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  • Cervical spine issues - confused

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    Old 09-17-2013, 10:34 AM   #16
    SoundsFamiliar
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    Cool Re: Cervical spine issues - confused

    I think it's (very) high risk, seeing a chiropractor for neck issues of this character.

    sf

     
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    Old 09-17-2013, 11:00 AM   #17
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    Re: Cervical spine issues - confused

    SF- thanks for the advice. I have since stopped doing Chiropractic care as it doesn't have any benefit. I was seeing a chiro that only worked with the C1-2 joint.

    WebDozer - it was C-3 through C-6 with a fusion to C-7.

    I have not heard of Laminotomy, I did some research and it looks promising as an avenue for me to further research. Any thoughts as to why it's not as common? i.e. not covered by insurance, FDA? it seems from medical transcripts that it has a good recovery/restorative prognosis.

    I do have disc bulges but the "real problem" seems to be from a smaller than needed canal space further intruded upon by bone spurs.

    Thanks again everyone. Very helpful feedback.

     
    Old 09-17-2013, 11:10 AM   #18
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    Re: Cervical spine issues - confused

    Two reasons I can think of for laminotomies being relatively unknown:

    1) Perhaps they cannot be (or are not) done in isolation. Mine was done as an extension to C3 of a C4-6 laminoplasty.

    2) In order to leave the lamina in place, perhaps it's not possible to cut a LOT of the inside of the bone off, which would limit the operation's effectiveness.

    Just guessing...

    And on another subject I don't know anything about... if that chiropractor told you he could limit what he was doing to the C1-C2, maybe it's just as well you stopped seeing him.

     
    Old 09-20-2013, 02:46 PM   #19
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    Re: Cervical spine issues - confused

    Lionor - I can totally relate to what you are going through....I'm at the beginning stages of this (See my thread "Not Sure What MRI Report Means" and I can see where this is going to get very confusing, very quickly. I've been researching the heck out of this trying to make sense of it all. I have a tiny advantage in that I work for a large healthcare system and actually helped the neurosurgeons develop a comprehensive Spine center a few years back (oh, the irony) and have sat and still in meetings with some of them from time to time. So I get to hear their thinking about surgery.


    Here's the thing...

    Current protocol 'dictates' that unless a patient is showing major signs of neurological damage (meaning loss of control of bladder/bowel and/or dragging a foot, etc) that non-surgical methods be tried first. The reason is that when they look at outcomes - surgical patients get faster pain relief but at a year out there is no difference between surgical patients and non-surgical patients who did PT, injections, etc. In fact, in some studies surgical patients had worse long-term outcomes because 'fixing' one or more vertebrates can place more stress on the other non-fused ones. Not to mention the possibility of loss of range of motion, etc. So surgery is not a slam dunk fix by any means.

    Now some of this is dependent upon the type of problem as well as type of pain. For example, I read a statement paper today from North American Spine Society that said that epidural steroid injections work well if you are having arm pain but not so well for neck pain. Obviously, there is a difference between a ruptured disk and a bone spur or narrow spinal canal (which is what I have). One article I read said that depending upon the location of the bone spur, a fusion might still be necessary to create stability in the neck since they have to remove 'good' bone along with the spur.

    Anyway, you get the drift. Now some surgeons are very aggressive in wanting to do surgery...you know - 'if you have a hammer, everything looks like a nail' philosophy. And some surgeons simply prefer doing certain procedures over others. They might be more skilled in those procedures, maybe they've done a lot more, etc. The fact that one surgeon is suggesting surgery and two are advising a wait and see approach would give me pause.

    I am experiencing intermittent tingling in fingers and arm, a tiny bit in my leg. I do have bilateral hyerreflexia, hoffman's sign, etc (freaked out my PT but neither the NS or my family doctor seems impressed), so like you I'm worried about progressing to permanent damage. I've had excellent results with PT in the past so I'm willing to give it a go and I am consulting with a physiatrist about doing an injection but I don't want to wait too long if things continue to progress. Luckily for me, I am not having pain anymore thanks to a course of prednisone.

    I don't know if this method appeals to you but I am compiling a spreadsheet with key information about each type of surgery - recovery time, possible complications, long-term results, pros/cons, etc. I find it is easy to make a decision with all the information laid out in a uniform format. If you don't mind reading research papers - there are some out there. Use more clinical terms like 'efficacy of Laminectomy'. Also Google scholar is a good source. Good luck.

     
    Old 09-23-2013, 05:56 AM   #20
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    Re: Cervical spine issues - confused

    Thank you very much for your reply MissJuneBug. It looks like you have done a bunch of research too. The spreadsheet idea sounds like a brilliant one - keep me updated if you don't mind.

    In terms of Prednisone - The doctor has prescribed Medrol - is that a comparable medication (don't worry I'm not going to hold you to anything). And when you took Prednisone- how was it? did you have any side effects? (I'm told you can have anything from thrush to bone death)

    And it got rid of your pain??

    Thanks again for taking the time to write.

     
    Old 09-23-2013, 07:13 AM   #21
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    Re: Cervical spine issues - confused

    Medrol is basically the same thing as prednisone - it's a steroid. I've taken both for a variety of things over the years but mostly because I get Eustachian tube swelling and have a lot of problems with my ears. Generally, at lower doses taken for shorter periods of time, it's fine. In fact, I feel really, really good on it as long as the dose isn't too high (for me). Apparently, it is standard treatment for back and neck issues. Even my dog was on it for a few weeks for a back issue she was having a while ago. My pain was gone within 24 hours of starting it - after I had suffered for three torturous weeks. I'm very surprised the NS didn't prescribe it. I got it from my family doctor. Sometimes, the FPs are better at dealing with these types of problems in the short-term because they see so many people with back and neck issues.

    There are people who take it long-term and at much higher doses. My husband has even had to do a daily IV course of it for his MS.That is where there is more concern for serious side-effects. The epidural steroid shot is basically the same thing except you are delivering the steroid straight into the inflamed area. I've had one done in my shoulder (worked well) and I get one in my big toe joint about once a year (also works well when the podiatrist manages to hit the exact spot).

    Even though the pain is gone, I am still experiencing the tingling, although only when my arm is in certain positions (like keyboarding). I have my doubts that ESI will work for that. Interesting, when I take Lortab, the tingling goes away for as long as I'm on it. I don't know why but I didn't expect that. I experienced some scapula pain this weekend after I worked out, so took a Lortab because I was worried that the horrible radiating pain and/or muscle spasms would start back up and noticed the tingling stopped. Not that Lortab is something I can or want to take long-term but it does help with the tingling.

    Understand, I am not a clinician so I'm just relaying my personal experience.

    PubMed has a lot of good studies regarding the different types of cervical surgeries. They are really just one page summaries and easy to follow. It will take me a while to compile all the information into a spreadsheet - I've already started - just because I have to read, read, read and then absorb it all and then read some more but eventually I get to point where I have a 'aha' moment. I think spine surgery is extremely tricky because a lot of it depends on the exact nature of each patient's issues and many patients present with multiple issues - so a budging disk is different from a budging disk plus a bone spur plus a narrow canal.

     
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    Old 09-23-2013, 08:02 AM   #22
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    Re: Cervical spine issues - confused

    <<I am still experiencing the tingling, although only when my arm is in certain positions (like keyboarding)>>

    Doesn't sound spinal in origin... more wrist or elbow... but I guess you know that.

     
    Old 09-23-2013, 10:43 AM   #23
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    Re: Cervical spine issues - confused

    MJB, thank you VERY much for the reference to the Pubmed site. I'm reading the article on "Posterior Surgery for Cervical Myelopathy: Laminectomy, Laminectomy with Fusion, and Laminoplasty". It's the best and most comprehensive article I've seen yet, although in retrospect I'm a bit puzzled that I haven't seen others like it.

    I'm feeling better about my choice of laminoplasty for my third(!) cervical operation. I'm also relieved to see that the article in no way contradicts the advice I've been spewing on this site for over two years!

    Last edited by WebDozer; 09-23-2013 at 01:28 PM.

     
    Old 09-23-2013, 06:09 PM   #24
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    Re: Cervical spine issues - confused

    Quote:
    Originally Posted by WebDozer View Post
    <<I am still experiencing the tingling, although only when my arm is in certain positions (like keyboarding)>>

    Doesn't sound spinal in origin... more wrist or elbow... but I guess you know that.
    I asked about that. They said the tingling in my middle, index and thumb lines up perfectly with the C5-6 and C6-7 bone spurs I have. The tingling occurs only when I move my shoulder/neck/ arm into certain positions. Those positions 'close up the spinal canal' in such a way that the bone spurs/disks impinge on the nerves. (At least that's what I was told). I get the same tingling by raising my arm up over my head. I finally had neck traction today at the PT and actually felt better afterwards. I think that might help me.

    Webdozer - you are welcome. Glad you found that useful. I have found your posts to be very informative and appreciate all the effort you put into answering people's questions.

    I read that study also. I'm surprised how many studies are out there - though they often contradict each other. As I said - spine surgery is a complicated issue.

    Last edited by MissJuneBug; 09-23-2013 at 06:11 PM.

     
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    cervical, disc bulge, neck pain, stenosis, surgery



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