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Suggest Treatment For Hirayama Disease

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Posted on Mon, 7 Mar 2016
Question: Dr. Spaho, I've e-mailed you before about my 17 year old son with Hirayama Disease. Dr. XXXXXXX XXXXXXX a neurosurgeon at the University of Kansas, has offered to do a posterior laminectomy and fusion on C5 thru C7 to try to arrest the disease. It is now scheduled to happen in 2 weeks time. Dr. XXXXXXX had never heard of Hirayama Disease until he met XXXXXXX but he says the surgery is simple. He "thinks" he can see spinal cord thinning in this area. XXXXXXX has had 3 MRIs from 3 different facilities in the last 3 months, including the Mayo Clinic. For some reason nobody can positively confirm the HD diagnosis through the MRIs. Is a posterior laminectomy the correct procedure or should it be anterior laminectomy? I really appreciate your opinion.
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Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
Laminectomy offers more space for the cord.

Detailed Answer:
Hello again and thanks for the question.

Hirayama disease was prescribed as a separate entity before the MRI invention, so, clinical features are those that matters most.

Surgery offers a permanent immobilization in comparison with cervical braces, and laminectomy is not possible through anterior route so posterior laminectomy is the right choice. Only discectomy and fusion could be achieved by anterior approach.

Laminectomy makes "more" space longitudinally than discectomy, so I agree with you son's opinion about the approach.

Hope I helped you.

I remain at your disposal for further questions and clarifications.

Wishing good health to you and your son.

Take care.
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Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4495 Questions

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Suggest Treatment For Hirayama Disease

Brief Answer: Laminectomy offers more space for the cord. Detailed Answer: Hello again and thanks for the question. Hirayama disease was prescribed as a separate entity before the MRI invention, so, clinical features are those that matters most. Surgery offers a permanent immobilization in comparison with cervical braces, and laminectomy is not possible through anterior route so posterior laminectomy is the right choice. Only discectomy and fusion could be achieved by anterior approach. Laminectomy makes "more" space longitudinally than discectomy, so I agree with you son's opinion about the approach. Hope I helped you. I remain at your disposal for further questions and clarifications. Wishing good health to you and your son. Take care.