Neuro or Ortho? - Spinal Cord Disorders Message Board

puparoo · 08-17-2006, 04:19 PM

I know this is a question that has been addressed before, but cannot seem to find it. However my dilemma is as follows:

I see a neuro (she's neurotic - ha ha) but she works closely with a team of neurosurgeons and pain management people - who I've gone to. I have herniations in C3/4, 4/5/ 5/6 and c7. Now I like my neuro, and the neurosurgeon is decent, but the PM is a jerk. Nobody tells me anything - I feel like I'm just waiting around for the next bad thing to happen to me. And I have lower back problems too, for three months now, an L5 bulge.

After feeling in the dark for a while, on my own, I made an appointment with an orthopedic specilaist at the TExas back institute, Dr. Guyer. He was the best doc I've ever seen. He explained everything to me. Showed me my MRI scans, showed me my darn spinal canal, my compression areas, everything. He scheduled tests, such as NCV and EMG and all of my options, including PT for my lower back, which the neuros don't seem to care about.

Now my question is, am I a fool to work with an orthopedic doctor on my very delicate and intricately important neck and upper cervical spine? I feel comfortable with this guy and right now no surgery is scheduled or in my near future. I am having some left arm weakness after cervical PT (don't do it people, don't do PT for your cervical problems, especially with stenosis or compression). And I'm having some twitching in my hand and forearm. So I feel like my symptoms are probably at the point of more investigation and I will probably need surgery eventually.

Any thoughts on this?? Should I just stay in contact with the neurosurgeon? How do I find out if the ortho guy is competent for neck problems? Oh, all of the confusion this causes .... I just don't know... I appreciate your help. I owe you all a big one for any help, insight or advice.

Thanks,

Puparoo aka Cheryl

ICC · 08-17-2006, 05:27 PM

hi cheryl---------i'm in the same boat. bad back that PT will fix, tendonitis in ankle and shoulder BUT the neck is the biggie. 3 bulges, DDD, spinal stenosis, a huge bone spur that is indenting my spinal cord. i will probably be facing surgery someday. PM dr. is focusing on my ankle so i can walk and not hurt my back anymore. all i do in PT for my neck is gentle stretches but i hurt like the dickens when i'm done. i have always been told that anything that has to do with the nerves needs a neurosurgeon BUT i have seen a spine specialist who is an ortho since 1999 when i first injured my back. i like him and trust him. he will probably be the first dr. i will have a consult with.

Lilacs&Lillies · 08-18-2006, 08:28 AM

I knew I wanted a neurosurgeon so I didn't look at/for any ortho. The PM doc that did my ESI's recommended neurosurgeons over ortho. He said he ususally doesn't stereotype, but feels ortho usually have better bedside manner than the neurosurgeons - but it's what happens in the O.R. that matters. Since you already have an ortho you like, it will probably be a tougher decision for you.

I think any major surgery deserves a second opinion, and many insurances will pay for multiple opinions. Since you are still in the deciding stage, I would get multiple opinions and see who you feel most comfortable with.

I have also asked any nurses or docs who they themeselves would go to. I've even made phone calls to the hospitals or surgery depts. etc. that would go something like "I assume you are not allowed to give referrals or recommendations, but I am new in town and do not want to be "flying blind" so, I would just like to ask who does the most (ie cervical fusion) cases, or ask who most nurses /docs go to." - I expected to have some that wouldn't give me info, but I if you are careful with your wording (like who does the most of these) so not to put them on the spot, sometimes you can get good info.
I also got the opinion of my GYN, the Pediatrician etc. Left message with nurse like "I know it's not Dr. X's dept, but value his/her opinion so would like to know who s/he recommend for such & such."
- - If you see the same name start popping up among all these then that's a very good sign.

Good luck with choosing the right healthcare provider and path to better health.

dennisgb · 08-18-2006, 08:39 AM

My successful ACDF surgery (2+years pain free), was done by an ortho surgeon. He is one of the leading spine specialists in my area, with 100's of successful surgeries.

I think experience plays a part in this. You should do complete background checks on any surgeon who will do surgery on you (except emergency surgery).

Dennis

ICC · 08-18-2006, 11:08 AM

EMERGENCY SURGERY

i think about that everyday. afraid i will move wrong and something horrible will happen. i will start with my pcp for recommendations and i do like the idea of asking others. i see so many dr.s for my personal health i'm sure i can accumulate a list before long. then maybe pick the 2 that come up the most and start consulting. i am so glad i found all of you. the fear is crippling at times.