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Acdf c5/c6 ???

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Unread 12-21-2011, 09:37 PM   #1
joojee22
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Confused Acdf c5/c6 ???

I need some pretty quick advice,
I only had trouble sleeping, some numbness in my left hand, but mainly just pain while I am sleeping.
Turns out its a small herniated disk on the right side.
The neurosurgeon said I was not a candidate for surgery but... the spine Dr. said that surgery is the only thing that will make my neck better... I dont know who to believe?

I need to do the surgery this Friday if I am ever going to be able to do it EVER, cause of money and time off of work. But if the pain is going to be worse than it is now I surely dont want to do it.

So far all I had 5 pain injections and none of them have worked. Epidurals and MBB & RFA.

Please vote for what I should do:

yes surgery?
no surgery?

Thank you.
Joann
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Unread 12-21-2011, 09:58 PM   #2
seahorse02
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Quote:
Originally Posted by joojee22 View Post
I need some pretty quick advice,
I only had trouble sleeping, some numbness in my left hand, but mainly just pain while I am sleeping.
Turns out its a small herniated disk on the right side.
The neurosurgeon said I was not a candidate for surgery but... the spine Dr. said that surgery is the only thing that will make my neck better... I dont know who to believe?

I need to do the surgery this Friday if I am ever going to be able to do it EVER, cause of money and time off of work. But if the pain is going to be worse than it is now I surely dont want to do it.

So far all I had 5 pain injections and none of them have worked. Epidurals and MBB & RFA.

Please vote for what I should do:

yes surgery?
no surgery?

Thank you.
Joann
Sweetie, only you can make that decision. Personally, I know I wouldn't want anyone making a decision as important as that for me BUT me.

Have you considered getting a third medical opinion - if possible?
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Unread 12-21-2011, 11:19 PM   #3
adult_aq_stenosis
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Dear Joanne,

I'm a neurosurgery PA. I have a lot of experience in this area. ACDF is a proven surgical solution for INDICATED operations. You mentioned the disc was small. I assume the side of herniation and level (C5-6) correlated with your symptoms, generally thumb/pointer finger and if weakness, biceps muscle. I assume if you hade 5 epidurals, then you also had physical therapy. I would always go the way of conservative mngt until I could no longer take the symptoms. Real weakness is another category. They should probably be operated on, but numbness or pain you may be able to sit on for a while.

Don't forget that surgery will expose you to the risk of developing adjacent level disease, aka, a herniation one level above or below the surgical fusion. Hope this helps. Age and comorbidities would also be useful for me to consider in your case. Hope this is helpful. Sorry to hear you have positioned yourself against an artificial clock.
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Unread 12-22-2011, 01:39 AM   #4
Dubious
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Quote:
Originally Posted by adult_aq_stenosis View Post
Dear Joanne,

I'm a neurosurgery PA. I have a lot of experience in this area. ACDF is a proven surgical solution for INDICATED operations. You mentioned the disc was small. I assume the side of herniation and level (C5-6) correlated with your symptoms, generally thumb/pointer finger and if weakness, biceps muscle. I assume if you hade 5 epidurals, then you also had physical therapy. I would always go the way of conservative mngt until I could no longer take the symptoms. Real weakness is another category. They should probably be operated on, but numbness or pain you may be able to sit on for a while.

Don't forget that surgery will expose you to the risk of developing adjacent level disease, aka, a herniation one level above or below the surgical fusion. Hope this helps. Age and comorbidities would also be useful for me to consider in your case. Hope this is helpful. Sorry to hear you have positioned yourself against an artificial clock.
Think I agree with the conservative approach. Some studies show NO difference in outcomes at 1 year for those who had surgery vs. those who did not. Tough call. While I agree that adjacent level accellerated degenerative changes are likely, there are mindless studies out there to refute that. Who knows? I'm 4 yrs post surgery and have no radiographic or clinical changes, yet.

I'm with what's-his-PA, get another opinion and don't rush this! You can always do surgery, you can't undo it! Oh, I speak from a perspective of 23 years experience as a primary health care provider and the recipient of a C5-6 fusion (for HNP with progressive neuro deficit) with great results, following 9 months of failed PT, facet blocks and epi's.
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Unread 12-22-2011, 10:35 AM   #5
joojee22
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Smile thank you

Thank you ! You all (as we say in TX, hehe) are correct, I decided againist surgery.

Having a timeline and money is not a good reason to do a surgery. even though I feel that PT and the pain meds will not work, I should give them a try. Especially since my pain level is so low and no reduction in strength, should it get worse I will revist the idea. Unfortunatley I will have to pay $2000+ for the waiting.

Is there any hope that the PT will help?

J.

(thank you again, and Happy Holidays)
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Unread 12-22-2011, 10:56 AM   #6
ginnie
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Surgery is a last resort. If you have any question in your mind about it, you should wait and get another opinion. Even if this messes up your time schedule off from work. A neurosurgeon, top notch should be involved. I am fused C3-7 after a failed C6-7. It was hard to go through. I didn't do enough research the first time around, and didn't understand all the tests. MRI and the proceedure itself before I agreed to it. I didn't look up myself, or find out exactly what the problem is. If you have nerve inpingment, or something invading the spinal nerve area that is reason for surgery. Not all herniated disks need, or respond to surgery. It all depends on that MRI and what the specialists say. If there is a difference of opinion, I would investigate that before I went ahead with the surgery. This is just my own opinion as I went through alot, and learned from my own experience. I wish you all the best. ginnie
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Unread 12-22-2011, 11:00 AM   #7
ginnie
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I also did not investigate the condition of my spine above and below the surgery I had origionally. I had degenerated in both areas. My surgery should have been addressed more the first time around. Don't go by a time line Joann, take your time with the research. ginnie
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Unread 12-27-2011, 03:18 PM   #8
joojee22
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Default nuero surgeon

The nuero surgeon would not even see me a second time (he said not surgical), he referred me to the pain clinic which has only made the situation worse.

The spinal Dr. said surgery. Unfortunatley I believe him but I am going to wait until I cant lift my arm I guess, it's starting to happen, my arm is in pain now all day.. argh.. I only had a small pain during sleep problem before those darn pain clinic people... rrrrrrr....

There is suppose to be a smaller disk therapy surgery thing that I cant seem to find info on, it's were they insert a needle and take a small piece of disk out and in theory the remaining disk gets sucked back in?

Thanks for any and all comments.
J.
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Unread 12-27-2011, 03:46 PM   #9
ginnie
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The pain clinic is suppose to help not hurt more. If you are not getting satisfactory results, consider going to a different pain clinic with all your records. I had two katamine infussion. and they did help. I had no problem after the injections at all. I wish you all the best. Glad you decided not to use a time line as a reason. take care. ginnie
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Unread 12-29-2011, 09:37 AM   #10
frenchfri1003
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You will know when surgery is right for you. Do not rush into surgery and get fused. I waited more than 5 years until the time was right medically and physically. My MRI showed bone on bone at the C6-C7 but my symptoms were manageable so I waited. Probably should have tried for an ADR back then, but didn't even know they existed. When the pain became unbearable and I could use my left hand or arm at all, I knew it was time. I couldn't even raise my hand without pain in order to put my hair in a pony tail. Driving was painful and difficult. I was working full time as a teacher. I waited too long with the pain. Don't suffer too long.
There are many things that you can do to reduce the pain and help prevent or slow down the progression of the problems. Physical therapy, home traction, acupuncture, many different types of shots, selective nerve root blocks, epidurals, trigger point massage and injections and more.
There are also many types of surgery to deal with 1 level: ACDF (fusion) ADF (artificia disk replacement) and the one I can't remember which you were referring to. Do all of your research now when you have time and hopefully not in too much pain. Good luck and hope you have a happy and painless new year.
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"Thanks for this!" says:
don1956 (06-27-2013), ginnie (12-29-2011)
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