon what represents "significant" compression. MRI can easily and consistently detect, for example, compression of the spinal cord by 10% of its diameter. However, most neurosurgeons would not consider this significant compression because a normal person who has 10% of the spinal cord often show little or not neurological deficit. On the other hand, if a person has compression of the spinal cord by about 30%, most neurosurgeons would agree that this is "significant" compression and the spinal cord should be decompressed. Please note that the criterion for compression of the uninjured spinal cord, which has more "reserve" than an injured spinal cord, may differ for the injured spinal cord. Perhaps 10% compression of the spinal cord is really bad for the injured spinal cord and therefore should be sufficient reason to operate.

        Tethering, on the other hand, is more difficult to detect. Normally, there should be cerebrospinal fluid all around the spinal cord. If the dura is contacting the spinal cord, this may be due to tethering (i.e. adhesive scar between the spinal cord and dura). There is also tethering between the dura and surrounding tissues. On the other hand, it may not mean tethering. In general, I think that a reasonable criterion for tethering is two consecutive MRI's showing contact between the spinal cord and dura, at the same place over time.

        Finally, there is the question of the criterion for operation. Even if the spinal cord is compressed or tethered, many neurosurgeons are reluctant to operate because frequently an operation alone can push the spinal cord to more damage and cause more neurological deficits. This is something that must be decided by a doctor with experience.


          Dr. Kao's operation

          The hyper-baric (sp) chamber also plays an important part in Dr. Kao's operation...the number of days spent in the chamber is also important. It helps the acceptance of the schwann cells and to keep the new nerve implants alive until they begin to grow. Jake found the chamber very uncomfortable the first day, so Dr. Kao gave him medication to keep him calm the second the third day, Jake was able to actually enjoy a movie and a nap while he was in the chamber. Dr. Kao's care of Jake was wonderful. He was so understanding and never made him feel inadequate.


            Dr Kao

            I know there has been around 3 or 5 people from/or know of someone from this web site that has returned from Ecuador about a month ago. Has anyone of you regained any function and what is your progress? My daughter is trying to get more info on him and would like to get a hold of people that has had this done a couple of years ago. Have you heard of anyone that was very unhappy with the results? [img]/forum/images/smilies/confused.gif[/img]


              There is a good discussion going on regarding Dr. Kao's procedures at the following Topic in the Cure Forum


                Kao patient group

                This is a list for patients of Dr. Carl Kao and for those who care for and participate in their lives. It it the place to share information about past, present and future patients: their needs, their problems,their questions.


                  More discussion on the Cure Forum about the Kao procedures:

                  DR Kao appears to best hope today (stew5758)

                  dr young, i met dr kao and need a few things clarified (thomas)