It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Spinal Cord Disorders Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 09-10-2009, 02:31 PM   #1
Senior Member
(female)
 
Join Date: May 2009
Posts: 103
binx HB User
conservative treatment not working for c5-c6 hernation w/ myelopathy

i posted a few months back after having been diagnosed w/ c5-c6 herniation that is impinging 2mm into my spinal cord in march of this year. it's not a super huge hernation (extending 2mm into the spinal column), and at the time of the last MRI (6/09) there hadn't been any cord signal changes. even so, i have experienced neurological deficits. i also have mild bulges at c4-c6 and c6-c7.

after consulting w/ 4 surgeons, the last one recommended i take a wait and see approach for 6-12 months to see if the herniation would resorb and pull away from the spinal cord. he didn't recommend surgery because he felt that i would need repeat ACDFs down the road based on the adjacent and subjacent level bulges. this NS came so highly recommended by both my PCP and a friend's husband who is an anesthesiologist that we decided to follow his recommendations.

3 months later i am still struggling with intermittent numbness and weakness in my left arm and both legs. i had intensive physical therapy for a couple of months which helped alleviate my headaches and the muscle spasms, but my insurance has now cut me off as i reached my limit of 20 PT sessions per calendar year. i feel exhausted and spaced out all the time, along with myriad other bizarre symptoms like blurred vision, burning b/w my shoulder blades and now my headaches have returned.

i am scheduled to see the NS again in 2 weeks to re-evaluate, but i don't know how much longer i can go on like this. on one hand, i am absolutely, positively terrified to have ACDF surgery, but on the other hand, i can't continue this way. i cannot work and i have a 4-year-old who really needs her mama

the main reason i'm so freaked out about the surgery is b/c my sister also has cervical disc disease (all 5 kids in my family and our dad have bad spines) and had a four-level laminoplasty and an ACDF at c3-c4 eight years ago at age 38. she has been rendered permanently disabled as a result of the procedures and can no longer work. she and her whole family has been so profoundly impacted by her illness--it has been truly devastating.

i don't know what to do

i know no one can tell me what to do in this case, but i wish someone would.

 
Sponsors Lightbulb
   
Old 09-11-2009, 07:32 AM   #2
Senior Member
(female)
 
Join Date: Nov 2003
Posts: 287
Kaycee41 HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

I wish I had some answers for you! That's the problem we have found with spine injuries/disorders....there are no clear cut answers. We are going through the same thing. Six weeks ago my husband injured his cervical disc while working in the yard. He has a hernation at c6-c7 and a bulge at c5. His symptoms are mild compared to most on this board. He had pain for a few days, but now it is just a slight discomfort. At times he feels no pain at all. He has a numbness in his thumb and sometimes his shoulder feels "funny". The NS told him at the first visit that herniations don't heal or go away and that surgery was his only answer. He said that many times you can go to physical therapy and your symptoms may improve, but in almost all cases, he will see you again down the road. This blew us away because everything we read said that surgery was the last option when all else had been exhausted. Different story with the PT. She seems to think that he will be able to live with the herniation if he modifies the way he does things. We don't know what to do. He is looking for a job at this time because he lost his job right before this happened. We don't know if he will be able to work and if he'll have insurance.

I was interested in your statement that your NS said the herniation may reasorb. Is that possible? My husbands NS didn't think that was possible from what I understand. What exactly did your NS say? Please post and let us know what you decide to do. Thanks!

 
Old 09-11-2009, 07:03 PM   #3
Inactive
(female)
 
Join Date: Feb 2009
Posts: 3,894
Blog Entries: 12
jennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Hi Kaycee and Binx...sorry you haven't gotten any better Binx but don't let the experiences of your family decide for you what will happen. Everyone is different and your response to the surgery may be very different. The laminoplasty has been further refined and is a much better surgery now but it isn't usually combined with an ACDF. They do one or the other. But it is still considered a stop gap surgery until fusion is necessary....buys you many years of none fusion relief. And ACDF's have come a long way too. There is no need, in the hands of a top notch neurosurgeon to end up disabled these days.

But part of the problem may lie with what I was about to tell Kaycee. Studies have shown that if you are going to do surgery it is best to do it within the first year after the injury. That is when you have the greatest chance of having a pain free recovery. After that, the chance of surgery relieving your pain is only 30%. Surgery then is mainly to stop mylopathy... nerve damage.

Yes, disks can resorb but they will eventually herniate again and you will be back to square 1. May take 20-30 years but by that time, the chance of a pain free recovery are gone. Or worse, like what I had, they slowly oozed out all over again far worse than the first time and not only pinched the nerves but compressed the spinal cord, badly.

Binx, with your spinal cord compression, yes, it can be let go for a quite a while longer but if you are miserable, why wait. Why risk more damage. If it has to be done, get it done now before it lasts so long the damage is permanent. You know the numbness and weakness is not good but surgery to relieve those is 70% successful...beats 30%! But since your sister did so poorly with an ACDF, ask your neurosurgeon about doing a posterior fusion. Mine is simply 2 titanium rods attached to the tops of the screws which are placed into the vertebrae prior to attaching the rods so the placement can be checked by X-ray right in the OR. I take no pain's a harder recovery as they have to cut all sorts of muscles but after the tales I've heard here, I'm glad I had it done that way....seems to have worked better than the front approach.....just a thought. Just something to consider.

Kaycee, I think your hubby may have gotten the advice he did because of the studies showing the better healing in the first year. He can wait but yeah, it will come back as some time but it could be in a couple of years or 30 years but it will never heal as well as it will right now. But the fact that the neurosurgeon didn't tell you that a disk could resorb and then re-herniate is disturbing to me. Makes me wonder about his competence and if he's a money doc....shade the truth to get the surgery now and the money now...he doesn't want to wait. The biggest key to a good recovery is getting the very best spine surgeon you can. Whether ortho or neuro, it should be a dedicated spine surgeon....not a neurosurgeon that divides his/her time between the brain and spine. Spine only and operates regularly...you can even find docs who do the cervical spines only but mostly in very large medical centers. My doc operates 4 days a week and sees patients one day a week....which is why I wait 4-6 months to get an appointment. But does anyone really want an appointment with a "not so busy" surgeon? Tells you something about their ability! So I'd think about getting a second opinion for your husband. In fact, I think anyone contemplating spinal surgery should get at least 2 opinions anyhow. It's not a place to screw up!

I feel for both of you. These decisions are so hard to make. But we are here for support and questions. If you'd like some educational resources, let us know and we can PM them(can't post them here). And I know others will be along to add their 2 cents. Ask and we'll try to help or do whatever you need doing.

gentle hugs to all..............Jenny(titanium from C3 to T1)

 
Old 09-11-2009, 09:17 PM   #4
Senior Member
(female)
 
Join Date: May 2009
Posts: 103
binx HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

thanks for jenny and kaycee for taking the time to respond.

first, i will respond to kaycee's inquiry re: what my NS said about disc resorption. he basically said that during his 25-year career, he has seen many disc herniations like mine reduce in size and actually pull away from the nerve root or spinal cord during the process. he said the disc will never truly heal since once it is injured, it is compromised forever; but he did say that a herniation will often recede enough from the spinal cord and/or nerve root to abate some of the more troubling symptoms, thus allowing one to avoid surgery.

he also stated that he didn't feel that the amount of cord compression i have put me at any more risk of paralysis from an auto accident or fall than someone of his age (54) who has normal, age-related arthritis in the cervical spine. (BTW--this conflicted with the first two surgeons i saw who said i was at a significant risk of paralysis given my condition.) as far as his reputation is concerned, he is not an exclusive spine specialist, but said he was doing 3 ACDFs the day i saw him for our follow up. it took me 2.5 months to get into see this particular NS and he came highly recommended by my PCP who said she'd let him operate on her own mother. also my friend's husband is an anesthesiologist and actually did have him operate on his own father, so my husband and i took his diagnosis and recommendations to heart. maybe he just told me what i wanted to hear since the notion of surgery is so terrifying to me. but here i am 3 months after our last visit and 8 months into this hellish journey. i have experienced some improvement here and there, but i still can't sit at a desk for more than 20 minutes without my legs falling asleep or walk up a hill without feeling like i'm ready to fall over. my feet buzz, my vision is tweaked and i can't pick up my child.

an additional tidbit is that the NS i refer to above doesn't take my insurance, so it is highly unlikely that he would perform my surgery if i decide to go that route. i just saw him to get his opinion on my case after seeing 3 other surgeons (2 NSs and 1 OS), and we certainly didn't expect the recommendation to avoid surgery that he provided.

oh, jenny, i know you are right. i know the numbness and weakness is not a good thing and that i should just bite the bullet and get this taken care of before it gets worse. i am normally not one of those people who lives in a state of denial or plays the ostrich game with my head in the sand, but this is such a delicate issue for me. i just keep hoping it will go away!!! my sister's situation weighs so heavily on my mind--she was such a beautiful, strong and active person and now she is a shell of a human being. she had the laminoplasty done 6 months before the ACDF, and they did the ACDF because her NS thought it would help alleviate some of her pain. it didn't.

so now i am left with the issue surrounding which surgeon to use. the spine specialists in my city work at less than stellar hospitals. in fact, the OS i saw who is a spine specialist works at a hospital that gave us the complete creeps. i am going to start researching additional surgeons in the greater Bay Area to find someone who specializes in spine surgery and works at a better hospital. hopefully that won't take forever.

man, i know this is long-winded, but i am just grateful to have an outlet like this to help me process through all of this really difficult stuff. THANK YOU, everyone, for "listening" to me.

 
Old 09-17-2009, 04:02 PM   #5
Senior Member
(male)
 
Join Date: Aug 2006
Location: seattle
Posts: 171
matt3507 HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Hi binx and sorry you are having such a bad time of it. I too have had a c5-c6 problem for 3+ years. My strength level is that of a 95 year old. 5 - 10 lbs. that's it. Please keep us updated on your condition, there are very experienced, nice people on this board. Take care

 
Old 09-17-2009, 08:30 PM   #6
Senior Member
(female)
 
Join Date: Nov 2003
Posts: 287
Kaycee41 HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Just wanted to update you on my husband. He has continued the physical therapy and is having really good results. The PT can detect some muscle weakness, mostly in his wrist, but his strength is coming back quickly. Here's the best news....NO pain. Even the numbness at the tip of his thumb is gone. We are almost afraid to be too hopful, but things are looking good. He will have two more weeks of physical therapy, mostly to streghten his neck muscles to avoid injury in the future, then he is on his own. He is very commited to keeping up with the program. We went to see the NS Tuesday and he was also pleased and agreed that no surgery was needed at this time. However, he did say again that it was likely he would have problems sometime down the road. Keep us in your good thoughts. Best wishes to all of you!!!!

 
Old 09-18-2009, 02:35 PM   #7
Senior Member
(female)
 
Join Date: May 2009
Posts: 103
binx HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

kaycee,

i am so happy to hear that your husband is experiencing some relief and that the NS is no longer indicating surgery for him. hurray!! thanks for sharing the good news, and i'll keep my fingers crossed he is able to keep the symptoms at bay for many years to come.

and thank you, matt, for touching base on my thread. it is good to know there are so many other people out there with this crazy injury. i just wish science would come up with better ways to "fix" the problem.

best wishes to you all.
binx

Last edited by binx; 09-18-2009 at 02:37 PM.

 
Old 09-20-2009, 03:39 AM   #8
Newbie
(female)
 
Join Date: Sep 2009
Location: St Petersburg, FL US
Posts: 3
MCandyG HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

please disregard my last post

Last edited by MCandyG; 09-20-2009 at 03:41 AM.

 
Old 09-21-2009, 12:32 PM   #9
Member
(female)
 
Join Date: Jul 2009
Posts: 67
p313rk HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Hi - I was looking at some of your posts and wanted to ask a couple of questions...
I have a large broad based disc herniation at C5/C6 with forminal stenosis. It is a result of degeneration, not one single incident or injury. Anyway, I've been out of work since 7/21 on rest and PT and I'm feeling a lot better and ready to return to work on Monday. I still have some aching in my left tricep and my left wrist gets taxed easily. But since the tingling and numbness no longer exists, I think I can put off surgery. My doctor will tell me tomorrow at a follow-up appointment,

Anyway - I see your husband has similiar issues and I'm wondering what he has been told by his doctor. It seemed from looking at the posts that there was conflicting information. My doctor told me that most people do not need surgery. But then I look at some posts here, and others seem to think that surgery will be needed eventually and sooner is better than later.

I know everyone is different, so there can be different approaches to take. Since I'm not in significant pain and there is progress, I'd prefer to wait. But I do worry that waiting may end up in a worse condition later on.

 
Old 09-23-2009, 06:33 AM   #10
Senior Member
(female)
 
Join Date: Nov 2003
Posts: 287
Kaycee41 HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

The information on herniated discs is very conflicting! We have a friend who's son has two herniated discs and has been in a great deal of pain for over a year and a half. His doctors have tried everything....injections, traction, physical therapy etc. It seems like they are avoiding surgery at all costs. Then my husband goes in with very little symptoms...slight shoulder pain and a little numbness in his thumb...and his NS says surgery will probably be needed. My husband pushed physical therapy. My friend said that one of the reasons her son's doctors wanted to put off surgery is that he is so young (30), but that does not make since to me. Our doctors discribed the nerve compression this way....if you have a heavy piece of furniture on a thick carpet it will put a dent in it. If you move the furniture, the "dent" will slowly come up, but if you leave the furniture there it will cause a permanent dent. My husband's disc injury happened the first of Aug and it has steadly improved. He had been faithful to the physical therapy, in fact, I have to remind him not to overdue it. Right now, he is almost normal. He still is a little weaker in his left grip due to weakness in his wrist, but it is getting stronger every week. That is the reason the NS said surgery was not needed. Now we just have to wait and see what happens in the furture. The PT and the NS said to avoid working overhead. They said he would start to feel a tingling or discomfort when he was pinching that nerve. However, the doctor said that discs do not heal and usually cause problems down the road, so it feels like you are living with a "time-bomb" waiting to go off. We are afraid every time he lifts something or looks up for any amount of time. Life will change from here on. At physical therapy, they are working on stengthening the muscles in his shoulder and neck so they will support the neck. Posture is also important. As long as there is improvement, I think I would postpone surgery and see what happens.

Last edited by Kaycee41; 09-23-2009 at 06:34 AM.

 
Old 09-23-2009, 12:16 PM   #11
Inactive
(female)
 
Join Date: Feb 2009
Posts: 3,894
Blog Entries: 12
jennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB Userjennybyc HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Kaycee....I think I can explain why it is so confusing for you.

First, spine docs do NOT operate for pain. Spine surgery to relieve pain is only successful about 30% of the time...bad odds. The pain is caused by the pinching of the nerve but it is a very much alive and kicking nerve. If it weren't a live nerve, it wouldn't hurt.

Second, spine docs DO operate when a nerve is in danger of dying as seen in loss of function. Loss of function shows as loss of strength, loss of feeling that starts as tingling or numbness, and muscles that don't work properly. And even a lessening of the pain while the other functions are getting worse is bad. All show a nerve in distress that if not relieved, may die.

Third, once you do have surgery, usually some kind of fusion, you then have arthritis setting in and the problems just SLOWLY escalate. If you make 2 vertebrae not move, then the others around it grate on it and you get arthritis and more pain and more problems with bone spurs causing more nerve compression. So for your husband, he is older and so the escalating problems will go on for just so many years. For a 30 year old, he is looking at 50+ years of escalating problems.

Does this make any more sense to you? If so, I'll confuse you more.

When it comes to the spinal NERVES, pain is a good sign. Not what we usually think. Spinal CORD compression doesn't hurt...like the brain doesn't hurt...has no nerve endings. But it's symptoms again are loss of function anywhere below the level of the compression. So if your cord is compressed in your neck, it can show up as numb toes and difficulty walking. Nerve compression shows up along the length of that individual nerve. Cord compression can show up anywhere below that level and in any nerve.

Everyone complains about the pain and pain is what sends us to the doctor. But pain is in and of itself, not a bad thing when it comes to the nervous system. If you think of what a stroke does it makes sense. A stroke from a clot causes brain cells to be deprived of blood and they die and the areas served by those cells then goes numb and useless. No pain. That is what the docs worry so much about with nerves. Continued compression will eventually cause the blood supply to the nerve to be cut off and then the nerve dies. Same with the cord. So symptoms that are showing slowly developing paralysis are what they operate for.Those are the symptoms of the blood supply being slowly but surely being cut off. Surgery's aim is to restore full blood flow.

But even then, part of the nerve can die. I won't go into that but that is what I'm dealing with right now.

Does this help?

gentle hugs...............Jenny

 
Old 09-24-2009, 01:57 PM   #12
Member
(female)
 
Join Date: Jul 2009
Posts: 67
p313rk HB User
Re: conservative treatment not working for c5-c6 hernation w/ myelopathy

Hello,
Well, I did see my doctor this week and there is no strength improvement in my left arm and it continues to be weaker than my left. (I'm left handed). He thinks I should consider surgery since he's concerned the herniation on my nerve may contribute to permanent weakening. In fact there's one particluar exercise in which I hold out both arms in front of me and pushes down on my hands. My right hand I'm able to hold up but the left one goes right down. Seeing that exercise result really hit home on how much strength I've lost. So even though I'm not in signnificant pain, I have to agree with him that I don't want this to continue. So I'm going 30 mores days with PT and in the meantimne schedule 2 more opinions with other neurosurgeons. At least this way I'll have more comfort in my decision.


So I totally get the explanation about the dent in the carpet. I need to move that furniture so the carpet will rise again

Kaycee - I hope your husbands progress continues on this positive path. Please keep us posted.

And Jenny - Best wishes to you since I know you've got your own issues now. Although it's nice to see you are still typing.

Robin

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Dentist told me there isn't conservative treatments for closed lock?? violet89 TMJ Disorder -TemporoMandibular Joint 4 03-01-2009 09:12 PM
Morton's Neuroma...does conservative treatment really work? jen9803 Foot & Ankle Problems 4 02-20-2008 07:43 AM
ANYONE ON HERE FROM THE UK - advise needed about treatment on nhs tkb Spinal Cord Disorders 27 11-19-2007 04:59 AM
Traction as conversative therapy moonchaser Spinal Cord Disorders 18 03-08-2007 10:25 AM
Conservative Treatments raylp TMJ Disorder -TemporoMandibular Joint 2 08-20-2006 11:32 AM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 09:09 PM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!