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  1. marcomonteverdi
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  3. Archive Ask the Doctor
  4. Monday, 13 July 2015
Hi,my name is Marco and I have a C4-C5 SCI.On the 20th of April I received an operation in St. Gallen to remove some of the scar tissue of injury to reduce the spasmi, the doctors told me i would feel a change in perception within the first months, but this is much more than I thought!I have strong spasmi, and feel my body much more sensitive.What do you recommend Ido?Thank you in advanceMarco
Accepted Answer Pending Moderation
Dear Marco,


I would
like to try to understand more about the operation that has been performed by
the neurosurgeons of St. Gallen.

I guess
that simply removing scar tissue was not the only target of this operation. Have
there been other problems or pathologies on your back that forced the surgeons
to operate on the spinal cord? (compressions, adhesions, disturbed flow of the
cerebrospinal fluid, arachnoiditis or even syringomyelia?)

To prepare
for an operation like this there must have been CT-scans or MRI pictures taken
which would show the pathology. What are the findings??


The same
diagnostics should be done after the operation once again to see it’s effect.
Usually there will be a check up by the surgeon between three and six months
after surgery.

The effect
of the operation should be discussed with the surgeons, rehabilitation
specialists and neurologists on that occasion. Often the effect will be seen only
after reasonable time after surgery (6 months). Never expect to have it


To get rid
of the spasms within short time you will have to take some antispastic drugs. Usually
you begin with Gabapentin and increase the dose until the effect is there or
you reach the maximum dose. I think you are experienced??

If there is
no effect, there are different drugs as well as combinations of selected drugs.

I have
published an article on general rules of treatment of spasticity in our
(English). Please read this also.


Maybe you can
provide additional information so that I will be able to give directed
advice for your problem.




  1. more than a month ago
  2. Archive Ask the Doctor
  3. # 1
Accepted Answer Pending Moderation
Thank you for the quick reply.The operation has been performed because I had adhesions and disturbed flow.
My main concern lately has been with headaches, In the last 5 days I've had one every morning and the cause wasn't a full bladder. 
Is it something to expect happening?
Regarding my spasmi, I take lioresal 25 mg four times a day plus a dantmacrin but it doesn't seem Like ir's helping at all.
Thanks for your timeMarco
  1. more than a month ago
  2. Archive Ask the Doctor
  3. # 2
Accepted Answer Pending Moderation
Dear Marco!


If the raising
headaches are new and lasting for days despite of the medication you have been
taken for months after operation you should contact the colleagues in St. Gallen
and ask for an extraordinary check-up.

They only
know what they have been operating on and can give you direct advice.

Without knowing
the whole story it is not possible for me to evaluate the problem and give well
founded advice. Sorry about that.


Yours sincerely

Dr_Hans, 20.7.2015
  1. more than a month ago
  2. Archive Ask the Doctor
  3. # 3
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