What does my MRI scan test report indicate?
This is for my close friends sister who is a ITP patient and is doing fine with medication. She is married for 3 years after she had developed ITP. She has remained fine with regular check ups and blood checks. Off late she has developed back pain for which she underwent a MRI scan. The reports are attached with this information. As one of her foot has become numb, they have decided to operate on her. I would want to know is this issue with her medications (steroids) for her ITP? How severe this might be for her? How well generally people respond to such surgeries? . As of now her platelet count is 90000. They have given a go ahead for the surgery next Monday. We would want a second opinion on the same.
She can go ahead with this surgery
I have studied your case. She can go ahead with surgery. She has to be on steroids during surgery. Steroids can increase chances of infection so operation theatre should be of highest standard with modular theatre. Also if possible surgery should be done with endoscope. In this surgery patent can be discharged on same day. Results of spine surgery is good in most of the cases. It should be done by expert spine surgeon. Her platelet count is ok. She should get her coagulation profile checked before surgery and may need platelet transfusion.
I hope this answer will be useful for you. let me know if there is any other followup questions. thanks
Doctor also gave a feedback that her bones have grown weak compared to her age.
So we would like to know, if this has been due to her pre-existing ITP problem?
Steroids makes bone weak
Her bones are weak due to prolong steroid therapy. So after this surgery she needs to take calcium and D 3 regularly. Also there is role of injection teriparatide for three months.There is no role of ITP is bone weakness .
This has helped us to prepare better.
Last I would like to know any precautions we need to take after her operations and additional steroids she would be on now for this operation, apart from the calcium tabs you mentioned.
Just make sure that it is done by as small incision as possible
I would suggest you to make sure that it should be done by as small incision as possible. If possible try to get it done endoscopically. As far as steroid is concerned she need to see a haematologist post surgery and then decide about doses of steroid.If possible try to to take as low dose as possible as steroids has serious side effects.
Along with steroid take calcium 1000 mg daily. 60000 unit vitamin D per week for six weeks. Teriparatide one daily injection for three months.
Wish your friend a fast recovery. Let me know if there is any thing else I can advise. You can ask direct questions from me.
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