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Cervical Epidural Anyone?


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Old 07-30-2006, 07:59 PM   #1
Suzy-Q
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Cervical Epidural Anyone?

Hello To One and All -
I'm looking for some feedback/information from those of you who have had cervical epidurals as a first step in dealing with a herniated disk?
I'm almost 6 weeks post-op for a second attempt to fuse L4-5. I am not in PT (yet) and have oxycodone and valium and neurontin for meds at this time.
Had a cervical MRI in May that showed a herniation at C5-6 with moderate stenosis and impingement of the nerve root at C6. Until this week my symptoms were all left side despite the report saying the herniation was centrally located. After a week- long nightmare episode in March that left my left thumb and index finger numb and my left arm markedly weak for about 6 weeks, the situation has improved though I am still store and my neck is painflul to move sideways. I have had several day-long 'frozen neck' events that always improve with gentle motion and ice.
But this week I had another 'episode' and all of the pain was on the right side. It is much better but it has given me four rough days of it. Luckily, I have the meds for my lumbar spine so I was able to talk to my doc and up the doses to get immediate relief though far from total relief. No numbness this time but the neck itself is still very sore.
OK - my spine specialist neurosurgeon has agreed when I asked him that trying an epidural injection was a reasonable next step. He will not allow me to enter regular PT for this since he feels it could jeopardize my lumbar recovery. As I am a revision patient I am inclined to heed his advice! What do you think?
I had 4 epis for my lumbar spine and they were at best duds and 2 increased my pain for days before fading to nothingness. Probably this has no bearing on what I can expect from the cervical epis, eh? My lumbar spine problems have been up and down but not nearly so much as this cervical problem. I've no doubt that within a few days my neck will be nearly normal with just a bit of pain as I try to bend it sideways. But I never know when I am going to wake up frozen and when the pain goes into my arm it is nothing to triffle with. Well, I'm driveling here. Just hoping some of you can tell me what you've learned along the way. Many thanks- Suzy-Q

 
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Old 07-31-2006, 06:44 PM   #2
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Re: Cervical Epidural Anyone?

wow you have a lot there.

If i were in your shoes I wouldn't do anything to jeopardize my lumbar recovery, I am a cspine patient and have heard lumbars are the worst. I am 2nd time acdf patient with 3 levels fused.

At best, most of us do not find relief from PT to solve stenois or nerve root impingement problems, I and I know a few others here where PT actually made us hurt worse. The injections were a stop gap, usually not working for more than a few days to few weeks, month at most for the majority of people who have posted here. On occasion some get some longer relief or at least a reduction in pain. Rest seems to be a good plan with ice and heat, a good cervical pillow, and you could talk your surgeon about sleeping in a soft collar to prevent you from moving into positions with your neck that aggravate the condition - until you can do something about it.

 
Old 07-31-2006, 07:13 PM   #3
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Re: Cervical Epidural Anyone?

Hi...I had a cervical ESI done a few weeks ago. I can only speak from my own experience; I didn't get any relief from it, but I did get some relief for a few hours from the small amount of anesthesia they injected along with the steroid. By the next day it had worn off, though, and I didn't really see any change. Mine was done under fluoroscopy and with light sedation, which I would highly recommend. I have had several other cervical injections (facet, nerve root blocks, etc) and the ESI didn't seem to cause the same flares that the other injections did, for which I was thankful! I am going ahead with surgery next week...
I do know that the ESIs sometimes provide significant relief, especially with a fairly new problem. I have heard of people keeping their neck issues in check (for a while, at least) with an injection every 6-12 months. My injury is 4 years old, and my neurosurgeon only gave me about a 50% chance of relief with it, anyway. Maybe yours is early enough. I would definitely not be afraid to give it a try! And take care of that lumbar area, too...not something you want to mess up! Take care...
Donna

 
Old 07-31-2006, 08:46 PM   #4
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Re: Cervical Epidural Anyone?

Thanks much for the replies - guess I posted in the wrong place. I guess i will give the epi's a try since I don't have a lot of other options. The lumber recovery is for sure the bigger fish! Thanks and best of luck - Suzy_Q

 
Old 08-01-2006, 12:16 AM   #5
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Re: Cervical Epidural Anyone?

I have had cervical epidural injections. The first set in 2004 provided me a great deal of relief and the effects lasted through 12/2005. When the pain came back then my MRI showed changes, I tried the epidural injections again but they didn't work as well this time, and I eventually ended up with a cervical fusion this past May (C5-C7). If the epidurals had continued to work I would have done them indefinetly. My pain management doctor would do the series of 3 (one injection every 2 weeks) up to 2x per year. I wish they had continued to work as they are, what I consider, a less invasive and easier way to manage pain.
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Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

 
Old 08-02-2006, 08:17 PM   #6
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Re: Cervical Epidural Anyone?

Hi Kross-
I'm sorry you ended up with the fusion but did it work? My surgeon has said the "S" word already though we both agree that it is not on my plate until I have a full lumbar fusion. I'm sure I went white at the mention of this since I really hadn't thought the level of pain I have had made the "S" word even a consideration. I'll admit I was thrown. But I sense my doc feels this isn't likely to improve and indeed it isn't getting much better. I keep thinking that it is pretty tolerable most days BUT I am on regualr doses of oxy and valium and neurontin - all of which I'm expected to phase off of ... fairly soon. And how will the ole neck feel then, eh?
My doc' response to my horrified explosion of, "More surgery! You're mad!", was to laugh and tell me that IF we ever got there it was a much easier surgery than what I've just had. But I am far past taking a surgeon's word on that! How was the surgery and recovery for you? Suzy-Q

 
Old 08-03-2006, 09:52 PM   #7
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Re: Cervical Epidural Anyone?

I had the lumbar fusion back in '93 and it was a bit more painful than the cervical fusion I had done in May of this year. Thus far, at 10 weeks post op, I am doing relatively well. I am not pain free, but I don't expect that for a while. I am on a non-narcotic pain medication now (with some muscle relaxants and narcotic meds if I need them). So far I'm glad I had it done and am also glad, 13 years later, that I had the lumbar fusion done. The only thing easier with the lumbar fusion was, for me, comfort in recovery. I could lay on the bed and get relatively comfortable even when in a brace for my back. With the neck fusion I had an aspen collar on for 6 weeks and could never quite get comfortable in any chair or bed so for 6 weeks I felt sleep deprived.

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Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

 
Old 08-04-2006, 06:44 AM   #8
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Re: Cervical Epidural Anyone?

i am somewhat confused since i am just starting the cervical problems. have multiple bulged lumbar disks that PT and injections have taken care of since 1999. never got close to surgery. thank God. now i am faced with some small bulges in my neck but the problem seems to be a large bone spur with impingement on the cord and stenosis. Pm dr. and ortho have both mentioned surgery but not what type. I have read and read. there are 2 kinds of arthroscopic surgery recommended for bone spurs in the neck without fusion. they say you are in and out with the least amount of discomfort afterwards. It seems everyone here has had fusions. why do some need it and some don't. i'm at a real loss right now. going to start PT on tues. and then shots if there is no relief but i really believe i will be in surgery before long. can someone explain the difference? i can never remember what the other 2 surgeries without fusions are called i think one is an ADF. the other might be CDF. not sure though. the disks don't seem to be the problem just this big spur.

 
Old 08-04-2006, 09:54 AM   #9
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Re: Cervical Epidural Anyone?

ICC...ACDF stands for anterior cervical discectomy with fusion, in which they remove the disc and replace it with bone; in my case, they will also put in plates and screws, called internal fixation, which will help hold the bone together until it fuses together. If your discs are not causing a problem, they may not need to do the fusion. I also have some spurring and relatively mild disc bulging, but seems to be some nerve root compression by one or the other, and since my symptoms get worse with activity my neurosurgeon felt the fusion would be the best option. I don't know anything about arthroscopy of the neck, but I'm sure it will be an easier surgery, and I hope it works for you!
Donna

 
Old 08-04-2006, 12:19 PM   #10
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Re: Cervical Epidural Anyone?

donna it must be ACD that i have read about.seems to only be a possiblity if it's the spur compressing the cord and not disks. every dr. i see mentions this lg. spur and say that is the problem. i wish you the best.

 
Old 08-06-2006, 09:15 PM   #11
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Re: Cervical Epidural Anyone?

Hello Donna, hi Karin, and Hello To All-
Well, by gum and by golly, it is always an education to read this board! I have been too busy for the past few days to respond. I am very happy to report that this was due to some new and much beloved neighbors having a weekend long open house party. They are fantastic people, good friends, and the property is a 5 acre knock-out with a built-in pool. In fact, I am able to begin aqua PT at 6 weeks post-op ONLY because I can use their pool and my PT is willing to come here to work with me. Otherwise, I'd have to drive 40 minutes into town and my surgeon refused to permit that. Anyway, it was a very special weekend and I was able to paddle about in the pool and I didn't hurt anything - I don't think!
My neck has calmed down and I am left with just range of motion pain and some weakness. This is my usual pattern. Right now, the very thought that I might have a surgery on my neck seems .... mad. But I just never know what I'll wake up to.
I will look into a cervical pillow. I am sure that sleeping position is a factor. Any advice? I have seen things in Dr. Leonard's but I wouldn't know what to look for. I asked my surgeon and he said it was very variable and he didn't have any set recommendation - so far as pillows go.
Well, the lower back has had it. Nice to chat with you all. Suzy-Q

 
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