Free Web NovelChapter 2156: Chapter 1421: Rebuilding Is Harder Than Repairing
On the afternoon of the day when Chen Jianguo and his wife arrived at the Institute, the examinations began.
August personally pushed Chen Jianguo’s wheelchair to the imaging department. Sanbo Hospital had just introduced a brand‑new MRI scanner half a year earlier, one of the most advanced models currently in Clinical use in the country, with extremely high resolution for imaging fine structures such as the spinal cord. When Chen Jianguo was transferred onto the examination table, Sister Li stood behind the leaded glass of the control room, her hands unconsciously clasped in front of her, her gaze following her husband as he was slowly pushed into that huge white cylinder.
"Sister Li, there’s no need to be nervous." Tang Shun stood beside her, keeping his voice very soft. "This kind of examination has no radiation and no pain. The whole process takes about forty minutes. You can sit for a while in the lounge over there."
Sister Li shook her head, her eyes never leaving that pane of glass. "I know, I’m not nervous. I’m thinking that he hasn’t had such a comprehensive examination in a long time." She paused, a trace of bitter smile appearing at the corner of her mouth. "In the past, when we went to other Hospitals, whether tertiary general or specialty, the Doctor would take one look at his chart where it said ’chronic spinal cord injury, injury duration eleven years,’ and their attitude would change. Some would say, ’No need to check, even if we check it doesn’t mean much.’ Others were more direct: ’We’ve seen many such cases, there are no new options.’ No one was willing to truly spend time on him."
Tang Shun listened in silence.
The scan lasted a full forty minutes. Multiple sequences and planes were acquired, including T1‑weighted, T2‑weighted, and an STIR sequence dedicated to the spinal cord. Lying in the confined bore of the magnet, listening to the machine emit knocking sounds of various frequencies, Chen Jianguo’s mind was unusually calm. It had been eleven years; he had long since learned to maintain inner peace during prolonged waiting.
When Chen Jianguo was wheeled out of the examination room, Manstein was already in the adjacent reading room, having pulled up the raw images that had just been transmitted. Sitting in front of three linked high‑resolution monitors, his body leaned slightly forward, his gaze moving back and forth across the gray‑white images. He scrolled through them slice by slice from top to bottom, pausing at several key segments, zooming in on local regions with the mouse and carefully scrutinizing the continuity of the spinal cord, the signal intensity, and the morphology of the surrounding soft tissues. Then he captured several images and quickly jotted a few lines of German in a paper notebook.
"Mr. Chen," Manstein turned around and gestured for Chen Jianguo to come closer to the screen. "Your injury level is at T5, that is, the level of the fifth thoracic vertebra, completely consistent with all prior case records. From the imaging, the degree of spinal cord atrophy below the lesion is milder than I expected, and the morphology of the distal cauda equina Nerves is preserved quite well. That is a positive signal."
He clicked the mouse and brought up several enlarged axial images. "But you must look at this: within the lesion itself there is very marked proliferation of glial scar tissue, the accumulated result of eleven years of chronic inflammation and repair responses. These scars are like insulating rubber piled up at the break in a cable; they wrap the injured segment tightly, forming a dual barrier, both physical and chemical. Repairing chronic injuries is much more difficult than in the acute phase." freёwebnovel.com
Chen Jianguo responded almost immediately. His voice was not loud, but it was unusually firm. "Professor Mainshtan, you don’t need to comfort me. What I need is the truth. Tell me the worst‑case scenario; that actually makes me feel steadier."
Manstein looked at him, a barely perceptible hint of approval flashing in his eyes. He had seen too many Patients: some collapsed instantly upon hearing bad news, others fell into unrealistic fantasies. The man in front of him, however, was as calm as a stone lying at the bottom of a deep pool.
The next examination was electrophysiological assessment, for which Clara was responsible.
The lights in the electrophysiology room were dimmed, with only the indicator lamps on the instruments emitting a faint blue and dark red glow. Clara was a German girl who was extremely meticulous in her work. She had Chen Jianguo lie flat on the examination bed and attached a dozen surface electrodes to both sides of his calves over the gastrocnemius, the tibialis anterior, the quadriceps, and different segments of the thigh, and then placed reference electrodes at his ankles and knees. After that, she powered up the equipment and let the machine deliver a series of precisely controlled electrical pulses through the stimulating electrodes.
Under normal circumstances, these pulses travel centripetally along peripheral Nerves to the spinal cord, then ascend through intraspinal pathways back to the Brain, while simultaneously forming complete reflex arcs downstream, producing characteristic compound muscle action potential waveforms on the oscilloscope. But in Chen Jianguo’s body, the signals came to an abrupt halt at the level of the fifth thoracic vertebra.
Clara stared at the nearly flat baseline on the screen, her brows knitting slightly. She checked the electrode impedance to confirm good contact, then increased the stimulation intensity, gradually raising it from the routine twenty milliamps to fifty milliamps, and triggered acquisition again. The lines on the screen remained deathly still, with no discernible waveform appearing.
"Professor Mainshtan," she switched into German, speaking very quickly but in a low voice. "There is absolutely no response below the level of injury. No CMAPs or SSEPs can be elicited on either side. This is not a pure demyelinating lesion, but a complete interruption of the axons. Although the distal Muscles retain passable morphology, the neuromuscular junctions have been in a denervated state for a long time."
Manstein walked over from the next room and stood in front of the screen, arms folded, silently watching that flat line. A few seconds later, he replied in a low voice in German, "I understand. Record all parameters in full, including the stimulation thresholds and the response status at maximum output."
