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    Old 03-17-2006, 08:17 AM   #1
    niteterrors
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    Neck surgery necessary??

    I had an MRI on my neck and after reading many of the posts here, I feel much better knowing that there are others with similar (if not almost exact) MRI results on their necks and/or backs. Eases my mind. However, my doctor gave me the impression that I've got some serious stuff going on and that he felt that surgery was likely the only option, but I'm not sure I want to have surgery.

    What I'm wanting to know is if those of you with extensive knowledge of MRI reports, do you think surgery would be the only option? Or do you think that maybe non-surgical treatments could be just as effective?

    My symptoms are as follows (progressed to this point over the past 3 years) :

    Headaches, beginning at the base of my neck and extending to the right temple and behind right eye.

    Excruciating pain in the trapezeus region, extending to below the shoulder blade. The side varies, sometimes it's on the left, sometimes on the right. It's inconsistent when it comes to the side affected, but the pain is always the same. This pain is intensified when I move my head (looking left, right, up or down. It also significantly reduces my ROM to the side affected, meaning, if the pain is on the right, I can barely turn my head to look right).

    Left arm numbness upon extension. If I reach down to pick something up off the floor, table, etc., I get a combination of tingles and numbness in my hand and get a sharp pain in the shoulder (rotator cuff region).

    I was recently given some muscle relaxants, which really helped the pain; however, it did not stop the numbness occuring in my left hand.

    Here are the MRI results:

    Mild degenerative changes of the cervical spine with central canal stenosis at c5/c6, c6/c7 levels.

    c4/c5: There is a tiny disc bulge w/o central canal stenosis or neural foraminal narrowing.

    c5/c6: There is a small disc bulge with moderate central canal stenosis and mild left sided neural foraminal narrowing.

    c6/c7: There is a disc spur complex, along with facet degenerative changes causing significant central canal stenosis and moderate left sided neural foraminal narrowing.

    ------

    My family doctor wasn't able to provide clear/concise translation of this report, admiting it was beyond his spectrum of knowledge. I have an appointment set with a neck surgeon, but it's not for another couple of weeks. In the meantime, now I'm freaking out thinking that I've got significant neck problems and will have to have surgery to fix it and based on reading some of the post op reports here, surgery doesn't necessarily make everything "all better.

    I'd really appreciate it if someone could help me better understand what's going on. All I know is that stenosis is the narrowing of the canal that my spinal cord runs through...so, my mind has me envisioning that my spine is being compressed and at any moment, my neck could break with the slightest of "wrong move". Please tell me that's not the case!!

    Btw...I'm 35 and had 3 seperate accidents affecting my neck between 1988 and 1998.

     
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    Old 03-17-2006, 09:49 AM   #2
    mb100
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    Re: Neck surgery necessary??

    Niteterrors,
    It's good that your going to a neck Dr. Is he an orthopedic surgeon or a neuro surgeon. Some folks prefer a neuro but both do alot of this kind of surgery.
    Your neck isnt gonna break, relax. The compression is on the spinal cord space and roots. I thought my head was gonna fall off, I was ready to start carrying around a bucket, just in case. I would take it easy until you see the doc though, no quick head movement, and dont try to turn it far in any direction. (They told me especially dont look up) My initial MRI was similar to yours.

    DONT TAKE MY ADVISE FOR ANY OF THIS, ONLY THE DR CAN TELL YOU FOR SURE!!!!

    Search the postings from this site, some of these folks have alot of experience with this type of injury and have some good things to say. But none are a substitute for a pro. You should educate yourself as much as possible on this problem before you go to the doc. Put together a list of questions for him.

    Best of luck and take it slow.....Mike

     
    Old 03-17-2006, 05:40 PM   #3
    wimpette
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    Re: Neck surgery necessary??

    The best opinion you'll get is from a neurosurgeon specialising in spinal surgery or an orthopedic spinal surgeon - I personally saw a neurosurgeon for my cervical problems. He or she can determine whether the symptoms you're having are confirmed by your mri results or not. It looks like you have one level that is a major contributor to your symptoms, whether it's something that absolutely needs an operation or can be managed by therapy and medication will depend on how it affects your life and what potential long term problems mights occur.

    Although this might not relate to your case, my husband has an MRI that several surgeons felt needed urgent intervention - when the scans were done he had extreme numbness and weakness of one arm affecting his ability to work. He was warned that even a minor car accident could result in significant injury. 10 years later after a blast of steroids and physical therapy he is fine although his neck mri looks horrible!!

    Good luck, don't be afraid to ask questions and not rush into surgery unless there are no other options and your quality of life is affected.
    W

     
    Old 03-18-2006, 04:57 PM   #4
    ThoreauFan
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    Re: Neck surgery necessary??

    I question the tale of the husband's condition above (doesn't sound like myelopathy). The physicans' comments above are what is known as informed consent; the Dr.s should tell you the risks of all options, including that of lesser or no treatment.

    People smoke for 40 years without consequence - that doesn't mean it's smart or without significant risk.

    As clearly stated, your specialist will be in the best position to answer your questions after he/she has had an opportunity to examine you and evaluate the full impact of your condition. Have any questions at the ready.

    You should be an active participant in any treatment decision.

    Surgery is typically the last option in a long series of treatment protocols.

    I wouldn't allow yourself be influenced one way or the other by somebody else's experience.

    Last edited by funny4mony; 03-18-2006 at 05:40 PM.

     
    Old 03-19-2006, 04:11 PM   #5
    ember919
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    Re: Neck surgery necessary??

    nineterrors,
    i had to laugh a little at your post. i remember saying almost exactly the same thing to my doc a while back - "i'm starting to worry that my head is going to fall off if i make a wrong move!" i know what you mean about thinking about things like spinal narrowing, too. yuck. an active imagination is a great thing, but not so much when you're worrying about what's going on inside your body.

    surgery is a tough decision and only you can decide if it's right for you. i put off the idea of surgery for a couple of years and have only now reached the point where i think it's the best thing to do. my friends and family are all saying, "finally! it's about time!" they can't understand why i put up with pain and numbness (and tingling and burning and aching and headaches) for so long and, honestly, i'm starting to wonder why, too.

    i told the surgeon i was concerned about limited mobility in my neck after a fusion and he looked at me like i was nuts and said, "it certainly won't be any worse than it is now" well, duh, i hadn't looked at it that way, but he was right.

    i'm headed for a 2-level acdf in a few weeks and i'm still a little scared, but i'm also ready to feel better and maybe get back to a "normal" life again.

    talk to your doc and surgeon and ask about your options. medications like anti-inflammatories, muscle relaxers, narcotic analgesics and/or drugs like neurontin that help block nerve pain may help. you might try physical therapy. or maybe steroid injections. or you may decide that your quality of life has been affected to the point that you're ready for surgery.

    the mri report on your c6/c7 sounds like no fun. neither do your symptoms. i certainly wish you some relief, soon, regardless of how it's achieved.

     
    Old 03-19-2006, 07:20 PM   #6
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    Re: Neck surgery necessary??

    Hi, only you and your dr. can decide to do surgery. Try all the conservative measures first. Rest, Physical Therapy, time, Epidural or Selective nerve root injections. Then talk to dr. and if your quality of life is impacted then you can decide.

    My MRI has similar issues, I ended up with a 2 level ACDF and am now going to have another surgery this year a 1 level acdf. I had no noticeable loss of range of motion (C4-6). there are lots of good spine sites on the internet, just google things like: Spine, neck, acdf, and lots of them will pop up, make sure to use one that is from an official medical organization!


    All these things are easily researchable if you google them...this is what you said:

    Here are the MRI results:

    Mild degenerative changes of the cervical spine with central canal stenosis at c5/c6, c6/c7 levels.

    [
    COLOR=Navy]DEGENERATIVE CHANGES MEANS: degenerative changes in the spine" refers to osteoarthritis of the spine Osteoarthritis may affect any joint in your body. When it affects your back, it causes slow deterioration of the disks between the bones (vertebrae) in your spine. This results in narrowing of the spaces between the vertebrae. Bone spurs often form. When bone surfaces rub together, the vertebral joints (facets) and areas around the cartilage become inflamed and painful. Gradually, your spine stiffens and loses flexibility. Once these changes appear on X-rays, osteoarthritis has already started.[/COLOR]
    c4/c5: There is a tiny disc bulge w/o central canal stenosis or neural foraminal narrowing.
    DISC BULGE: The disc bulge occurs when the cushion between the vertebrae pushes outwards towards the spinal cord or the spinal nerves


    c5/c6: There is a small disc bulge with moderate
    central canal stenosis and mild left sided neural foraminal narrowing.

    MODERATE CENTRAL canal stenosis and neural foraminal narrowing, FYI< the central canal is where your spinal cord runs, that disc bulge is causing narrowing in there. the foamin are where the nerve roots exit the spinal cord to your extremities and it is narrowed.



    c6/c7: There is a disc spur complex, along with facet degenerative changes causing significant central canal stenosis and moderate left sided neural foraminal narrowing.

    I think you get the picture from the above.

     
    Old 03-19-2006, 10:36 PM   #7
    ThoreauFan
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    Re: Neck surgery necessary??

    I hate to be the big jerk here, but we're all either dancing around what that MRI indicates at C6-C7, or some of us aren't fully informed. A properly trained specialist would need to conduct a physical exam to determine the full impact of what is indicated on that MRI. Physicians do not treat tests; they treat people.

    An osteophyte complex causing significant stenosis can mean different things in different people.

    In some serious cases, there aren't any "conservative" options.

    I really hate the idea of somebody suffering long term damage to his/her spinal cord because they read about someone receiving cortisone injections and/or physical therapy in an effort to address foraminal narrowing / nerve root issues, or some other types of less serious conditions.

    Damage to the spinal cord - myelopathy - is a COMPLETELY different issue.

    A rare few on these boards have had issues with cervical myelopathy.

    As I wrote earlier, your specialist will be in the best position to provide you with the full range of treatment options.

    Let us know how it goes.

    Last edited by funny4mony; 03-19-2006 at 10:43 PM.

     
    Old 03-20-2006, 07:53 AM   #8
    whackedback
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    Re: Neck surgery necessary??

    Consider insisting your GP provide a referral to a NeuroSurgeon to go over the MRI results. You may not need surgery, but the NS may guide you with Meds or PT to help your condition.

    wb

     
    Old 03-22-2006, 06:40 AM   #9
    mb100
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    Re: Neck surgery necessary??

    Howdy Niteterrors!

    I'm gonna go out on a limb here.......

    No one, a patient such as myself or even a Dr. can diagnose you over the internet. NO ONE. I know you already know this, I looked over your previous postings and saw that you have had medical issues before. So you aint no rookie........

    Sounds like, from your MRI and your symptoms, that you have some issues.
    Repeat, SOUNDS LIKE.

    Sounds like you need a Dr.

    Having said that........

    The impression listed on your MRI report is just that. The impression the person reading it got from looking at the films. Now he was trained on how to do this and to put into writing what his findings were. Thats not to say that another Dr. with the same training couldnt come up with different findings

    I have been to a neurosurgeon and an two orthopedic spine surgeons ( one is the head of spine surgery at a university hospital), and all three wanted to look at the films themselves, in addition to reading the reports. If they dont trust another doctors opinon that viewed the films, how could we trust someones opinion that hasnt. Its asinine.

    There is a guy on this site named Dennisqb, or something like that I'm not sure. Research his previous threads, his was a good example of conservative recovery. He educated himself on the issues and followed his docs advise and is enjoying a complete recovery. Awesome!

    I dont think he recieved treatment or therapy over the internet. Not sure about that...... you might ask him.

    Anyway......

    Take it from me...... DONT take it from me, or anyone else on the net.

    Take it slow, Mike

     
    Old 03-27-2006, 10:47 AM   #10
    IAN45
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    Wink Re: Neck surgery necessary??

    Hi Nite,

    Try not to get to paranoid, as this will cause you to get tense and this causes spasms which in turn causes more discomfort. I had 2 discs between C5 AND C7 removed in May 2001. In their place my Neurosurgeon put two Titanium Cages. Since the operation I have had very little pain and no I repeat no numbness in fingers or anywhere else for that matter. Before I was in horrendous pain through nerves being compressed between the Facet joints. I now have less movement in my neck, which I accept. Please feel free to reply to me if you need any other help. I am in England but just at the end of your fingers. Keep your chin up, as we say over here and try to see a good Neurosurgeon. I send my regards to you, there is light at the end of that tunnel.

    Ian

     
    Old 03-27-2006, 11:33 AM   #11
    niteterrors
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    I want to thank you all

    Your replies have been both reassuring and informative. I'm looking forward to finding relief, but am still wary of surgery. I do find temporary relief with OTC NSAID therapy in conjunction with muscle relaxants which keep me from allowing that tension to get out of control. So far, some days are better than others and the pain isn't intolerable, but the numbness and tingling is getting very bothersome. I have also restricted my activity to the point of not lifting anything heavy or anything that involves putting strain/stress on my neck. After taking it easy for 3 days, I did attempt my normal routine, which involved lifting heavy things and within an hour, my entire neck and upper back swelled up and went numb. That's all I needed to confirm that rest is probably the best thing to do right now.

    Since NSAIDS seem to nearly eliminate the numbness in my arm/hand, I'm hoping that will be useful when it comes to the idea of cortizone injections (as I understand it, it's an anti-inflammatory, right?). I'm really looking forward to seeing what the doc says and I'll surely let you all know. 10 more days...the countdown begins!

    One thing I should say is that I do fear the idea of having my neck fused at any level...the mere thought of that scares the living daylights out of me.

     
    Old 03-27-2006, 12:32 PM   #12
    IAN45
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    Re: Neck surgery necessary??

    Hi Nite,
    You don't have to have the neck fused. My operation allowed just slight restricted movement. I can't put my chin on my chest anymore, which I can live with. Mind you I have trouble finding crumbs on my chest when I'm having a biscuit with my cup of tea. Also you mention mustle relaxants, I found Diazapam brilliant or even a few pints of beer!! Don't be frightened of surgery, if you get the relief I got, you will be well pleased. Take care

    Ian

     
    Old 03-27-2006, 01:25 PM   #13
    ThoreauFan
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    Re: I want to thank you all

    Quote:
    Originally Posted by niteterrors
    One thing I should say is that I do fear the idea of having my neck fused at any level...the mere thought of that scares the living daylights out of me.
    NT, obviously, nobody is going to force you to do anything. If you have specific concerns about fusion and range of motion, that's probably worth adding to the list of questions "just in case" the topic arises.

    Yes, cortisone is an anti-inflammatory treatment. Many people use it with great success.

    The problem is, a physician(s) can't provide effective treatment options until he/she knows what he/she is treating.

    Each physician conducts his/her own exam, which has nothing to do with trust, by the way. Failing to view your films or conduct an exam would be completely reckless conduct on the part of a physician.

    Keep in mind, written reports, such as an MRI, tend to be composed as much from a legal perspective as a medical one. At least where I live, health care professionals have to contend with a host of non-medical issues, such as insurance and potential questions of liability, etc.

    We look forward to hearing good news!

     
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