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Old 02-16-2012, 08:43 AM   #1
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Question herneated disc on C7, surgery to prevent nerve dying?

My MRI shows a moderately herneated disc, putting pressure on C7. The neurosurgeon says the sooner we operate, the better so as to allow that nerve to heal and hopefully regain the strength in my tricep. Currently other parts of my arm are hurting, but the tricep doesn't hurt. He says that means it is dying. The MRI was done on Saturday, day one of my prednisone Rx. I took the last prednisone yesterday. I am also taking a narcotic for pain. Tramadol. I am in much less pain than before (horrible pain), but it is still a big problem and I am going around with my arm over my head. I have to sleep this way also to get relief. I don't know what to do.
My big questions:
1. Should I just go ahead and have the surgery through the back of my neck? He says I would go in the morning and come home the next day.
2. Is endoscopic surgery better? I am seriously considering making an appt with a place that does this.
3. Am I really in a race against time with this nerve damage?
4. If I don't have the surgery, can I expect this pain to get better? Will I likely be on pain meds for a long time?
5. Why does everyone say to avoid surgery? What's so bad about surgery?

This situation makes me sick to my stomache. I am a stay at home Mom to a 4 year old. Any advice is greatly appreciated.

 
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Old 02-16-2012, 11:33 AM   #2
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Re: herneated disc on C7, surgery to prevent nerve dying?

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Originally Posted by rbeck View Post
My MRI shows a moderately herneated disc, putting pressure on C7. The neurosurgeon says the sooner we operate, the better so as to allow that nerve to heal and hopefully regain the strength in my tricep. Currently other parts of my arm are hurting, but the tricep doesn't hurt. He says that means it is dying. The MRI was done on Saturday, day one of my prednisone Rx. I took the last prednisone yesterday. I am also taking a narcotic for pain. Tramadol. I am in much less pain than before (horrible pain), but it is still a big problem and I am going around with my arm over my head. I have to sleep this way also to get relief. I don't know what to do.
My big questions:
1. Should I just go ahead and have the surgery through the back of my neck? He says I would go in the morning and come home the next day.
2. Is endoscopic surgery better? I am seriously considering making an appt with a place that does this.
3. Am I really in a race against time with this nerve damage?
4. If I don't have the surgery, can I expect this pain to get better? Will I likely be on pain meds for a long time?
5. Why does everyone say to avoid surgery? What's so bad about surgery?

This situation makes me sick to my stomache. I am a stay at home Mom to a 4 year old. Any advice is greatly appreciated.
If you are able to transcribe your MRI report here it would help greatly. Many of us here can help you with terminology. As for me I'm 16 days out of a Cervical Laminectomy with fusion,screws,and rods. The levels involved were C3 - T2. The diagnosis was Cervical Myelopathy. Anyways, I wih you the best.

 
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Old 02-16-2012, 12:57 PM   #3
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Re: herneated disc on C7, surgery to prevent nerve dying?

<< 1. Should I just go ahead and have the surgery through the back of my neck? He says I would go in the morning and come home the next day. >>

You have not said what kind of surgery he suggested. "Going in from behind" could be at least four different things.

<< 2. Is endoscopic surgery better? I am seriously considering making an appt with a place that does this. >>

same answer as (1)

<< 3. Am I really in a race against time with this nerve damage? >>

"Race" may be overly dramatic. If you are going to have surgery, there is no point in waiting and doing so increases the chances of permanent damage.

<< 4. If I don't have the surgery, can I expect this pain to get better? Will I likely be on pain meds for a long time? >>

No one should even think of trying to answer that w/o knowing what your MRI radiologist's report says. Can you post it?

<< 5. Why does everyone say to avoid surgery? What's so bad about surgery? >>

Everyone does NOT say that. Certainly, things CAN go wrong with surgery, and the more extensive the surgery the more likely that is. Still, a lot of these anti-surgery attitudes seem to be left over from the past. Spinal surgery is drastically better than it used to be.

 
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Old 02-16-2012, 01:35 PM   #4
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Re: herneated disc on C7, surgery to prevent nerve dying?

I'll take a stab at answering a little more thoroughly.

1) sounds like the doc wants to go in and open the hole around the nerve...foraminotomy...maybe a laminoplasty of the bone as well but obviously he doesn't think you need a full fusion of the vertebrae(ACDF) as that is done from the front. If that is what is being proposed, that is good...fusion is the big problem in a neck and no fusion but allowing the pressure to be taken off the nerve is a good idea...I'm scheduled for the same thing in my lumbar spine.

2) I talked to my physical therapist about this this AM and we both agreed that being able to see what you are doing is REALLY important in spine surgery. Endoscopic surgery means doing the same thing through a scope so you are dealing with cameras and tools at the end of a fiber-optic scope. Now, I've had 8 of these in my knees and got to watch one of them, and both of my shoulders and I'm not so sure I'd want it in my neck where a fraction of a millimeter can make the difference between using a limb and losing that limb to paralysis. My doc works under microscopes with open incisions and I'd go that way if it were me.

3) No you aren't. You still have feeling and movement in your arm. If the arm was numb and you had lost muscle function in the muscles served by the nerve, then you'd want to move faster but I had surgery with no use of my left arm at all and still got almost everything back. You probably could wait at least another year and not have any permanent damage.

4) The pain in all likelihood will get better but not for the reasons you think. As the compression gets worse, you slowly go from bad pain to numbness and the pain goes away. No pain IS a sign that permanent damage may be occurring. Pain is actually a good sign as only a live and kicking nerve can hurt. As for surgery alleviating the pain....there are no guarantees. You may continue in the same pain or be worse...no one knows. Surgery is done to make sure it doesn't get any worse and you avoid paralysis.

5) Traditionally, docs jumped right into fusions with almost any problem in the spine. But recent studies show that fusions can actually make the spine worse...lumbar or cervical. If you are structurally unstable, a fusion will make it more so and lead to further fusions. If your doc just wants to open the holes to alleviate pressure and do no fusion, then that is a good start. Always to the most minimal surgery you can do.

Jenny(fused C3 to T1)

 
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Old 02-16-2012, 08:51 PM   #5
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Re: herneated disc on C7, surgery to prevent nerve dying?

[QUOTE=jennybyc;4929012]I'll take a stab at answering a little more thoroughly.

1) sounds like the doc wants to go in and open the hole around the nerve...foraminotomy...maybe a laminoplasty of the bone as well but obviously he doesn't think you need a full fusion of the vertebrae(ACDF) as that is done from the front. If that is what is being proposed, that is good...fusion is the big problem in a neck and no fusion but allowing the pressure to be taken off the nerve is a good idea...I'm scheduled for the same thing in my lumbar spine.

2) I talked to my physical therapist about this this AM and we both agreed that being able to see what you are doing is REALLY important in spine surgery. Endoscopic surgery means doing the same thing through a scope so you are dealing with cameras and tools at the end of a fiber-optic scope. Now, I've had 8 of these in my knees and got to watch one of them, and both of my shoulders and I'm not so sure I'd want it in my neck where a fraction of a millimeter can make the difference between using a limb and losing that limb to paralysis. My doc works under microscopes with open incisions and I'd go that way if it were me.

3) No you aren't. You still have feeling and movement in your arm. If the arm was numb and you had lost muscle function in the muscles served by the nerve, then you'd want to move faster but I had surgery with no use of my left arm at all and still got almost everything back. You probably could wait at least another year and not have any permanent damage.

4) The pain in all likelihood will get better but not for the reasons you think. As the compression gets worse, you slowly go from bad pain to numbness and the pain goes away. No pain IS a sign that permanent damage may be occurring. Pain is actually a good sign as only a live and kicking nerve can hurt. As for surgery alleviating the pain....there are no guarantees. You may continue in the same pain or be worse...no one knows. Surgery is done to make sure it doesn't get any worse and you avoid paralysis.

5) Traditionally, docs jumped right into fusions with almost any problem in the spine. But recent studies show that fusions can actually make the spine worse...lumbar or cervical. If you are structurally unstable, a fusion will make it more so and lead to further fusions. If your doc just wants to open the holes to alleviate pressure and do no fusion, then that is a good start. Always to the most minimal surgery you can do.

Jenny(fused C3 to T1)

Hi Jenny, how long has it been since you had your surgery, did you have help around the house and how sore was your neck? I had 3 level in 2002 and I remember my neck was very,very sore, they went in the front, so does that mean they will have to go in the back this time ,If I have a plate in already will they leave it in , sorry so many questions but I am facing surgery in the near future , my neck is a mess , I was born with a narrow canal ,I should have had surgery 3 years ago, I also have lumbar stenois ,so I am thinking they will do the neck first since it can cause more nerve damage , the other day I bent over to pick up something and I felt the bones in my thoracic make a crunching sound, that was scary , thanks for your replies

 
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Old 02-16-2012, 09:55 PM   #6
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Re: herneated disc on C7, surgery to prevent nerve dying?

Quote:
Originally Posted by rbeck View Post
My MRI shows a moderately herneated disc, putting pressure on C7. The neurosurgeon says the sooner we operate, the better so as to allow that nerve to heal and hopefully regain the strength in my tricep. Currently other parts of my arm are hurting, but the tricep doesn't hurt. He says that means it is dying. The MRI was done on Saturday, day one of my prednisone Rx. I took the last prednisone yesterday. I am also taking a narcotic for pain. Tramadol. I am in much less pain than before (horrible pain), but it is still a big problem and I am going around with my arm over my head. I have to sleep this way also to get relief. I don't know what to do.
My big questions:
1. Should I just go ahead and have the surgery through the back of my neck? He says I would go in the morning and come home the next day.
2. Is endoscopic surgery better? I am seriously considering making an appt with a place that does this.
3. Am I really in a race against time with this nerve damage?
4. If I don't have the surgery, can I expect this pain to get better? Will I likely be on pain meds for a long time?
5. Why does everyone say to avoid surgery? What's so bad about surgery?

This situation makes me sick to my stomache. I am a stay at home Mom to a 4 year old. Any advice is greatly appreciated.
First of all xrays and MRIs are pretty useless in a case like this. As soon as you know you can get relief from putting your hand on your head plus the rest of the history it is evident that you have a C6 disk causing a C7 root palsy. Triceps becomes weak and also wrist flexors or extensors although you probably don't notice that. Sometimes serratus anterior, the muscle that can be seen along the outer ribs in bodybuilders can also weaken. It may be that your triceps has already been weakened and may or may not be helped by an operation. Folks who have a weak triceps, unless they do work which loads up the triceps will hardly notice that it is weak. If you are going to stack high shelves with heavy boxed all day you will have a problem. The good news is that C7 root pain spontaneously recovers in about 3 to 4 months. Some muscles recover almost fully, I don't know the percentage. Any spinal operation, at least to me is a big deal.
James

 
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Old 02-17-2012, 07:37 AM   #7
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Re: herneated disc on C7, surgery to prevent nerve dying?

Thanks so much for the replies. I have the actual MRI, but no text report to go with it, unfortunately. I wish I could provide more details. I would have posted last night but I had to keep my arm over my head again and couldn't type. I was only taking one pain pill at a time yesterday, and it wasn't enough. I'm also having some nausea and headaches.
I think I may have been feeling some pain in my tricep muscle yesterday, which I thought was a good sign, since the doc says that is where I have weakness from the dying pinched nerve(s).
I'm meeting with a 2nd neurosurgeon today- one who does less invasive endoscopic spine surgery. I understand what you are saying about needing to be very precise in the neck. I will ask him about this.
Has anyone out there had endoscopic surgery for a herniated disc in the neck? Maybe I can ask the Dr today for references.
Because I was in shock over the whole 'dying nerves' situation at the visit with the first Dr, I wasn't able to concentrate on what he said about the actual surgery. I should've been taking notes. He said it would be through the back of the neck and would be less involved than going through the front and using metal parts. I don't know the name of the surgery though. I have another appointment with him on Monday. I had gone to see a chiropractor two times last week before going to a MD. He is very interested in my situation and wants to review my MRI with me for no charge. He says that surgery is barbaric. My MD said not to go back to him until after having the MRI results. I won't be going back for any adjustment unless I'm advised that would be okay/good.
My husband and I really appreciate the answers. If anyone has anything else to add, please do share.

 
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Old 02-17-2012, 09:57 AM   #8
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Re: herneated disc on C7, surgery to prevent nerve dying?

Not knowing how much you know about neck anatomy, let me explain what is going on(what I presume is going on) so you can talk about it with some understanding.

The C6-7 vertebrae are at the bottom of the neck and the nerves that exit go out to your arms but also feed all the way down to the fingers...important area. Between the 2 vertebrae is a disk that acts as a cushion and as we age, it gets drier, shrinks and is liable to tear(herniate). When it does that(through age or injury)the disk material can come in contact with the nerves that are peeling off the spinal cord. At each vertebra, a pair of spinal nerves peels off the cord and go out to the body...1 to the right and one to the left side. They exit the spinal cord canal through small holes they call foramina. Since this is a "fixed" point of exit, this is where all the trouble is as the nerves can't move away from the trouble. So if the disk just so happens to tear and bulge out in the area of these holes, the nerve is trapped between the rock(disk) and the hard place(bone)...literally.

So the problem can be alleviated in 2 main ways...one...they make the hole bigger so the nerve can move away from the disk material(foraminotomy done from the back) or two...they go in from the front and remove the entire disk, insert something to take it's place(usually bone grafts) and then they hold the 2 vertebrae together with screws and plates until the bone grows and fuses them together(ACDF done from the front).

If the disk material is also touching the spinal cord, they may do a "laminoplasty" as well where the back of the vertebra is opened and re-shaped to make more room for the cord...but they don't do this with the C7 vertebra(or at least they shouldn't...C6 yes). Also done from the back.

The least intrusive of these is the foraminotomy and it will not destabilize the neck further but alleviate the problem. HOWEVER, as with so many of the neck problems...it can return. Since the disk is still there, it may move further and then you'd have to address the problem again. But even the ACDF with the disk removal may mean more surgery as it destabilizes the neck and you often end up with the fusion having to be "enlarged" and the go back and remove more and move disks and fuse more and more vertebrae. Even the laminoplasty can end up with additional surgery. Any of them can can end up needing more.

Anyone tells you it is a permanent fix and they aren't being honest.

So now, Rbeck, think of what you'd like to ask the doc and tell us what it is and we'll try to guide you on what else to ask or what to expect for an answer.

Jenny

 
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Old 02-17-2012, 10:03 AM   #9
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Re: herneated disc on C7, surgery to prevent nerve dying?

Capatga....I don't want to hijack Rbeck's thread so why don't you start another thread about your problem specifically and I'll answer you there. Just title is..."Jenny can you help me" or something like that so I know to respond. I don't respond if I know others have done so(lots of intelligent folks here)so it's best to ask for me specifically if you have a question for me.

glad to help you............Jenny

 
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Old 02-17-2012, 10:48 AM   #10
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Re: herneated disc on C7, surgery to prevent nerve dying?

Let me repeat, it will resolve within 4 months of onset if you just leave it alone.
James

 
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Old 02-18-2012, 07:30 AM   #11
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Re: herneated disc on C7, surgery to prevent nerve dying?

I discussed my condition with a chiropractor yesterday. He looked at my MRI and believes that with adjustments, he can restore the curve of my neck and alleviate the pressure. If only there were no risk of further damage with this, as it seems to be a way to fix the original problem. I don't plan to see him right now. I also don't want to have the surgery if it means that more surgery will likely be needed in the future. I want to go backwards, instead of digging the hole deeper.
I would like for my body to heal itself. Could you elaborate on how this takes place? How should I manage the pain and how I can best help my body to reverse the damage? Is it possible for my neck, disc, etc. to be normal and healthy again on its own? How do I get there? Do you have specific recommendations like ice/heat, steroid injections, physical therapy, traction...?
Would it be safe to allow for chiropractic adjustments after some period of time? My Mom had success with a chiropractor- her neck was straight, and was able to get the curve back in several weeks of adjustment.
This morning, my arm/hand hurts some, but I haven't felt like I needed to take any pain medicine for it yet. I can use my arm any way I want. The back of my hand is achey. My Rt tricep is a little weaker than my left, and is sore, but not numb. This seems like healing, not dying. What do you think?
James, do you have personal experience with neck trouble? You have observed many instances of C7 discs healing on their own?

 
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Old 04-03-2013, 12:29 PM   #12
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Re: herneated disc on C7, surgery to prevent nerve dying?

I know this is an old thread but I'm wondering if the OP had surgery and how she did. I'm also curious about James079 statement about the C7 nerve healing and would like to hear more about this. I have a compressed nerve at C6-7 and a weak triceps and numb forefinger which sometimes spreads to the thumb and middle finger. But mostly the index finger. I do not have pain currently (two months post injury). I am currently receiving manual traction via PT and saw a chiropractor once, with another visit tomorrow. He is using an Activator, not manual adjustments which I would not allow anyway and he says he would do them.

I have a neurosurgery consult next week and am quite terrified. I was under the impression that you do NOT want to wait as the longer the nerve is compressed, the lesser chance you have of the nerve bouncing back and the muscle working normally....but JennyBYC thinks otherwise. I have an already paid for huge, dream trip overseas this summer that I do not want to miss. :-(

 
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Old 04-03-2013, 12:40 PM   #13
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Re: herneated disc on C7, surgery to prevent nerve dying?

I know this is an old thread but I'm wondering if the OP had surgery and how she did. I'm also curious about James079 statement about the C7 nerve healing and would like to hear more about this. I have a compressed nerve at C6-7 and a weak triceps and numb forefinger which sometimes spreads to the thumb and middle finger. But mostly the index finger. I do not have pain currently (two months post injury). I am currently receiving manual traction via PT and saw a chiropractor once, with another visit tomorrow. He is using an Activator, not manual adjustments which I would not allow anyway and he says he would do them.

I have a neurosurgery consult next week and am quite terrified. I was under the impression that you do NOT want to wait as the longer the nerve is compressed, the lesser chance you have of the nerve bouncing back and the muscle working normally....but JennyBYC thinks otherwise. I have an already paid for huge, dream trip overseas this summer that I do not want to miss. :-(

 
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Old 04-04-2013, 09:59 AM   #14
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Re: herneated disc on C7, surgery to prevent nerve dying?

SusanB61, I did not have the surgery. It was scheduled, but as it came closer, I decided to cancel because I was beginning to be able to better manage the pain with my Rx. After about one month, I was able to switch to OTC meds. I saw a physical therapist for a while. Now, one year later, I don't notice any problem with my arm or hand at all. My neck is still sometimes sore/stiff. I am interested to hear how well the activator and traction helps, and what you decide.

 
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Old 04-04-2013, 06:17 PM   #15
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Re: herneated disc on C7, surgery to prevent nerve dying?

Thanks for the quick reply rbeck! How weak was your right triceps? How long did it take for you to regain strength? I'm going on 9 weeks post injury and I'm having trouble with my right hand/arm but I REALLY want to avoid surgery. I have very little pain, it's mostly weakness and numbness that I'm dealing with.

To me surgery is a last resort but this idea that "time is not on my side" is quite anxiety provoking. Also, the ACDF procedure sounds like a potential nightmare. How many weeks or months did you wait post injury or onset of symptoms to schedule surgery? You must be incredibly relieved that you did *not* go through with it! Your reply is actually giving me a lot of hope!

Last edited by SusanB61; 04-04-2013 at 06:18 PM.

 
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