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Old 01-15-2013, 09:01 AM   #1
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Question Surgery for cervical spondylosis with radiculopathy?

Hi all, This is my first post on here. I'm looking for feedback on your experience dealing with treatments or surgery. I've been trying to decide if I should have surgery (removing C5-6 disk and splint with cadaver bone) or just suck it up and live with the condition.

For the past 15 months, I've had pain in my neck, shoulder & upper arm (all left side), with tingling & numbness running down to my thumb & index finger. I've done PT, epidural steriod shots and medication. The PT helped initially relieve the muscle spasms. Shots didn't help. Gabapentin (neurontin) helps the pain and numbness, but I can't take a full dose and work. It leaves me in a fogged, drugged state. I've had 2 MRIs and I've seen a neurosurgeon who has explained the procedure and the risks of paralysis, voice change, death... I now need to decide if the risks are worth the potential results.

So how do I know if I should have the surgery now, wait until I have worsened symptoms or try something else? What have you done, and what were the results?

 
Old 01-15-2013, 12:25 PM   #2
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Re: Surgery for cervical spondylosis with radiculopathy?

If you only have radiculopathy (that is, if you have no accompanying symptoms in your legs, which would indicate a cord problem), then you may get by with just a foraminotomy, which is a MUCH less drastic surgery than an ACDF. Post your latest MRI report here, and you will get some informed opinions.

 
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Old 01-15-2013, 01:00 PM   #3
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Re: Surgery for cervical spondylosis with radiculopathy?

First MRI report below (done last Jan). I don't have a copy of the second MRI report.

Findings: There is a left posterolateral/foraminal disc extrusion at c5-c6 resulting in impingement on the cervical cord and exiting nerve root. Mild right-sided C5-C6 foraminal stenosis present secondary to uncovertebral joint hypertrophy.

Bilateral neural foraminal moderate stenonsis is present at c6-c7 secondary to uncovertebral joint hypertrophy, worse on the left.

At C3-C4, there is left posterolateral/foraminal osteophytic ridging and disc bulge resulting in moderate severe foraminal narrowing. Mild foraminal narrowing is noted on the right at this level. The remaining discs are unremarkable. There is mild flexion through the mid cervical spine, likely due to splinting. The cervical cord signal and cervicomedullary junction are unremarkable.

Impression: C5-C6 left posterolateral/foraminal disc extrusion and psteophytic ridging resulting in impingement on the cervical cord and exiting nerve root.

 
Old 01-15-2013, 01:17 PM   #4
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Re: Surgery for cervical spondylosis with radiculopathy?

OK, so you have only one anomaly that the radiologist believes merits special mention, which is that you seem to have C5-6 disk that's herniated toward the left. That's entirely consistent with your symptoms.

I do not know if a foraminotomy could take care of that or not. It's a surgery that comes in from diagonally behind the spine, so it might not be able to access that disk herniation. Should be easy enough to find out. If the first surgeon recommended an ACDF, I would STRONGLY recommend getting a second opinion, and specifically asking about foraminotomy, or even non-surgical options. It just seems to me that an ACDF might be overkill, at this point.

I am NOT saying the surgeon you talked to is wrong (assuming he did actually recommend an ACDF). I'm just saying it's best to explore alternatives, and you seem to have some time. I hope your system will allow you that freedom.....

Last edited by WebDozer; 01-15-2013 at 01:19 PM.

 
Old 01-15-2013, 02:00 PM   #5
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Re: Surgery for cervical spondylosis with radiculopathy?

My husband would like me to try acupuncture. I'm going to look into that tomorrow. I'm also going to contact my insurance provider and see about a 2nd opinion. I've been reading a lot of posts on here today and other internet searches. I see people saying don't wait until you have permanent nerve damage. Get 2nd & 3rd opinions. Also a lot of subsequent surgeries needed.

A couple of things that I've come across and wondered about myself is balance issues and effect on thyroid. I've fallen twice in the past 3 weeks. I've also put on about 20 lbs since I started taking the neurontin, and total of 30lbs since I started having the neck and arm pain. I'm wondering if these could be due to the nerve issues or medication.

 
Old 01-16-2013, 09:51 AM   #6
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Smile Re: Surgery for cervical spondylosis with radiculopathy?

Thank you for your comments. The surgeon that I've seen is at Dartmouth Hitchcock Hospital (Dartmouth College Medical School) in their Spine Treatment Center. He is a spine neuro-surgeon. They are about an hour and a quarter away from home. My local hospital does not have a neuro-surgeon. The other medicial school hospital in the area is Fletcher Allen (University of Vermont Medical School). I'll probably have to go there for a second opinion. Other options would be Massachusetts or Connecticut.

I'll let you all know what I find out.

 
Old 01-16-2013, 10:03 PM   #7
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Smile Re: Surgery for cervical spondylosis with radiculopathy?

I had cervical disk c4-c5 removed and fused just after thanksgiving, I went home from the hospital the next day. My spinal cord was being pinched by the ruptured disk, and hopefully I won't have permenant damage, I just went back to work on Monday, part time. The reason is I have terrible pain in my lower extreminities that has been keeping me from working due to the use of narcotics. Due the sugery before something bad happens, it won't get better on it's own, only worse.

 
Old 01-22-2013, 06:59 PM   #8
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Re: Surgery for cervical spondylosis with radiculopathy?

Most states have online databases for their medical professionals and it will tell you about any kinds of medical malpractice they might have on their files.

 
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