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cervical 5-6 herniation with moderate cord compression

From: cherrberry - on 04/01/2010 11:14pm

Advice please! I have a c5-6 herniated disc with moderate cord compression. I also have a very small herniation at c4-5 with no cord compression. I have seen 2 neurosurgeons. The first stated he thought I would not be able to go without surgery but he wanted me to have physical therapy for 4 weeks first to see if it would help. The second suggested I have surgery right away and does not want me doing any physical therapy in fear it would cause further compression of my cord. He rather bluntly stated due to the degree of cord compression my only option is to have a single acdf to repair vs. living with a daily risk of any additional trauma such as a bad car accident or slip and fall could cause me to have permanent paralysis. I explained to him that since my acute onset of all of my pain and synmptoms 2 weeks ago, I feel considerably better with the treatment from the steroids and muscle relaxers. In his thinking, my pain is secondary to the danger of the cord compression, meaning he wants to perform the surgery BECAUSE of the cord compression and not necessarily to relieve any pain that I am in. My questions are: Don't most cervical spine herniations compress the cord? and How many of you were told the same as I - to have the surgery because of the cord compression, not the pain?

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on 04/10/2010 5:52pm

As a veteran of cervical/lumbar/thoracic surgeries I say:If you can avoid surgery, avoid the surgery.

With rest, exercise, cold/heat application, muscle relax and disks can retract/ shrink and can stop pressing on cord. A disk is a soft cushy thing..it is not hard and therefore is amenable to treatments other than surgery.

The 2nd surgeon may want to put an addition on his home or is in need of $ or else he sees something more than a herniated disk. If the neck bones are broken or there is a slippage, then having surgery makes sense. But something does not make sense as stated. If you don't have objective weakness or numbness then operating on a simply herniated disk that has gotten better with other treatment makes no sense.

I am not a doctor but have had multiple/multiple spine surgeries and am currently fused from C4-C7. The last fusion was in 1991. I am having a flare up now and am miserable.. The reason?
I have herniated the discs above and below the fusion. That is one of the bad things of fusions...you bend at levels not made to take all that pressure and then can (not always) blow out the disc above and below.

I worry alot about car accidents because since the fusions, I know it will put more strain at levels not intended to handle it. So I am not sure why that doc wants to run into a fusion where a car accident can still affect your neck. My opinion (non doc) is that the more levels you can bend, the better off you are in an accident. To have preventive surgery for an accident that may never happen doesn't seem like a good bet. Never heard of that reason. Once you start having surgery/fusion it just keeps going on every 5-10 years unless you exercise like crazy and do not have a genetic predisposition to degenerative disc disease. (the latter you have no control..except to try to make the muscles of neck stronger and take pressure of disc)

Avoid it if you can. I would discuss the findings and opinions of the 2nd doctor with the 1rst doctor and let him give you medical reasons why he disagrees with immediate surgery even though your symptoms have gone. Maybe there is something more than a herniated disc going on.

My motto is if 3 spine specialists (not general Ortho or Neurosurgeons) SPINE SPECIALISTS (only operate on spines..not hips or brains...only spines) agree that only surgery will resolve problem then I go for it. Surgery is not without its own risks and always leaves scar tissue which can possible cause problems in the future.
Good luck. I hope you can avoid the surgery.

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on 04/12/2010 10:31am

No most cervical herniations do not cause cord compression. I have two herniated discs in my neck, it causes no cord compression, no foraminal stenosis, no root nerve compression, etc. I just have "forward head syndrome". I have heard of dr's recommending surgery for the very issue stated with u. What u need to to is outweigh the risks of having surgery vs the risk of getting paralized in a by chance car wreck. Let me know what u decide, best of luck to ya:)

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on 05/04/2010 8:33pm

Get another opinion from a second neurosurgeon. Run fast when any physician wants to do surgery and you don't feel that it is the right thing to do.

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on 05/05/2010 11:45am

Hi Cherryberry,

I know it's been a while since your post. I had a similar diagnosis but with 3 herniated discs...2 moderate and one severe. Two highly regarded neurosurgeons told me the only option was surgery...or face almost sure paralysis if there was a fall or accident. Of course there are dangers with any surgery but I was told that neurosurgeons do this surgery all the time with lots of success. I took the risk and think it was the right one.

I had this surgery on 4/20. I was having severe numbness and tingling from chest down, gait problems, weakness in arms and legs.etc. No pain. I have severe damage to my spinal cord from 3 ruptured discs smashing into it. I was shocked to see the MRI and find this problem. Discs were removed, replaced with plastic ones, a cage built around them...and a titanium plate fused them together. I am experiencing some improvement in those symptoms. Today I see the Dr. to evaluate my progress. The surgery went very well with minimal pain to me. Most significant is the swelling in my throat as he had to bruise me up in there to get the job done. I hope you feel better soon.. If you choose surgery, I'd like to hear about it...and from anyone else who can say what recovery is like..especially losing the numbness and tingling and healing of the spinal cord.

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on 06/03/2010 4:29pm

Please advice! I have scheduled a surgery on June 15th. I have no pain for last 15 days and just wondering if I have to go through the surgery. My MRI report says Disc protrusion and Spur cause significant stenosis at C5-6. I had neck pain and headache when i took MRI a month ago. I consulted Orthopeadic Surgeon and also NeuroSurgeon, both suggested for surgery. Now I have scheduled the surgery with Neurosurgeon.
I don't have any pain or tingling in arms or hand. However for last 6 months I has right leg tingling and foot burning and also sciatic nerve symptoms. But my MRI for Lumber and mid back looked fine. I started using Cobroxin (containing Cobra venum) , a homeopathy medicine sold in CVS Pharmacy. for last 20 days and I am feeling perfectly alright. Even my leg pain and tingling has disappeared.
Can I postpone the scheduled surgery and take MRI again after a month? Both surgeons are telling that I may get paralysed if I have a fall or accident in the neck area. Please help.

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on 03/19/2011 7:19pm

5 weeks post surgery, C5-6, 6-7 fusion, was in very little pain presurgery, but had moderate to severe numbness from neck to finger tips> I have talked to people that have had fusion that woke up from surgery with total relief from the numbness, 5 weeks and still no relief, now he is telling me up to a year, NOT the answer I wanted to hear

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