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  • Asymptomatic Severe Cervical Spinal Cord Compression

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    Old 05-15-2015, 08:28 AM   #1
    Andrade
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    Asymptomatic Severe Cervical Spinal Cord Compression

    I'm 65 years old, male.
    In Nov 2014 I found by casualty (MRI – magnetic resonance imaging) that I have severe spondylotic cervical myelopathy (SCM) at C4-C5.
    I don’t feel or show any neurological symptoms, like gait or radiculopathy. Neither feel any pain.
    One neurosurgeon strongly recommends surgery, because, he says, I’m in great danger and I will get symptoms soon. Another neurosurgeon strongly recommends not doing surgery, as long as I don’t show any symptoms, because, he says, my case is clinical, not surgical, and recommends me to take care, don’t walk in slippery floors and don’t put my head to much backwards.
    Does anyone has a similar condition that may help me to decide for surgery or "wait an see"? Is there any less invasive surgery that in spite not decompressing the spinal cord might at least delay progression, like ozone therapy or foraminotomy?
    Many thanks

     
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    Old 05-16-2015, 09:28 AM   #2
    nancyjune
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    I'm a 69 year old female who has had Degenerative Disc Disease of my cervical spine for many years and knew it was a matter of time before I had to have surgery. My neurosurgeon confirmed that because an accident on a NYC bus last August caused a herniation between T1 and T2 it was time to fix the whole shebang. And he's very conservative as far as surgery; I first saw him in 2000 when three other neurosurgeons wanted to fuse my neck. But I had no symptoms; just what they saw on the x-rays. In my gut I knew it wasn't right for me just yet. So when I first saw my current Dr. - the 4th opinion neurosurgeon - he said sure, based on your x-ray films I'd agree this should be fixed, But since you're not having any symptoms let's wait and see. It took you 55 years to get to this point; who knows? It may be many more years before it bothers you and we need to operate.

    Bless his heart. He was right. On April 23 of this year I had a 7-level posterior cervical thoracic laminectomy and fusion involving C3-T2. The surgery went extremely well and I am now three weeks and two days post-op. The recovery and healing has been excellent so far. And I am very careful in regards to no bending, lifting, or twisting. I'll be in the cervical collar four to six weeks, and once the Dr. determines the fusion is well underway I will start physical therapy.

    Please keep in mind this was my experience and everyone is different. You have to decide what is best for you. But the bottom line is go with your gut feeling. I've found it rarely if ever steers you wrong. Good luck!

     
    Old 05-16-2015, 04:47 PM   #3
    ChuckStr
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Wow Nancyjune that is an enormous surgery. I'm so happy that recovery is going well.

    Andrade, welcome to the board.

    I have some spinal cord compression at c5/c6 although not severe, i do have some symptoms. I get muscle twitches in my legs and they are "heavy" and I have some numbness and tingling in my hands and feet. I also had a couple of bouts of severe radicular symptoms (pain, weakness) worse on my left side that have mostly resolved. At one point my left grip was about 50% reduced but it is more or less back to normal now 14 months later. I visited a total of 5 spine specialists including a couple of teaching spine surgery professors and an ex professor ranked among the top surgeons in the country. The consensus was to watch and wait which is what I've done the last 14 months. I visit the main surgeon every few months and they make sure my symptoms ate not progressing. I also self monitor strength etc more frequently myself. Overall I'm doing ok so far. All of the surgeons I saw said it is likely I'll need surgery at some point in the future but I've been able to fight it off so far. I have limited ROM in my neck and my left arm still doesnt feel right. It definitely tires more quickly and cramps more than my right arm. I still have the twitching in my legs. Overall though I don't feel too bad and I'll probably stave off surgery as long as I can.

    One other thing I'll mention is that the different surgeons all had slightly differing opinions. One, said he expected I wouldnt be able to use my arm within a year (which, thankfully isn't true) and one said don't bother with surgery. Others were somewhere between. I point that out because I think it is a good idea to get multiple opinions so you feel more confident in your decision.

    Good luck and let us know how you get on...

     
    Old 05-18-2015, 07:14 AM   #4
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by nancyjune View Post
    I'm a 69 year old female who has had Degenerative Disc Disease of my cervical spine for many years and knew it was a matter of time before I had to have surgery. My neurosurgeon confirmed that because an accident on a NYC bus last August caused a herniation between T1 and T2 it was time to fix the whole shebang. And he's very conservative as far as surgery; I first saw him in 2000 when three other neurosurgeons wanted to fuse my neck. But I had no symptoms; just what they saw on the x-rays. In my gut I knew it wasn't right for me just yet. So when I first saw my current Dr. - the 4th opinion neurosurgeon - he said sure, based on your x-ray films I'd agree this should be fixed, But since you're not having any symptoms let's wait and see. It took you 55 years to get to this point; who knows? It may be many more years before it bothers you and we need to operate.

    Bless his heart. He was right. On April 23 of this year I had a 7-level posterior cervical thoracic laminectomy and fusion involving C3-T2. The surgery went extremely well and I am now three weeks and two days post-op. The recovery and healing has been excellent so far. And I am very careful in regards to no bending, lifting, or twisting. I'll be in the cervical collar four to six weeks, and once the Dr. determines the fusion is well underway I will start physical therapy.

    Please keep in mind this was my experience and everyone is different. You have to decide what is best for you. But the bottom line is go with your gut feeling. I've found it rarely if ever steers you wrong. Good luck!
    Nancyjune,
    Many thanks for your so comforting words. Indeed the decision-making process is so painful, since my will is accepting right now the surgery, in the expectative of solving the problem and that’s it.
    But on the other hand I realize it may not be so straightforward, because surgery may not be so successful as I would desire, has a huge amount of risks, and also natural progression of the disease is an unknown issue.
    Listening to wise words and refraining my natural impulse to get problems solved immediately, I will have to refrain myself to accept right now the surgery, and “wait-and-see”, patiently and with resignation.
    Sorry for my bad English (I’m Portuguese).
    Many, many thanks

     
    Old 05-18-2015, 07:15 AM   #5
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by nancyjune View Post
    I'm a 69 year old female who has had Degenerative Disc Disease of my cervical spine for many years and knew it was a matter of time before I had to have surgery. My neurosurgeon confirmed that because an accident on a NYC bus last August caused a herniation between T1 and T2 it was time to fix the whole shebang. And he's very conservative as far as surgery; I first saw him in 2000 when three other neurosurgeons wanted to fuse my neck. But I had no symptoms; just what they saw on the x-rays. In my gut I knew it wasn't right for me just yet. So when I first saw my current Dr. - the 4th opinion neurosurgeon - he said sure, based on your x-ray films I'd agree this should be fixed, But since you're not having any symptoms let's wait and see. It took you 55 years to get to this point; who knows? It may be many more years before it bothers you and we need to operate.

    Bless his heart. He was right. On April 23 of this year I had a 7-level posterior cervical thoracic laminectomy and fusion involving C3-T2. The surgery went extremely well and I am now three weeks and two days post-op. The recovery and healing has been excellent so far. And I am very careful in regards to no bending, lifting, or twisting. I'll be in the cervical collar four to six weeks, and once the Dr. determines the fusion is well underway I will start physical therapy.

    Please keep in mind this was my experience and everyone is different. You have to decide what is best for you. But the bottom line is go with your gut feeling. I've found it rarely if ever steers you wrong. Good luck!
    Nancyjune,
    Many thanks for your so comforting words. Indeed the decision-making process is so painful, since my will is accepting right now the surgery, in the expectative of solving the problem and that’s it.
    But on the other hand I realize it may not be so straightforward, because surgery may not be so successful as I would desire, has a huge amount of risks, and also natural progression of the disease is an unknown issue.
    Listening to wise words and refraining my natural impulse to get problems solved immediately, I will have to refrain myself to accept right now the surgery, and “wait-and-see”, patiently and with resignation.
    Sorry for my bad English (I’m Portuguese).
    Many, many thanks

     
    Old 05-19-2015, 03:57 AM   #6
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by ChuckStr View Post
    Wow Nancyjune that is an enormous surgery. I'm so happy that recovery is going well.

    Andrade, welcome to the board.

    I have some spinal cord compression at c5/c6 although not severe, i do have some symptoms. I get muscle twitches in my legs and they are "heavy" and I have some numbness and tingling in my hands and feet. I also had a couple of bouts of severe radicular symptoms (pain, weakness) worse on my left side that have mostly resolved. At one point my left grip was about 50% reduced but it is more or less back to normal now 14 months later. I visited a total of 5 spine specialists including a couple of teaching spine surgery professors and an ex professor ranked among the top surgeons in the country. The consensus was to watch and wait which is what I've done the last 14 months. I visit the main surgeon every few months and they make sure my symptoms ate not progressing. I also self monitor strength etc more frequently myself. Overall I'm doing ok so far. All of the surgeons I saw said it is likely I'll need surgery at some point in the future but I've been able to fight it off so far. I have limited ROM in my neck and my left arm still doesnt feel right. It definitely tires more quickly and cramps more than my right arm. I still have the twitching in my legs. Overall though I don't feel too bad and I'll probably stave off surgery as long as I can.

    One other thing I'll mention is that the different surgeons all had slightly differing opinions. One, said he expected I wouldnt be able to use my arm within a year (which, thankfully isn't true) and one said don't bother with surgery. Others were somewhere between. I point that out because I think it is a good idea to get multiple opinions so you feel more confident in your decision.

    Good luck and let us know how you get on...
    ChuckStr, thank you for your so kind words.
    I do really believe it is very important to share our problems with others going through similar experiences. I’m very fortunate in being able to use the internet and participate in this forum.
    I realize that sharing experiences is much better than reading all studies about the disease – I tend to think that there is a kind of “market of studies”, each one supporting their point of view. But at the end of the day there’s a paucity of arguments against ,or in favor of surgery, at an early stage, or only when symptoms get worst, not to speak about the different cervical surgery options (invasive, minimally invasive, foraminotomy for decompression, ozone therapy – that doesn’t decompress the spinal cord but argues that delays progression, etc. etc.).
    The outcome seems to be: nobody knows well the natural history of the disease and can’t make any definitive prognosis. And one important think for us is the psychological condition – we have to be confident, and live in day-to day basis, otherwise a bad psychological condition definitively will not help to keep us walking in this life! I will keep in touch.
    Many thanks to all of you for you so kind availability to share your comforting words.

     
    Old 05-19-2015, 04:01 AM   #7
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by ChuckStr View Post
    Wow Nancyjune that is an enormous surgery. I'm so happy that recovery is going well.

    Andrade, welcome to the board.

    I have some spinal cord compression at c5/c6 although not severe, i do have some symptoms. I get muscle twitches in my legs and they are "heavy" and I have some numbness and tingling in my hands and feet. I also had a couple of bouts of severe radicular symptoms (pain, weakness) worse on my left side that have mostly resolved. At one point my left grip was about 50% reduced but it is more or less back to normal now 14 months later. I visited a total of 5 spine specialists including a couple of teaching spine surgery professors and an ex professor ranked among the top surgeons in the country. The consensus was to watch and wait which is what I've done the last 14 months. I visit the main surgeon every few months and they make sure my symptoms ate not progressing. I also self monitor strength etc more frequently myself. Overall I'm doing ok so far. All of the surgeons I saw said it is likely I'll need surgery at some point in the future but I've been able to fight it off so far. I have limited ROM in my neck and my left arm still doesnt feel right. It definitely tires more quickly and cramps more than my right arm. I still have the twitching in my legs. Overall though I don't feel too bad and I'll probably stave off surgery as long as I can.

    One other thing I'll mention is that the different surgeons all had slightly differing opinions. One, said he expected I wouldnt be able to use my arm within a year (which, thankfully isn't true) and one said don't bother with surgery. Others were somewhere between. I point that out because I think it is a good idea to get multiple opinions so you feel more confident in your decision.

    Good luck and let us know how you get on...
    ChuckStr, thank you for your so kind words.
    I do really believe it is very important to share our problems with others going through similar experiences. I’m very fortunate in being able to use the internet and participate in this forum.
    I realize that sharing experiences is much better than reading all studies about the disease – I tend to think that there is a kind of “market of studies”, each one supporting their point of view. But at the end of the day there’s a paucity of arguments against ,or in favor of surgery, at an early stage, or only when symptoms get worst, not to speak about the different cervical surgery options (invasive, minimally invasive, foraminotomy for decompression, ozone therapy – that doesn’t decompress the spinal cord but argues that delays progression, etc. etc.).
    The outcome seems to be: nobody knows well the natural history of the disease and can’t make any definitive prognosis. And one important think for us is the psychological condition – we have to be confident, and live in day-to day basis, otherwise a bad psychological condition definitively will not help to keep us walking in this life! I will keep in touch.
    Many thanks to all of you for you so kind availability to share your comforting words.

     
    Old 05-28-2015, 01:02 PM   #8
    Hillcrest
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Dear Andrade,
    I noticed that you live in Portugal.
    Did you also notice that the attitude of doctors in Europe is way different than in the US ? I saw for my very similar problem 2 surgeons in Europe and they
    both strongly recommended me to wait with the surgery as long as I can while the docs in the US told me to have surgery as soon as possible. Go figure

     
    Old 05-28-2015, 02:06 PM   #9
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by Hillcrest View Post
    Dear Andrade,
    I noticed that you live in Portugal.
    Did you also notice that the attitude of doctors in Europe is way different than in the US ? I saw for my very similar problem 2 surgeons in Europe and they
    both strongly recommended me to wait with the surgery as long as I can while the docs in the US told me to have surgery as soon as possible. Go figure
    Many thanks, Hillcrest.
    In principle I want to avoid any kind of surgery, invasive or minimally invasive, until the onset of symptoms. Meanwhile, I want to prepare myself for taking a decision as soon as symptoms appear. For this reason tomorrow I will travel to another city in Portugal to a Clinic specialized in minimally invasive surgery (MIS) to evaluate if I am a candidate to this MIS and the recomended timing for it. i will vive news on the outcome. Regards

     
    Old 05-28-2015, 02:08 PM   #10
    Andrade
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by Hillcrest View Post
    Dear Andrade,
    I noticed that you live in Portugal.
    Did you also notice that the attitude of doctors in Europe is way different than in the US ? I saw for my very similar problem 2 surgeons in Europe and they
    both strongly recommended me to wait with the surgery as long as I can while the docs in the US told me to have surgery as soon as possible. Go figure
    Many thanks, Hillcrest.
    In principle I want to avoid any kind of surgery, invasive or minimally invasive, until the onset of symptoms. Meanwhile, I want to prepare myself for taking a decision as soon as symptoms appear. For this reason tomorrow I will travel to another city in Portugal to a Clinic specialized in minimally invasive surgery (MIS) to evaluate if I am a candidate to this MIS and the recomended timing for it. i will vive news on the outcome. Regards

     
    Old 05-30-2015, 10:08 PM   #11
    PaulC456
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    Re: Asymptomatic Severe Cervical Spinal Cord Compression

    Quote:
    Originally Posted by Andrade View Post
    Many thanks, Hillcrest.
    In principle I want to avoid any kind of surgery, invasive or minimally invasive, until the onset
    I have severe stenosis inC4/5/6 and have been waiting 20years for the bad urgent symptoms. It may take that long or longer for you. It is treated as an emergency here and I will have a 3level fusion when it does go bad, whenever that may be.

     
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