I'm new to this website, but have read alot of the messages u have all posted and i am in the same boat. I have severe spinal stenosis in c3-4 moderate in c5-6, and moderate in c6-7, i saw a NS yesterday who looked at my mri, and told me and my husband all this information. Now i have been a registered nurse for 11years on a med/surg floor, but all of this is very difficult to understand even w/ medical knowledge. I had an injury when i was 16 doing a full twist that unfortunately one time of doing it landed on my head, hearing my whole neck crack, and my chin going into my chest, bruising my sternum. Nothing was broken but pulled all my tendons in my neck. So since this injury i have always had neck pain. I have had numbness here and there, had mri's 5yrs ago saw NS but reported if i didn't have pain then u want to just see if i could deal with it, and said looking at the mri' it didn't look as bad as the pcp thought and called me right away saying i needed to see a NS right away. So for the five years i dealt w/ it and the numbness weirdly went away but this year has come back all the time w/ neck movement and thats' when i had the mri, and they told me i had all this severity and moderate spinal cord compression from bone spurs and herniated discs. So this NS said i would have to have an anterior fusion from c3-c7. I'm so scared!!!!!! i have looked on the internet and read horror stories, i'm scared of not having good results, and ruining my life w/ my son and husband and step kids. i want to be able to continue being a nurse, i've worked in a hospital since i was 15, this dr. i was recommended by a physiotherapist to go see, and then i discussed what this dr. said and said i should just get a second opinion, and recommended one in boston so they had me fax over my mri report and will let me know in a few days when to schedule an appointment. what if this dr. says something totally different how do i know wh/ way to go. I know worry doesn't help, and sometimes i'm ok, but others i worry, their is so much to do, for being out of work. I just went back to work after having to have surgery for a benign tumor removal of my foot. UGH i also increased my hours worked for a couple of wks and this happens, nothing to provoke that i was aware of just woke up in the am, w/ severe rt shoulder, neck, and rt arm, forearm pain and numbness in both hands, i also get spasms of my lt elbow and in my rt rib area, and some tingling in my legs at times. So i know that something is definitely wrong. I just don't know what the right surgery is for me and scary that u trust all this to dr. that do a 4hr non stop surgery holy crap. I may be a nurse but i honestly hate dr's. or dislike i should say less harsh. i don't mind working w/ them, but when i see them i get sooo scared, and nervous, and i'm very sensitive and not all dr's have a nice warm and fuzzy personality. I think i am very compassionate w/ my patients, not all dr's are like this. You don't know if they are good or not, u can't interview them, i go to websites to read about them for peoples comments, but still difficult cause their is always someone who says they were 4 stars and someone who says they were 1 so that's my story so i don't know gotta just go w/ the flow, and see. i have a very supportive family w/ helps and fb games that keep my mind off of stuff, but i thought maybe talking to others who have been through it might be helpful as well. If u read this thanks for listening, i know it's alot LOLOL
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I know surgery is scary but I had a 4 hour non stop level 2 acdf and I'm fine. Sometimes you just have to be brave-it's either surgery which in most cases does help or staying the way you are in pain.
If you want to find out about a doctor go to your state's medical board-it should be online. Finding out if they have any malpractice or disciplinary measures against them is the first step. When it comes to online reviews I would go for what the majority says about a doctor. Some people think having surgery is going to be a cure all and when it isn't they tend to blame the surgeon.
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Thank you for ur responses, i'm hoping i have a good outcome, i will try to be positive. that's all i guess i can hope for, hoping to get some more answers when i go to the dr. in boston, so we'll see Also what do u mean level 2 ? was ur's just c2 and that's it or from c2 down????
Hi Brandi....this is my story, maybe it will help you.....
I had my first ACDF in 2006, I was fused from C4-C7, considered a 3 level fusion because 3 discs were done. I was great for almost 2 years, then I started to have problems again. Had another MRI and found out that C2-3 blew, which is a 1 level, since it's one disc; and had surgery in Jan of 2009. Again, I was great for about 2 years, then started having issues again--just had my 3rd surgery in January to fuse C7-T1. So, I am fused from C2-T1, almost my entire neck, and I am fine. There are days that I feel discomfort, but it's nothing like what I was experiencing prior to the surgery. The reason I had to have the surgery was because my discs were sitting on top of my spinal cord, if I didn't have the surgery there was a very big change that I would have become paralyzed. If you have to have surgery, you have to have it.
Here is my recommendation, you want to go to a neurosurgeon that specializes in the spine. You want to see that doctor at a teaching hospital, such as a University Hospital, they are the best doctors because they teach the medical students and are up on all the latest things. They are all associate professors or professors, that is the type of physician you want. If you have a second opinion and he says something out of left field, go get a 3rd opinion. You do what you have to do until you find the right doctor and you feel absolutely comfortable with him/her.
I wish you the best of luck.
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i'm so glad u replied, ur response brought me to tears, i am very scared. I'm so glad to know someone who has had some good outcomes. i have been thinking and thinking about all of this, and having some knowledge of all this i think makes it worse. I don't understand totally the terminology i'm learning, like trying to understand my mri, trying to even look at the mri is difficult. i do know my spinal cord instead of looking like an oval that it should it looks like a thin boomerang at spots. I appreciate all of the posts, i'm so glad that i found this site, and i think both the dr.'s that i have seen, one is an assistant professor at umass spine clinic and the other is a professor as well at a spine clinic at newton wellsley in boston. so that's good to know, i know they were recommended by the physiotherapist i saw to begin with. seriously thank you it gives me a little hope.
I had a posterior laminectomy & foramenectony with fusions from c3 - T2. The operation lasted 6 hours. I too was very scared about the operation. I sought two opinions from prominent doctors. One said I could wait on the surgery while the other said I needed it in the very near future or end up possibly paralyzed. To break the tie, I went to a 3rd NS. He broke the tie and agreed I needed the surgery very soon. From his examination, he noted that the stenosis was beginning to affect the messages in my legs and that I could have permanent nerve damage of my left arm ( it was very weak). I was terrified but realized it had to be done. I had it done by the second neuro I visited. He is rated as one of the top 100 in the country. When he planned the surgery, he decided to go in the back for more stability and was planning from C3-C7. The day of my operation, he had the MRI I had done two weeks prior from the surgery. He told me he would have to go further - to the T2. I trusted him completely. It is now 6 months later & I'm doing better. The strength is returning to my right arm.
So all is going well. It's normal to feel this way. Select a doctor that is extremely experienced, highly rated and one you can trust. Do your homework and all will be well. I give you all my best wishes.
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thank you so much so glad to hear all your stories, it truly makes u feel better and a little more confident, i hope i get to see the boston dr. and ur right i will get a 3rd if i need to, u guys are all wonderful. Thank you all
Brandi - Please post your most recent MRI. A four-level ACDF is a big deal, and we ought to at least consider alternatives, but that can't be done w/o the MRI. If you take the trouble to enter it, I will say as much as I can...
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curious if u are a physician or radiologist, would like to see what u think anyway,
Findings: Vertebral body morphology, marrow signal and alignment are w/in normal limits. The spinal cord is normal in signal. the craniocervical junction is normal.
C2-C3: There is broad osteophytic spurring. There is left c3 neural foraminal stenosis. The right c3 neural foramen is patent.
C3-C4: There is bilateral uncovertebral joint hypertrophic change. There is moderate spinal canal stenosis (axial T2 image 8) and bilateral C4 neural foraminal stenosis.
C4-C5: There is a broad-based disc osteophyte that flattens the ventral margin of the thecal sac, causing mild spinal canal stenosis. There is also bilateral C5 neural foraminal stenosis.
C5-C6: there is a broad -based disc osteophyte that causes mild spinal canal stenosis and bilateral C6 neural foraminal stenosis.
C6-C7: There is a prominent central disc protrusion and there is a broad osteophytic spurring. There is moderate spinal canal stenosis and moderate, bilateral C7 neural foraminal stenosis.
Impression: Diffuse sppondylosis causing multilevel spinal canal and neural foraminal stenosis. Findings are predominantly bilateral.
So this is it, however the neurosurgeon didn't agree w/ some of the report saying that c3-c4 were severe and c5-c7 were moderate, so i don't know??? waiting to see the other neurosurgeon for a second opinion.
For starters, I have to say that's a LOUSY radiologist's report. He shouldn't have been paid for that. In fact, he should be fined and censured for turning out crap like that. Either he's lazy and indifferent, or he doesn't know enough about what he's looking at to make decent commentary. Let me see what I can do with it, though...
<< curious if u are a physician or radiologist >>
Neither one. Just a guy who's had three cervical surgeries over 16 years, looked at a lot of MRI's, read a lot of reports, and researched things a little. So you should, of course, keep in mind that I'm an amateur, and I can only supply background.
<< C2-C3: There is broad osteophytic spurring. There is left c3 neural foraminal stenosis. The right c3 neural foramen is patent. >>
So you have bone spurs at these levels. The R doesn't bother to tell you WHERE they are, but I guess he didn't think that matters. "Foraminal stenosis" literally means "narrowing of the opening", and refers to the opening (foramen) in the bony cage of the spine through which the peripheral nerve leaves the spinal cord and heads off to the neck, shoulder and arm. The C3 nerve leaves from the C2-3 level. You might want to find an online graphic of this, because your problems seem to be entirely foraminal in nature.
<< C3-C4: There is bilateral uncovertebral joint hypertrophic change. There is moderate spinal canal stenosis (axial T2 image 8) and bilateral C4 neural foraminal stenosis >>
The uncovertebral "joint" is a formation on the side of the vertebra that stabilizes the spine when bending and twisting. Hypertrophy means that you're laying on extra bone there, which could eventually interfere with the nerve pathways (foramina). Something is pushing into the spinal canal (which holds the spinal cord), but the R doesn't say what. He also doesn't bother to indicate the severity of the foraminal stenosis.
<< C4-C5: There is a broad-based disc osteophyte that flattens the ventral margin of the thecal sac, causing mild spinal canal stenosis. There is also bilateral C5 neural foraminal stenosis. >>
A "disk osteophyte [complex]" is where, over long time, the parts of the vertebrae where they interface with the disks start to form bone spurs which push backward into the spinal canal and into the foramina. Sometimes the disk itself is also bulging out. The "thecal sac" is the membrane enclosing the spinal canal, and at this level it is being pushed on by the osteophytes. The R is kind enough to tell us he thinks the effect is "mild" (nothing to worry about, yet) there, but can't be bothered to supply an adjective to the foraminal stenosis.
<< C5-C6: there is a broad -based disc osteophyte that causes mild spinal canal stenosis and bilateral C6 neural foraminal stenosis. >>
Same thing at this level.
<< C6-C7: There is a prominent central disc protrusion and there is a broad osteophytic spurring. There is moderate spinal canal stenosis and moderate, bilateral C7 neural foraminal stenosis. >>
OK, at least here he bothers to use adjectives. At this level the disk itself is pushing out in addition to the osteophytes. "Moderate" is one step below "severe", and means the R thinks this is worth a close look. Just because you have CANAL stenosis does NOT mean that your CORD is affected, though. You have some leeway in the canal where the spinal fluid surrounds the cord. A halfway-decent radiologist would have told you that you either do or do not have cord involvement. (can you tell I'm ****** at this guy?)
<< Impression: Diffuse sppondylosis causing multilevel spinal canal and neural foraminal stenosis. Findings are predominantly bilateral. >>
Just awful. This guy should be sentenced to picking up trash for a few months so he can think about maybe earning the $100's he's collecting for each hour of "work".
<< So this is it, however the neurosurgeon didn't agree w/ some of the report saying that c3-c4 were severe and c5-c7 were moderate, so i don't know??? waiting to see the other neurosurgeon for a second opinion. >>
I'm sure the NS is much better at reading cervical MRI's than the R. In fact, I've had two NS's tell me they don't even bother reading the R's reports. The NS is clearly disagreeing with the R as to where the worst level is.
In summary, though, I am VERY surprised that a surgeon wants to fuse from C3 to C7. In fact, I'm surprised he wants to fuse ANY level. I must repeat, though, that I'm basing this on the R's report, which I've already said is lousy. I'm not looking at the images and, even if I were, my opinion isn't worth much more than you're paying for it. Still, C3-C7????
You REALLY need TWO more opinions, and from the best surgeons you can find. You need to look into two other kinds of surgeries, also. The first is the foraminotomy, which is the least invasive cervical surgery and is simply to carve the bone spurs that are growing into your foramina. Since your problems are multi-level and bilateral, you might need several foraminotomies. I don't really know how much they can accomplish at one time. Still, one HELL of a lot less intrusive than fusions, and with no lasting damage.
The other operation is the laminoplasty. This is an op for people whose spinal canals are too narrow to start out with. The surgeon goes in from behind and opens up the canal by swinging one side of the bony cage (the lamina) out and propping it open. He can do 3-4 levels at a time, and can, in the same operation, do foraminotomies where needed. Many American surgeons do NOT KNOW HOW to do laminoplasties, so they won't even tell you they are an option. They've been done for decades, though, in Japan.
I have had all three operations (C3-4 fusion, C5 foraminotomy and C4-5-6 laminoplasty) so I do know something about it.
See if you can get a couple of names for Boston surgeons from Jennybyc. She knows the best. Get TWO more opinions. I mean it. TWO. If you have to pay out of pocket, don't think twice about it.
Last edited by WebDozer; 05-25-2012 at 06:47 AM.
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Wow, lol u seem to know a bit about this stuff. So u think i should get a total of 3 opinions??? i don't know that person who knows a lot of people in Boston would be helpful to get in touch w/ her if u know her?
So omg i had to laugh with my husband at your comments about the radiologist, now this Dr is a radiologist at the hospital i work at. I know he's been there for a long time. I hope he wouldn't discriminate on my severity and not explaining things because of being an employee there? I don't think he would but I've had an old report from 2007 that reads i think a little better with more description in that one. let me know if u want to read that one. i type fast.
I don't disagree w/ your thoughts and i'm going to write them to my list of questions and try to get a little more fluent w/ the medical terminology wh/ i know some but not others. So to see if that idea of having the foraminotomy, or laminoplasty would be an option for me. I have been scared about being coming Frankenstein w/ nuts and bolts in my neck LOL
The neurosurgen performed his exam and when having me do certain things says just w/ that exam that their was spinal cord involvement compression, my reflexes are hyper, i also told him a couple of times when i put my neck down for a stretch cause it's tired or what ever, i feel this snap/and zing all through out the body to my foot, horrible feeling so i don't stretch my neck in that way anymore. So i'm going to find out if the guy in boston will see me, i'm kind of ****** cause by this radiologist report i don't want him thinking that i have mild symptoms by basing his decision to see me on this report. and then not taking me to reallly look at my mri and do an exam. so we'll see i may ask this dr. who said he would give a call to the dr their if i have trouble getting in to see him. then we will try to get a 3rd opinion as well and then see thanks for the humor and the great information