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  • C 5-6 herniation with spinal cord thinning

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    Old 06-01-2004, 05:38 PM   #1
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    C 5-6 herniation with spinal cord thinning

    Any advice or anyone out there with a similar dx ? I am posting on behalf of my friend. She has been in terrible pain for about 2 months now. About a month ago i noticed a bulge about the size of a baseball on the back of her neck. I had been telling her that her symptoms were that of a c-spine herniation seeing that i have already been through that. I told her that she needed to go to her pcp asap. She went and he ordered a c-spine mri which came back showing a herniation at the c 5-6 level with it pushing against the spinal cord and spinal cord thinning. The pcp told her that she should not be doing anything at all that with the thinning of the spinal cord that she could become paralyzed. He also told her that if she opted to have surgery that she may have a 50/50 chance of coming out of surgery paralyzed. So off to the neurosurgeon she went. When she got there in came a physicians assistant. I am not knocking the PA'a out there but with the pcp talking about how serious this was........ the PA didnt really tell her anything but wrote her a script to have PT for a month and see if the pain was better! Also he didnt even suggest coming back to be rechecked or see if the PT was working. When her pcp found out about this he wanted her to have a 2nd oppinion so i called and got her scheduled to see my neuro. She isnt due to see him till next week. Her pain is much worse and now she is telling me that she has this weird feeling that she cant explain, other than saying that it is almost like a numb feeling, in the left side of her head. She is already a migraine sufferrer so i believe that this is also triggering her to have more migraines than usual. I wanted to know if anyone else out there had the same kind of dx with the thinning of the spinal cord and if the docs had also suggested to any of you about paralysis? Any input would be super! Thanks a bunch in advance. Hurdy

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    Old 06-01-2004, 08:12 PM   #2
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    Re: C 5-6 herniation with spinal cord thinning

    After many years of conservative therapy to include pt, arthritis pool therapy, TENS unit, NSAID's, heat, massage, steroids, muscle relaxers, and epidural steroid injections in the cervical spine for degenerative disc disease caused by severe spinal osteoarthritis, I finally came to the point that surgery was the only other option and my neurosurgeon told me the danger of paralysis was high, so it really was a no-brainer to decide to have the surgery. I had four levels (C2-3, 3-4, 4-5, and 5-6) both ACDF and PCDF with titanium plating. The posterior incision runs from the base of my skull to about 6 inches downward and the anterior incision is about 3 inches and is hardly noticeable now after 9 weeks, although the posterior incision is still very tender and I am still wearing a Miami J hard collar except for sleeping. I am feeling a little better every day and have cut down to just one pain pill and a muscle relaxer at bedtime. The recovery from this surgery is no picnic but considering the alternative, and after having obtained opinions from three neurosurgeons, I'm sure this was the only option I had. I am glad that I had it done and I am sure that even with the pain and muscle spasms that have followed the surgery, I would opt to have the surgery again. I was so scared of surgery as I am 74 years young, but I had excellent care both in the hospital (5 days) and since I have been home from two doting daughters and my wonderful compassionate husband. I was able to work out in my flower garden almost all day today (taking lots of little rests) and that is a great improvement for me. Good luck and God bless!

    Old 06-02-2004, 09:05 AM   #3
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    Re: C 5-6 herniation with spinal cord thinning

    Hi Wendy sorry to hear that your friends sx are getting there any
    chance your NS can get her in sooner considering her sx have progressed ?
    I have never had headaches before but since my recent dx of C-5,6 disc
    protrusion I have noticed I am getting a few..I am not sure how comparable
    my MRI results are to your friends..however I did have my appt. yesterday
    with the Physiatrist and the results are as follows : no PT was recommended,
    this doc did say it would not get any better anatomically-no mention of
    paralysis per say however,she did recommend epidural injections first with
    a 50 % chance of improving the sx if no improvement then surgery.She did
    not do an EMG test as she felt with her physical exam there was already
    evidence of nerve impigement at C 7 in regards to the left arm,hand. The
    problem from my perspective is she expressed herself she has done over
    500 of these injections in lumbar area but less than 100 in cervical area and
    explained in cervical area with the cord,etc it is more risky there.She gave
    me an rx for morphine for the pain and I just set up an appt. with the director
    of spinal surgery at our local teaching hospital for a second opinion- at this
    point I would agree to try the epidural injections first but I want a doc that
    has more experience in the cervical area.This has been my experience so far
    and I hope it at leasts gives you guys something to compare to...

    Take Care..Chris

    Old 06-02-2004, 11:39 AM   #4
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    Re: C 5-6 herniation with spinal cord thinning

    Hi Chris!!!!! It's been a few days since i heard anything from ya on here. I was getting a little concerned for you. I am glad that you finally had your appt and that you are getting a second oppinion. I am a believer of second opinnions especially when it comes to your spinal cord. I sure wish that my friend could have gotten in sooner but i guess i thought we were doing good seeing when i called my NS to make her an appt her wait was about 3 weeks and when her pcp wanted her to see a ns asap and they scheduled her at a large teaching hosp as well, they werent going to see her for 2 1/2 months!!!! A couple of days later they called her and had an openning and wanted her to come in the next day so she went and after she got there found out her appt was with a PA. I guess i wouldnt sound so harsh about her seeing a PA if he would have been a little more aggressive and given her more guidance as to what she should do instead of having to live with the pain. When she went back to see her pcp and told him that the pa just suggested pt for a month he said that maybe the pa just wanted to do that because of the fear of possible paralysis during surgery. I guess we will know more when she sees my ns next week. As far as you are concerned it sounds like you may be heading for surgery. Are you getting good pain relief with the ms? Also, what strength and how often is it prescribed and does it make you tired? Let me know, i am curious. I am just frustrated because i am still having ALOT of pain in my neck. Most days i am wishing i didnt have surgery. This pain that i am having since surgery is different than the pain i had before surgery. I went back to see my ns 2 weeks ago and the x-rays looked good, but i dont feel good. I was surprised when i seen my x-rays because the hardware was not what i had expected. I had the acdf C 4-5 and 5-6 with titanium cages. No plating, soft collar 24/7 except when showering for approx 6 weeks. During surgery the ns put these cages in the disk space and then filled the inside of the cages with demineralized bone matrix. As the ns described the demineralized bone..... it's like a powder substance that he adds water to and makes a putty out of and then injects it inside these cages. It is actually really neat, on x-ray my c-spine looked normal except where he removed the discs all you could see was these tiny little metal clip looking cages slid into where the discs should have been. I did like this whole concept because there was no questions about donor bone and i didnt have to endure any extra pain from having bone taken from my hip. Well, i have yacked your ear off long enough, let me know how you are doing. Wendy

    Old 06-04-2004, 08:52 AM   #5
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    Re: C 5-6 herniation with spinal cord thinning

    Hi there Wendy sorry I didnt get back to you sooner but I had to work early
    yesterday-you know one of those lovely back to back shifts...I am also in
    agreement with you about the PA situation as I dont think that was appropriate for an initial neuro exam,dx and plan of treatment for your
    friend - I definately would have wanted the NS for the intial exam,etc and
    the PA used for follow-up,etc. Yes,it does appear surgery may be on the horizon for me,however at this point I am ready for some resolution in this
    matter. As to your question,the Physiatrist rxed morphine 15 mg I.R. tabs
    to take 1-2 every 4 to 6 hours as needed.There is no doubt this med has
    provided superior pain relief for me as opposed to the Vicodin-however,it
    does make me less alert,etc but I am still able to function at home-the operative word being at home as when I am at work if the pain gets bad I
    use 1/2 Vicodin with an extra strength tylenol to get by.I can definately
    understand your frustration concerning your pain still present after post-op..
    from what I understand a good majority of patients still have to be on some
    sort of long term pain management-some for life,even after having surgery
    in the cervical area.In your case,I definately would be aggressive in seeking
    out pain management to allow yourself to get back to the quality of life you
    had before this medical dx. Pretty cool about your x-rays and how the actual
    proceedure was done...I am glad the X-rays looked good..

    Take Care....Chris

    Old 06-04-2004, 08:54 PM   #6
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    Re: C 5-6 herniation with spinal cord thinning

    Originally Posted by Hurdy
    About a month ago i noticed a bulge about the size of a baseball on the back of her neck. I had been telling her that her symptoms were that of a c-spine herniation seeing that i have already been through that. Hurdy
    A bulge the size of a BASEBALL???? I have never heard of that in relation to a disc herniation - the discs are nowhere near that big anyway! Maybe it was just swelling? Muscle spasms big-time? Some kind of mass?

    Anyway, there is no way I would accept a treatment plan from a PA. She needs a thorough neurosurgical evaluation first, and then the neurosurgeon should plan the treatment (or surgery). I have nothing against PA's either (I'm an RN), but it seems really inappropriate to me. PA's can do the follow-up. If it were me, I'd definitely hold off on the PT until after seeing the neurosurgeon.

    I also think it was inappropriate for her PCP to give her "odds" on paralysis with or without surgery. That's why God made surgeons!!

    So now, she's probably scared to roll over in bed - some docs are sooooooo stupid. I hope she can relax a bit - anxiety increases pain!! - and that the neurosurgeon will give her some news she can be comfortable with.

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