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Old 01-27-2003, 04:54 PM   #1
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KeithEugeneW HB User
Post Nerve Block Injections vs cervical fusion?

I have severe disk degeneration of C5-C6 and C6-C7, and what little is remaining of the 2 disks is bulging back into the spinal column, putting pressure on the spinal cord. For about 18 years I have had progressively increasing neck stiffness and pain, followed by varying numbness in my right fingers and hand, and then whole arm for about the last 4 years. Now my shoulder hurts continuously, my neck is in constant pain, and the migraines feel as though they may very well blow my head off my shoulders! I had 2 MRI's, a year apart, which confirmed the above, and showed significant changes in just one year (for the worse). The orthapedic (spine) surgeon is well respected and I trust him. He has sent me first to a pain management doctor and I am scheduled for 3 sessions of epidural injections/nerve blocks, with hopes that there is a 50% chance of avoiding anterior cervical diskectomy on the 2 disks. This pain management doctor also has me on naproxen and neurontin (1200mg per day). This seems to help me ignore the pain very well, but I'm ini a fog most of the time now. Fortunately I have an understanding boss, but I'm not interested in being like this for a long period of time. Is 50% a reasonable percentage to expect for positive results, or is this just prolonging the inevitable to appease the SOBs running the HMO? Also, is there a better alternative to neurontin? I guess 25 years of working with computers wasn't such a good idea.

 
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Old 02-03-2003, 08:52 PM   #2
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Post

Hi, Keith. Sorry to hear about your neck pain. I know how frustrating and tiring it is to keep running back and forth to doctors but in my own opinion, anything that helps to avoid surgery is a good thing and worth a try. As far as meds go, to be honest, nothing I tried really stopped my neck pain (see profile), but, believe it or not, simple prescription ibuprofen took the edge off and helped me sleep at night(however, it was a megadose). You could also try Carisoprodol or Methocarbonal - both muscle relaxers.

If you decide to try the injections, let us know how they worked for you. Good luck and feel better.

Renee

------------------
1982 Fusion surgery for scoliosis with stainless steel Harrington Rod - T5 - L3 - using pelvic bone for grafting
1999 Neck problems began
2001 Cervical Kyphosis
2003 3 Herniated Cervical Discs - C4 thru C7. One disc (C5-6) pressing on the spinal cord (no nerve root compression) causing leg problems - diagnosed with Myleopathy and anterior cervical discectomy recommended.
__________________
1982 Fusion surgery for scoliosis with stainless steel Harrington Rod (T5 - L3) using pelvic bone for grafting
1999 Neck problems began
2001 Cervical Kyphosis
2002 Diagnosed with Epstein-Barr (level was 7+) and Chronic Fatigue Syndrome
2003 3 Herniated Cervical Discs - C4 thru C7. One disc (C5-6) pressing on the spinal cord (no nerve root compression) causing leg weakness, tingling, burning and numbness - diagnosed with myelopathy and ACDF recommended.
2/24/03 One-Level Anterior Cervical Discectomy with donor bone and titanium plate (C5-6)
Post 2/03 - Symptoms returned and worsening. Weakness in my legs is like walking against a 50 mph wind - pain in lower back and all the way down my right leg to the ankle - vertigo, muscle spasms in trunk and legs
7/03 EEG, BAERS and MRI of brain all normal
7/03 MRI of lumbar spine showed mild herniated disc (L4/5) with moderate to severe DDD and edema in the endplates. HOLDING OUT FOR ARTIFICIAL DISC REPLACEMENT!

 
Old 03-22-2005, 12:32 PM   #3
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chefbart HB User
Re: Nerve Block Injections vs cervical fusion?

I submit that trying the epidurals is a definite pre-requisite to any fusion. I have had both. My fusion is at L4-5, S1. I did not have any epidurals to this area before surgery, in fact they were never offered. I currently have degenrative disks at C4-5, C7, and likely anywhere else they might look! But after having had my first round of 3 epis, I really didn't think they were the solution. I had a secondary round of 3 a few months later, again thinking there was no benefit. But after some time passed, I must say that amazingly all the symptoms were gone (arm numbness, rib pain), and very little pain along the spine also. It has been over 2 years since the injections, and other than stifness in the neck and upper back, I have remained symptom free. So wether it was prayer, medical efficiency or both, I highly suggest the epidurals and some patience, which I realize is the hard part when pain is your constant companion.
Best of luck to you.
this is the guy who used to reside in my neck, but no more.

 
Old 03-22-2005, 01:23 PM   #4
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wimpette HB User
Re: Nerve Block Injections vs cervical fusion?

Hi Keith,
Nerve blocks serve two functions. Firstly they can alleviate symptoms often to a stage where surgery is no longer necessary. Secondly they can help the surgeon diagnose what surgical procedure to do and how extensive based on your response to blocks at different levels. This can mean having fewer levels fused based on how you do after the block.
Remember, surgery should be considered a last resort and is not necessarily a cure.
Good luck, hope the blocks help.
W

 
Old 06-01-2005, 07:48 AM   #5
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Lightbulb Re: Nerve Block Injections vs cervical fusion?

Hi All,
I am new to this board and find it facinating with the information that is being shared among the users. Thats why I decided to join and ask a few questions.
My back ground: I am a police officer and I suffered a neck injury from an accident while in a cruiser in November 2000. With minor but steady pain, I was sent to PT for a while. After the couple of years my neck pain worsened, finally to the point where I had to see an orthopaedic surgeon. I have had two MRIs. One about 14 mos ago and one about 3 months ago. The first one showed a problem (misallignment) with c4-c5 and c5-c6. It has progressively worsened since I drive a minimum of 2 hours each way to and from work. On a bad day my commute both ways can be over 3 hours. My pain is worse when I drive (I guess its the seated position). On 2/8/05 I woke up and was in severe pain. My right arm felt numb and was painful. I shrugged it off because I had to testify in court that day. After finally being able to get to sleep the that night, I woke the next morning and I was in unbearable pain with my neck, shoulder, upper and lower arm and my entire hand was numb (feeling like its sleeping). Although the pain has subsided, my right thumb is still numb and has been since February 9th.

Treatments/Testing:

*2003 nerve conduction test (needles in the back and shoulders, showed some carpal tunnel type symptoms in LT hand )
* 2004 First MRI (showed misalligned discs)
* 2004 Second MRI (after 2/9 and awaking to severe pain) Showed degenerated discs, sitting on a nerve causing pain/numbness in rt arm/hand
* 3/05 doctor treated me with steroids for my neck. Seemed to have helped some w/pain and releaved some pain/numbness with rt arm
* 03/05 Numbness in RT thumb remains. No change. Doc starts to treat me with Carpal Tunnel treatments (steroid injections and splits)
* 04/05 treats the carpal tunnel with neurotin. All to no avail. Numbness remains unchanged.
* 04/05 Doc now believes that I do not have carpal tunnel and all my hand problems are a direct result of my neck injury (disc pressing on a nerve). He abandons the Carpal Tunnel theory.
* 05/05 Doc is sending me for Cervcal Epidural Blocks

My questions are this:

* The epidural blocks simply treat the symptoms right and not treat the injury itself causing the problem?

* WHat are normal treatments? Docs office says I need 1 treatment each week for three weeks.

* SIde effects of the proceedures? Death in a small percentage??? Yikes!

* How long do they last? I assume this will be a repeat treatment if I am to keep the pain in check right?

* ALso, does anyone know the specific steroid that is injected? Is it the same that they put in my wrist to try to treat me for carpal tunnel?

Thanks guys. Sorry it's so long winded.

Bobby

 
Old 06-01-2005, 08:43 AM   #6
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Scorpio24 HB User
Re: Nerve Block Injections vs cervical fusion?

I have the same questions as leatherman. Hopefully somebody will have info about it.
Thanks

 
Old 06-01-2005, 09:10 AM   #7
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dennisgb HB User
Re: Nerve Block Injections vs cervical fusion?

Quote:
Originally Posted by KeithEugeneW
I have severe disk degeneration of C5-C6 and C6-C7, and what little is remaining of the 2 disks is bulging back into the spinal column, putting pressure on the spinal cord. For about 18 years I have had progressively increasing neck stiffness and pain, followed by varying numbness in my right fingers and hand, and then whole arm for about the last 4 years. Now my shoulder hurts continuously, my neck is in constant pain, and the migraines feel as though they may very well blow my head off my shoulders! I had 2 MRI's, a year apart, which confirmed the above, and showed significant changes in just one year (for the worse). The orthapedic (spine) surgeon is well respected and I trust him. He has sent me first to a pain management doctor and I am scheduled for 3 sessions of epidural injections/nerve blocks, with hopes that there is a 50% chance of avoiding anterior cervical diskectomy on the 2 disks. This pain management doctor also has me on naproxen and neurontin (1200mg per day). This seems to help me ignore the pain very well, but I'm ini a fog most of the time now. Fortunately I have an understanding boss, but I'm not interested in being like this for a long period of time. Is 50% a reasonable percentage to expect for positive results, or is this just prolonging the inevitable to appease the SOBs running the HMO? Also, is there a better alternative to neurontin? I guess 25 years of working with computers wasn't such a good idea.
Keith,

In my opinion, you hit the nail on the head in the last few sentences. My situation sounds very similar to yours. I lived with it for 20 years. I had the shots, and they lasted about a month. Eventually I had ACDF on C5-6 and C6-7 last June. I feel great.

Consider, your disks have degenerated pretty far. In my case it was bone on bone. The shots are only going to kill the pain, not fix the problem. Once the shots wear off...

BTW, I hated the neurotin, and fought with my docs, because I couldn't do my job while taking it.

Dennis

Last edited by dennisgb; 06-01-2005 at 09:14 AM.

 
Old 06-01-2005, 09:59 AM   #8
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Scorpio24 HB User
Re: Nerve Block Injections vs cervical fusion?

Having a level 2 cervical problem; what are the consequences or long term effects if a person does not have the ACDF surgery? Do I loose the use of my left arm or more neck problems?
Thanks,
Frank

 
Old 06-02-2005, 07:08 AM   #9
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dennisgb HB User
Re: Nerve Block Injections vs cervical fusion?

Quote:
Originally Posted by Scorpio24
Having a level 2 cervical problem; what are the consequences or long term effects if a person does not have the ACDF surgery? Do I loose the use of my left arm or more neck problems?
Thanks,
Frank
Frank,

It really depends where you are at. In my case, I would get up in the morning and feel fine until I drove to work, and then the pain would start. If the disks are shot over time you will irritate and possibly damage the nerves due to the rubbing of bone on them, etc.

Really need more info on your situation to tell.

Dennis

 
Old 06-02-2005, 07:24 AM   #10
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chitowngl HB User
Re: Nerve Block Injections vs cervical fusion?

Bobby,
First of all welcome to the boards, but sorry for the problems!! I had a ACDF on C5-C6 back in January. My symptoms prior to that: woke up one morning and could not raise my left arm over my head. I had all the tests: MRI, XRrays, EMG, CT myelogram. My ortho (who has a spine fellowship-Very Important) suggested the steroid shots in my neck along with PT. I had one shot and definately would not do that again! For me it was incredibly painful and did not relieve my symptoms at all. However I will point out that EVERYONE is different. Some people have found incredible relief with these shots, though you are only allowed 3 in a six month period. I was on neurontin which didn't help and vicodin for the pain. The physical therapy didn't really help me and after much discussion with my doctor we decided to go ahead with surgery. I had a severly pinched nerve along with bulging and stenosis. My doctor felt that I stood a chance of permanent nerve damage, which of course I did not want. However, I will point out again that everyone is different, as you will find out from the members of this board. What was right for me may not be right for you.
I wish you good luck and take care.
Carrie

 
Old 06-02-2005, 09:13 AM   #11
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Scorpio24 HB User
Re: Nerve Block Injections vs cervical fusion?

Quote:
Originally Posted by dennisgb
Frank,

It really depends where you are at. In my case, I would get up in the morning and feel fine until I drove to work, and then the pain would start. If the disks are shot over time you will irritate and possibly damage the nerves due to the rubbing of bone on them, etc.

Really need more info on your situation to tell.

Dennis

Dennis,
I have C4-5, C5-6 and C6-7 herniated disks with bone spurs, moderate flattening of the nerves and reduction of the spinal canal in those areas. So far I have seen one NS with a second opinion schedule for June 14 and my regular Neurologist on the 10th. My symptoms started about 8 months ago with a stiff neck then later developed a dull pain and numbness to the left arm and thumb. The pain and numbness are not constant and only get more intense at the end of the day but nothing excruciating. I have taken medications and physical therapy for about 2 months but the pain and numbness level are about the same after all the treatments. My NS wants to do a level 2 ACDF with a plate as my only option because I have tried the other methods with no change. I mentioned the steroid injections and he said that is a temporary solution. Iím concerned about the loss of range in motion of my neck and the surgeon scaring the nerves during surgery. So I was not sure if waiting to have the surgery it was going to have more irreversible damage or continue to have the same pain for rest of my time on earth. Of course the NS did say that it would damage the spine but Iím always cautious about the sales pitch.
Thanks for your words,
Frank

 
Old 06-02-2005, 10:39 AM   #12
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Re: Nerve Block Injections vs cervical fusion?

Frank,

You are a candidate for surgery, but, with the level of pain you have, you can go for a while. I lasted for about 8 years from the point you are at before my surgery. The last 2 years were pretty bad. Listen to your docs...and your body.

My pain was pretty much constant left shoulder, left arm and hand. It got to where it was difficult to sleep at all. I have allergies to many pain meds, so I lived with the pain.

I had basically the surgery that you are talking about on June 30, 2004. I had donor bone.

I have zero pain with the exception of muscle spasms when I overdo things. I also have a very slight tingle in the tip of my left index finger that I feel in certain positions. This I think might be permanent nerve damage.

I can hardly see the scar from the surgery. I don't know about internal scaring, but I don't feel anything.

While you may read a lot of negatives on this and other boards, consider, that most who come here are looking for answers to problems. Once people are "fixed" they have no need to come back. I am one of the exceptions, because this board helped me so much prior to my surgery and during recovery, I feel I owe it to others who need the same help.

One thing that I am coming to understand, is that it's important to make some lifestyle changes in order for this surgery to work. I quit smoking 8 weeks before the surgery and have not had a cigarette since. I have been doing my excercise routines, a dicipline that I never was good at before. I also have changed my diet, and drink lots of water. I know this sounds like some sort of soap box I'm up on, but my docs were straight with me and said you do not have to do these things, but you will have a much higher chance for success if you do them.

When I came out of the surgery, I felt so much better, that the pain from the surgery wasn't that bad. I never took any morphine in recovery or in my room, and went straight to oral meds. and home. While I was laying there, I said to myself that this was a miracle (after living with the pain for so long, it was like being given your life back), so I decided, I was going to do everything I could to make sure this lasted.

Dennis

Last edited by dennisgb; 06-02-2005 at 10:41 AM.

 
Old 06-02-2005, 11:39 AM   #13
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Scorpio24 HB User
Re: Nerve Block Injections vs cervical fusion?

Dennis,
Thanks for the information and your support.
That is the part I have concerns about the waiting or procrastinating but I will over this when I go to see the other Docs to double check my options. Currently my left arm is a little weaker than the right and I guess that is the reason why the NS wants to do the surgery soon rather than wait for further damage.
If I have this procedure done I will also come back from time to time to this board to offer my experiences to others. Is the right thing to do.
Thanks Dennis and take care.

 
Old 06-02-2005, 11:58 AM   #14
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dennisgb HB User
Re: Nerve Block Injections vs cervical fusion?

Quote:
Originally Posted by Scorpio24
Dennis,
Thanks for the information and your support.
That is the part I have concerns about the waiting or procrastinating but I will over this when I go to see the other Docs to double check my options. Currently my left arm is a little weaker than the right and I guess that is the reason why the NS wants to do the surgery soon rather than wait for further damage.
If I have this procedure done I will also come back from time to time to this board to offer my experiences to others. Is the right thing to do.
Thanks Dennis and take care.
It's a really hard decision to make. I know I tried everything I could before doing the surgery. It won't be so scary once you get there. You and your docs will know when the time comes.

BTW, my left arm was about 40-50% weaker than my right. Now, it's as strong if not stronger, and I'm right handed.

Take care, and let us know what you find out.

Dennis

 
Old 06-07-2005, 04:27 AM   #15
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goawaypain HB User
Re: Nerve Block Injections vs cervical fusion?

Hey, I have the same thing going on with my neck, but just c5-6. I have tried the shots, did not work. Did the nerve burning thing, did not work. Did the neucleoplasty, did not work. Surgery is last hope except the said don't expect too much pain relief, just that it would stop the progression at that level, but could cause the levels above it and below it to go bad from the fusion. Ask about Topamax, much better than neurontin imo, and I take fioricet for the headaches. good luck.
t

 
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