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Surgery vs. Watchful Waiting.

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Old 03-29-2007, 11:43 AM   #1
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Join Date: Mar 2007
Location: boston, ma
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codemonger HB User
Surgery vs. Watchful Waiting.

Hi All,

I'm trying to decide whether to have surgery or just to wait and hope things get better (or I just get used to the pain). Here is the excerpt from my most recent MRI (in Nov. 06):

Large disk-osteophyte complex at C4-5, slightly enlarged since 4/17/06, resulting in increased moderate left-sided central stenosis and cord deformity without definite edema or myelomalacia. Moderate to severe left and moderate right C5 foraminal stenosis, stable since the prior study.

(Paraphrased: mild to severe foraminal stenosis C4-C8...)

No evidence of intrinsic signal abnormality of the cervical cord.

This has been going on for a little over a year. I'm seeing a Neurologist every few months and I've had a consult with a NS (before my most recent MRI). Neither of them is pushing surgery, but they said they wouldn't rule it out or fight me if I asked for it. The NS does ACDF and hinted that I may be a candidate for the CerviCore artificial disk.

My symptoms are constant mild and occasionally moderate neck pain and associated headache and pain around my eyes, mild pain in my shoulder/chest and vague weakness in my arm and leg. I spent a weekend in the hospital before I had this diagnosed because they thought I was having a heart attack. Usually this is left sided, but occasionally I'll get a neck spasm on the right and then I'll feel it in my right arm/leg (this has only been happening since October or so). I don't take any drugs too regularly (other than a few glasses of wine or a G&T at night ☺). If things flare up I'll take Aleve and Valium. I'm still working full time (sedentary job). I've stopped fitness running and I really notice it if I do hard physical labor so I avoid that. I was a little scared when I rode a pretty mild ride at Disneyworld and started getting symptoms afterward.

My neurologists mentions about a 1/10000 chance of bad things happening if I have surgery and about the same odd if I don't have surgery (auto accident, etc. causing cord problems).

I guess my question is what to expect in both cases, quality of life wise. If I don't have surgery are things going to get better or will I get used to the pain? Is it better to have surgery now when I'm relatively young (I'm 48)? If I get ACDF or an artificial disk will I be able to run and do physical labor (and ride amusement park rides ☺)

Any advice would be appreciated.


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Old 03-29-2007, 01:58 PM   #2
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Join Date: Jun 2005
Location: Utah
Posts: 198
BobM HB User
Re: Surgery vs. Watchful Waiting.

Whether to have surgery or not is a hard call to make - depends on each person and their situation. For me, the deciding factor to go ahead was the loss of function (weakness, atrophy, etc) which can become permanent if it goes on too long. My condition (fusion of C4/5/6/7 with two ACDF surgeries) went undiagnosed for so long, that I ended up with some loss that is probably permanent, but I've recoved 90%.

Pain is one thing, but symptoms like weakness may be an indication of something that could become permanent - maybe a good idea to talk with your Drs about the risks you would be taking, if you want to play 'wait and see'. Most people seem to report improvement from having surgery, but there are no guarantees, and there are risks.

Good wishes!

Old 03-29-2007, 04:44 PM   #3
Join Date: Nov 2006
Posts: 355
julyg HB Userjulyg HB User
Re: Surgery vs. Watchful Waiting.

Check out my posts. I had same odds and I am as young as you. I came out of surgery this past Oct. (2 level fusion donor bone and plate) with a paralysed vocal cord which has HUGE reprecussions.
Speaking, breathing, swallowing.

I was readmiited to hospital 2 days after surgery because I thought I was having chest pain (nope, just couldnt breathe) and then had complications from 2nd hospital admission.

Have had 2 vocal cord proceedures and I am still not out of the woods.

Before you all say I went to a quack Dr, I had top NS in top hospital.

So in hindsight I would never have this surgery unless I couldnt walk.

I work with a man who had artidicial disk replacement lower back a yr ago and he bent down wrong the other day and he cannot walk! He has not had MRI yet so who knows what is up there for a while.

PS Still in plenty of pain.


Old 03-30-2007, 11:12 AM   #4
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Join Date: Jul 2006
Location: franklin, tn usa
Posts: 129
bw67 HB User
Re: Surgery vs. Watchful Waiting.

I agree that every situation/condition is different, but here's what I did...

I had disc herniations at C5/6 and C6/7 that were pressing on the nerves going into my right arm, causing extreme achy pain. Some mild pain in my shoulderblades if I turned right/left. But not any more than that. No numbness, etc.

I saw several NS's who recommended fusion, but they also said it was up to me as to when to do it. They said aside from a car accident or fall etc, I wasn't putting myself at a greater risk by waiting. They said it was a matter of how much pain/discomfort I could tolerate.

I put up with it for 2 years before caving in. I had found some relief primarily from traction and massage therapy that bought me some time. But it got to the point where I couldn't sit down for dinner, watch a movie, or drive for more than 10 minutes w/out feeling miserable. So I decided to do it.

BUT, I chose a non-fusion procedure- see my post NON FUSION OPTION. so far 7 months post op, so good.

I am definitely glad I held off, and that I didn't do fusion once I decided enough was enough.

But again, every situation is different, I'd consider a 2nd or 3rd opinion too if I were you...

Good luck


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