Spinal fusion ... Anterior Cervical Discectomy

[Julie1119]

Looking for advise ... My husband was diagnosed with 3 herniated/bulging discs affecting C3-C7 (Extensive detail can be provided, if needed). C5 is the major culprit, bulging "moderate to extreme" to where there is no fluid passing on one side. The other buldges are "moderate".

His symtoms are numbness/tingling on right side from right nipple to the toes; this has been since May '07. Initial diagnosis was MS, they did an MRI of the lower back and brain. Which then eliminated MS theory. They finally did and MRI on his neck. When the neurologist first saw the MRI, he recommended surgery "immediately". Then the neurosurgeon came in an said, well let's schedule for Dec. 18th where they plan to remove the disks, place spacers, then titanium plate and add bone graft, then add a halo. In the mean while, they decided to schedule a meeting (11/19) with the physical therapist for possible traction. (Holy crap, first it's drop everything and surgery is today, then it's "okay" to have a therapist touch "try". Sounds risky?!)

Given the symptoms, shouldn't someone have been looking at the neck vertebrae initially? ... This has caused me to lose faith in these Drs. and our heads are spinning trying to find the right path for the best care. The main questions we have are: 1) Is it safe to wait with the bulging c5? 2) Is traction therapy safe? 3) What facility is the BEST in SE-Wisconsin in working with spinal issues? 4) What risk factors are involved with the procedure?

I'm trying not to get too detailed so I'm probably missing something ... So any other advice would also be appreciated!

Thanks in advance.

[feelbad]

given the situation,personally,and this is just strictly my opinion,but i would think even trying traction on him to be potentially dangerous,not that surgery isn't,but anytime you start moving a disc around(espescially when the compression is so heavy as with your hubby)using traction,it would be considered a 'blind' adjustment?meaning they cannot actually see what is truely going on within that area or if the traction could be making things worse,you know what i mean?i,myself,just having actual spinal cord injury(just knowing what can happen when the cord gets damaged),this would really be too scarey for me to even think of having.there are just too many uncontrolled random things that could take place within that spinal area that would not be seen while doing type of thing?if all he had ws a herniation without the spinal compromise going on to the extent he has,it would be a whole different story.but this is kind of a dangerous situation for hubbys cord right now.i can totally see why these docs have you wondering.

my best advice to you would be to go to the nearest university teaching type hosp and get a second opinion before anything actually gets done on him.you DO need to have more than just these docs opinons on something like this.for my spinal cavernoma i went to the U of MN here and was sooo thankful i did.i ended up with the head of neurosurgery doing my surgey and it was a huge thing for me since the other two NSs i had seen before him really did not understand about how freaky these little globs of vessels could be when they are in your spinal cord.this man had over 30 years of experience with what i had. that is what you really do need here the most,knowledge and experience with whoever you decide to go with.but you DO definitely need more than this these docs opinions.its just something anyone should do for a more in depth type of surgery.but honestly,if you can get to a university teaching hosp,they just really know their stuff at these facilitys and are usually on the more cutting edge when it comes to procedures and the less invasive types of surgical intervention.

just wondering what your hubbys MRI states exactly about that area where there is no CSF flow?any myelomalacia?if you could just state what the summary states at the very end of that report,it really would be helpful.just trying to understand the extent of compression.

i would really try and hold off on that traction til you have at the very least,consulted with another experienced knowl;edgable neurosurgeon.once certain things are done,they just cannot be undone,you know what i mean?you just really need to find out the full story of risks and how this could go if not done exactly as they plan.or if it should even realistically be attempted.please let me know that info,it would help alot.thanks,marcia

[Julie1119]

MRI of the cervical spine with and without contrast:
C2-3 Small to moderate sized left paracentral disk protrusion with a small inferiourly extruded comonent. This does not compress the cord. There is bilateral moderate hypertrophic facet arthropathy and mild bilateral neural foraminal stenosis. The midline AP dimension of the spinal canal is 10 mm and there is not appreciable cord flattening.

C3-4 There is a minimal broad-based disc bulge and mild right and moderate left hypertrophic facet arthropathy. The midline AP dimension of the spinal calan is 10 mm at this level, and this level is notable for a small area of intrinsic cord edema eccentric left within the cord measuring 5x8 mm in AP and height dimensions, and best appreciated on teh sagittal T2 and STIR sequences.

C4-5 Minimal posterior broad-based disc bulge and mild to moderate facet arthropathy with some unsovertebral spurring. There is mild bilateral neural foraminal stenosis, but no central canal stenosis at this level.

C5-6 There is a large broad-based disc protrusion centered in teh right paracentral region with extension into the right interforaminal region as well as the posterior central disc area. There is also a small to moderate right paracentral inferiourly extruded component. The AP dimensions of theis disc protrusion is as great as 6-7 mm, and there is some moderately severe impingment involving the right c6 nerve, and there is mild to moderate mass effect on the cord with a midline AP dimension in the vicinity of 7-8 mm. THere is intrinsic cord edema involving the left aspect of the cord, there is the suggestion of very mild far left lateral enhancement.

C6-7 Moderate-sized broad-based disk protrusion slightly eccentric right. The midline AP dimension of the spinal canal is 8 mm and there is mild cord flattening. There is mild impingement with respect to the right C7 nerve and its intraforminal course.

There are levels of mild bilateral neural foraminal stenosis as discussed above.

[faubs110]

i see no need for a halo....that's usually only for patients with fractures of the cervical vertebrae....seems to me from the mri that c5-6 and c6-7 are the problems....traction is not all that dangerous...i i actually knew someone who swore by it.....i'd say time to find a new surgeon...cause i don't know why your husband would need cages.....i had an acdf in june of 04 for c5-6/6-7 with donor bone and a titanium plate.....left the hospital the next morning no collar no meds......had a tough time sleeping but some xanax and ambien cured that right up.....my neuro symptoms are cured but i'm left with varying degrees of neck stiffness....please excuse my spelling i had one too many last night

[Julie1119]

Thanks for the replies, your opinions are helpful.

We have set up a 2nd review. Our homework (so far) indicated Froedtert to be a teaching institute; though we have to wait until Nov 30th to see them. I've also heard good things about the Bay Group that offers less evasive procedures...?

In the mean while - the first doc has already set up the surgery, contacted the blood center, etc. They are recommending the acdf from c3-c7... but like I said, the current doc seemed insistent and hurried to do this, and we're questioning the whole deal right now; aside from the MRI evidence.

Faubs110- Young and healthy I imagine, that sounds like an unusually fast recovery. Did you have a similar diagnosis with the body numbness?