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  • C6-C7 herniation with spinal cord distortion

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    Old 06-07-2011, 06:43 PM   #1
    mahoney67
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    C6-C7 herniation with cord distortion since April

    I'm new to this board. On April 18th I woke up with some neck pain which quickly became right scapular pain/pain radiating down my right arm. I went to my chiropractor, and then to an orthopedic surgeon who recommended PT. PT and pain meds didn't help, and the radiating pain became worse. Finally on May 23rd I convinced my caregivers that I needed an MRI, which showed three disc herniations. The C6-C7 herniation is really impinging on my spinal cord, which is causing tricep weakness and the pain down my arm. After I get the results the neurologist referred me to a surgeon. That surgeon recommended I start with steroid injections and if that fails I should get a foraminotomy. I then had my first epidural steroid injection, which has not helped yet. I went for a second opinion, and that surgeon wanted to do a C6-C7 fusion in two weeks. Today I went to the PA who is affiliated with arguably the top spine surgeon in my state, and this PA recommended I wait it out and spend a couple more months seeing if the disc repairs itself. He prescribed neurontin for the nerve pain and also a high dose oral steroid. I'll get another steroid injection next week. So now I will see the PA again in 10 days and we've booked an appointment with the surgeon on August 17th. That will be 4 months since the onset of my pain. I guess my question is - am I doing the right thing? I don't want to jump into surgery. Then again, I am 39 years old and have 2 small children and the pain is really discouraging. Three months ago I was running 3 miles a day. Now each day is filled with pain and I can barely get through a full day of work. Any guidance or words of encouragement/hope would be greatly appreciated!!!!

     
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    Old 06-08-2011, 02:38 AM   #2
    mahoney67
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    C6-C7 herniation with spinal cord distortion

    I originally posted this in the BACK forum, not realizing there was a forum for Spinal issues.

    I'm new to this board. On April 18th I woke up with some neck pain which quickly became right scapular pain/pain radiating down my right arm. I went to my chiropractor, and then to an orthopedic surgeon who took an x ray and recommended PT. PT and pain meds didn't help, and the radiating pain became worse. Finally on May 23rd I convinced my caregivers that I needed an MRI, which showed three disc herniations. The C6-C7 herniation is really impinging on my spinal cord, which is causing tricep weakness and the pain down my arm. After I got the MRI results I was referred to a spinal surgeon. That surgeon recommended I start with steroid injections and if that fails I should get a foraminotomy. I then had my first epidural steroid injection, which has not helped yet. I went for a second opinion, and that surgeon wanted to do a C6-C7 fusion in two weeks. Because of the two different opinions, I went for a third opinion yesterday. The third opinion was with a PA who is affiliated with arguably the top spine surgeon in my state. This PA recommended I wait it out and spend a couple more months seeing if the disc repairs itself. He prescribed neurontin for the nerve pain and also a high dose oral steroid. I'll get another steroid injection next week. So now I will see the PA again in 10 days and we've booked an appointment with the top surgeon I was talking about on August 17th. That will be 4 months since the onset of my pain. I know I can't ask for medical advice, but I'm wondering what people who have been through this think about the path I am taking. I don't want to jump into surgery. Then again, I am 39 years old and have 2 small children and the pain is really discouraging. Three months ago I was so active, running 3 miles a day. Now each day is filled with pain and I can barely get through a full day of work. Any guidance or words of encouragement/hope would be greatly appreciated!!!!

     
    Old 06-08-2011, 04:45 AM   #3
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    Re: C6-C7 herniation with spinal cord distortion

    You are definitely on the right board for people to help. My ACDF surgery was required due to a fall causing the vertebrae to be pushed into my spinal cord, but I didn't know for nearly a year, that I had injured myself so severely, since the absence of pain fooled me into thinking I hadn't been hurt. The worst symptom that indicates actual severe nerve damage is numbness and loss of strength. You just have to go with your gut on which doctor has the right path for you. I'm not sure if the epidurals really help much with the cervical discs. There are others who have experience who could comment. Hoping you get relief soon.
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    Old 06-08-2011, 06:48 AM   #4
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    Re: C6-C7 herniation with cord distortion since April

    Welcome to the board. I'm sorry you are going through these problems and find the need to seek us out! Most people on this board are dealing with lumbar issues. Some have cervical issues as well, but most cervical patients are having out on the "Spinal Cord" injury board. If you post again there, I'm quite sure you will get more responses.

    It sounds like you are getting appropriate advice from your doctors. In my opinion, the cervical area is a bit trickier to deal with in that you are dealing with the spinal cord. At the lumbar area, there is every bit as much pain and disruption of the patient's life as he/she knew it, but you aren't usually dealing with the potential for paralysis should a disc compress the spinal cord, etc. There is always that potential danger when dealing with cervical issues.

    Not knowing how severe are your herniations, I really couldn't guess if you are doing the right thing...but current thinking seems to be that trying conservative measures for four to six months is adequate. If the patient is no better by then, surgery is considered.

    Regarding the ESIs, I know people who had no result from the first injection, but then responded very well to the second and/or third and were able to avoid surgery. I did not have similar results, but you should follow through with the second one just in case you are one of the lucky ones!

    When faced with several options from different surgeons, it is difficult to decide which option to pursue. I would advise you to do your research, try to learn all you can about your condition and gather information from a variety of sources. Try not to let pain be an influencing force. Take your time and make the best decision you can, as you will have to live with it for a long time.

    Good luck in your search for answers.

     
    Old 06-08-2011, 11:16 AM   #5
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    Re: C6-C7 herniation with spinal cord distortion

    Minstrel - I am wondering how you are doing since the surgery? Do you consider yourself healed? Do you still have pain?

     
    Old 06-08-2011, 11:34 AM   #6
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    Re: C6-C7 herniation with spinal cord distortion

    The surgery prevented any further damage and stabilized my spine. I regained grip strength with physical therapy, and have regained some balance, but my situation is complicated, since my lumbar stenosis is what originally caused my left leg to be weak and contributed to the fall that I had. I fell backwards and hit the base of a granite tombstone with the back of my neck. Foolishly I thought I wasn't injured severely and didn't get checked out for that, but as the symptoms of spinal cord compression worsened over the next nine months, I had a cervical MRI which showed the damage to the vertebra. Since the nerves were permanently damaged, I still have numbness, tingling, pins and needles, burning in feet, hands, elbows, upper arms. If I hadn't stopped the damage, I might not be able to walk, or use my hands. The fusion with titanium plate has helped me to lead a fairly normal life. I can't walk far without a cane, but can walk short distances indoors, and I don't take any heavy duty meds. I do have to concentrate totally on walking when I walk though. Sometimes the limitations I have frustrate me, but I try to consider that others are much worse off. Most of the pain that I have other than the neuropathy is caused by my lumbar spine, which is not considered something that surgery will help. I deal with that my limiting certain activity and resting when needed. I have heard of many on these boards who have had successful surgeries, and I know of a few friends that have also with pain relief. Mine was just to stop the damage.
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    Old 06-08-2011, 08:54 PM   #7
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    Re: C6-C7 herniation with spinal cord distortion

    Be careful about allowing the symptoms you describe from going on too long as they can become permanent. So ask the doctor you prefer how long they would wait before taking action. I didn't move fast enough with my ACDF and I still have numbness at the tip of my index finger (left hand).
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    Old 06-08-2011, 09:23 PM   #8
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    Re: C6-C7 herniation with cord distortion since April

    If you have a C7 root with a weak triceps you should get some relief by putting your hand above your head.
    Also the mid fibres of your pectoralis major can be supplied by C7 and so you may see some slight wasting there in your chest.
    It is interesting that most C7 roots begin on awakening in the morning so it may be the position of sleeping is the cause, or the last straw. If a neck is manipulated within the first hour at times relief is instant.
    Many settle after about 4 months but if it does not more damage can be done by waiting. What a dilemma.
    James

     
    Old 06-09-2011, 05:07 AM   #9
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    Re: C6-C7 herniation with spinal cord distortion

    Minstrel - Wow. Thanks for sharing your story. You've gone through alot! My situation is so much more simple than yours. I wish you continued improvement. I can imagine how frustrating your limitations must be. I have the same thoughts... my issues haven't been going on that long, but I remember how healthy and active I was just three months ago and I can't believe how quickly things have changed and I that I am now in constant pain. I took so much for granted. As you said, it could be much worse.

    SpineAZ - I agree!!! That is my fear!! I don't want this to be permanent. I had one doc who wanted to rush me into surgery on June 21st. That seemed so quick. I feel like getting into see that top surgeon on August 17 is a good compromise. At that time it will be 4 months since the onset and I'll have gone through a couple rounds of epidural steroids. I'm keeping a pain diary too.... The neurontin is dulling the nerve pain, but that's just masking the pain....

    Thanks to everyone!!!

    Michelle

     
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    Old 06-09-2011, 05:13 AM   #10
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    Re: C6-C7 herniation with cord distortion since April

    Thanks to both of you. I found the spinal cord board!!!!

    Yes, it is a dilemma. I am happy that I have an appointment with my surgeon of choice on August 17th. That gives me two months to see if the ESIs help at all. And that will bring me to 4 months since the onset. I'll be able to honestly say I gave it a try. My only fear is that my symptoms will worsen before then. The PA tells me that it could heal itself. I don't know what I'm talking about, but I have a hard time believing that will be the case for me. Stay tuned!!!

     
    Old 06-09-2011, 08:27 AM   #11
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    Re: C6-C7 herniation with spinal cord distortion

    The ESI can induce swelling reduction in the disc and this alleviate pain. Unfortunately it's not as if we can get weekly MRI to check, so the only way to tell for sure is if you feel symptom relief. Even if, for exampele, you feel some arm/hand numbness alleviating, that is progress. So next time you see the.doc tell him/her exactly what symptoms have improved, stayed the same, worsened. If no relief consider further action. For me ESI did work for 12-18 mo. I'd have a series of 3 ESI (1 injection every 2 wk for 6 wk). If it had worked and.I'd tolerated the ESI well I'd have continue he's. But they stopped working and I had some adverse steroid symptoms (steroid hunger and steroid hot flashes) so that they aren't an option for me unless it's an emergency. (I had a large knee steroid injection in March due to torn meniscus which helped a lot but the adverse side effects lasted 3 mo).
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    Old 06-12-2011, 06:21 PM   #12
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    Re: C6-C7 herniation with spinal cord distortion

    Thanks SpineAZ. So even though the first round of ESIs did nothing, my PA put me on dexamethasone and the neurontin, which I have to say have minimized some of the pain. The steroids are keeping me up at night, which is a drag, but otherwise I seem to be spending a lot less time in pain. So that's good I guess. I'll be starting to down-titrate the steroid tomorrow. I have another ESI on Thursday. Fingers crossed that the pain stays away and maybe the disc is healing. I'd LOVE to get another MRI to see what's going on. I know I can't get a weekly MRI, but how does it work? I mean, my first MRI was May 23rd. I'd think I should be able to have another one maybe in July or August to see if things are improving? I'll have to bring it up at my next appointment.

     
    Old 06-12-2011, 06:59 PM   #13
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    Re: C6-C7 herniation with spinal cord distortion

    It's rare to get a second one, they likley wouldn't be able to see much of improvement or worsening. MRI are great, but not as clear as we'd all hope. When I had some nerve pain after my neck surgery my surgeon did an MRI and said "you have minor stenosis impinging on the cervical nerves, if your really want we can go in and open the stenosis". I did, I was in tears. He did the surgery and as I awoke he was telling my husband the stenosis was horrible and he didn't know how I was surviving daily (I was in deep pain so barely surviving). So the MRI told him something minor, which was actually worse. The opposite can happen as well.

    So symptoms are key. What they'll be looking for is symptom changes. If you still have significant symptoms after all the treatment keep an active communication process with your doctors to determine when, if ever, surgery is needed.
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    Last edited by SpineAZ; 06-12-2011 at 07:00 PM.

     
    Old 06-13-2011, 08:14 AM   #14
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    Re: C6-C7 herniation with spinal cord distortion

    That's horrible. I'm sorry you had go go through that. I feel bad for everyone on this board!!!! My MRI in May showed that my spinal cord is kind of like a sausage. Being squeezed slightly at C4 and C5, then at C6 there is a massive bulge pressing on the cord and the nerve. No spinal fluid around the cord at that point. I wish I could go back to April 1st. Maybe if I did some things differently I could have prevented this... cut back on my workout routines, not carried my 4 year old on my back up a sand dune.... so many, "what ifs".... and no real answers as where to go from here. One day at a time....

     
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