Nerve Block Injections vs cervical fusion?

[KeithEugeneW]

I have severe disk degeneration of C5-C6 and C6-C7, and what little is remaining of the 2 disks is bulging back into the spinal column, putting pressure on the spinal cord. For about 18 years I have had progressively increasing neck stiffness and pain, followed by varying numbness in my right fingers and hand, and then whole arm for about the last 4 years. Now my shoulder hurts continuously, my neck is in constant pain, and the migraines feel as though they may very well blow my head off my shoulders! I had 2 MRI's, a year apart, which confirmed the above, and showed significant changes in just one year (for the worse). The orthapedic (spine) surgeon is well respected and I trust him. He has sent me first to a pain management doctor and I am scheduled for 3 sessions of epidural injections/nerve blocks, with hopes that there is a 50% chance of avoiding anterior cervical diskectomy on the 2 disks. This pain management doctor also has me on naproxen and neurontin (1200mg per day). This seems to help me ignore the pain very well, but I'm ini a fog most of the time now. Fortunately I have an understanding boss, but I'm not interested in being like this for a long period of time. Is 50% a reasonable percentage to expect for positive results, or is this just prolonging the inevitable to appease the SOBs running the HMO? Also, is there a better alternative to neurontin? I guess 25 years of working with computers wasn't such a good idea.

[Renee016]

Hi, Keith. Sorry to hear about your neck pain. I know how frustrating and tiring it is to keep running back and forth to doctors but in my own opinion, anything that helps to avoid surgery is a good thing and worth a try. As far as meds go, to be honest, nothing I tried really stopped my neck pain (see profile), but, believe it or not, simple prescription ibuprofen took the edge off and helped me sleep at night(however, it was a megadose). You could also try Carisoprodol or Methocarbonal - both muscle relaxers.

If you decide to try the injections, let us know how they worked for you. Good luck and feel better.

Renee

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1982 Fusion surgery for scoliosis with stainless steel Harrington Rod - T5 - L3 - using pelvic bone for grafting
1999 Neck problems began
2001 Cervical Kyphosis
2003 3 Herniated Cervical Discs - C4 thru C7. One disc (C5-6) pressing on the spinal cord (no nerve root compression) causing leg problems - diagnosed with Myleopathy and anterior cervical discectomy recommended.

[chefbart]

I submit that trying the epidurals is a definite pre-requisite to any fusion. I have had both. My fusion is at L4-5, S1. I did not have any epidurals to this area before surgery, in fact they were never offered. I currently have degenrative disks at C4-5, C7, and likely anywhere else they might look! But after having had my first round of 3 epis, I really didn't think they were the solution. I had a secondary round of 3 a few months later, again thinking there was no benefit. But after some time passed, I must say that amazingly all the symptoms were gone (arm numbness, rib pain), and very little pain along the spine also. It has been over 2 years since the injections, and other than stifness in the neck and upper back, I have remained symptom free. So wether it was prayer, medical efficiency or both, I highly suggest the epidurals and some patience, which I realize is the hard part when pain is your constant companion.
Best of luck to you.
this is the guy who used to reside in my neck, but no more.

[wimpette]

Hi Keith,
Nerve blocks serve two functions. Firstly they can alleviate symptoms often to a stage where surgery is no longer necessary. Secondly they can help the surgeon diagnose what surgical procedure to do and how extensive based on your response to blocks at different levels. This can mean having fewer levels fused based on how you do after the block.
Remember, surgery should be considered a last resort and is not necessarily a cure.
Good luck, hope the blocks help.
W

[Leatherman]

Hi All,
I am new to this board and find it facinating with the information that is being shared among the users. Thats why I decided to join and ask a few questions.
My back ground: I am a police officer and I suffered a neck injury from an accident while in a cruiser in November 2000. With minor but steady pain, I was sent to PT for a while. After the couple of years my neck pain worsened, finally to the point where I had to see an orthopaedic surgeon. I have had two MRIs. One about 14 mos ago and one about 3 months ago. The first one showed a problem (misallignment) with c4-c5 and c5-c6. It has progressively worsened since I drive a minimum of 2 hours each way to and from work. On a bad day my commute both ways can be over 3 hours. My pain is worse when I drive (I guess its the seated position). On 2/8/05 I woke up and was in severe pain. My right arm felt numb and was painful. I shrugged it off because I had to testify in court that day. After finally being able to get to sleep the that night, I woke the next morning and I was in unbearable pain with my neck, shoulder, upper and lower arm and my entire hand was numb (feeling like its sleeping). Although the pain has subsided, my right thumb is still numb and has been since February 9th.

Treatments/Testing:

*2003 nerve conduction test (needles in the back and shoulders, showed some carpal tunnel type symptoms in LT hand )
* 2004 First MRI (showed misalligned discs)
* 2004 Second MRI (after 2/9 and awaking to severe pain) Showed degenerated discs, sitting on a nerve causing pain/numbness in rt arm/hand
* 3/05 doctor treated me with steroids for my neck. Seemed to have helped some w/pain and releaved some pain/numbness with rt arm
* 03/05 Numbness in RT thumb remains. No change. Doc starts to treat me with Carpal Tunnel treatments (steroid injections and splits)
* 04/05 treats the carpal tunnel with neurotin. All to no avail. Numbness remains unchanged.
* 04/05 Doc now believes that I do not have carpal tunnel and all my hand problems are a direct result of my neck injury (disc pressing on a nerve). He abandons the Carpal Tunnel theory.
* 05/05 Doc is sending me for Cervcal Epidural Blocks

My questions are this:

* The epidural blocks simply treat the symptoms right and not treat the injury itself causing the problem?

* WHat are normal treatments? Docs office says I need 1 treatment each week for three weeks.

* SIde effects of the proceedures? Death in a small percentage??? Yikes!

* How long do they last? I assume this will be a repeat treatment if I am to keep the pain in check right?

* ALso, does anyone know the specific steroid that is injected? Is it the same that they put in my wrist to try to treat me for carpal tunnel?

Thanks guys. Sorry it's so long winded.

Bobby