Once again as in the past with my lumbar - USA doc's are saying either do no surgery for the neck & do TOS surgery instead, which is a rather complicated & risky surgery or do a 2 level fusion for the neck. Stenum & Dr B both agree in saying ADR 2 level possibly 3 TBD by discogram. I would prefer to have just one USA doc who has seen me in person to agree.
The spine doc's who say fusion are scared due to loss of Lordosis which is normal, when you have loss of disc height intergrity of the discs & also the facets which also wont be perfect if you have the above. You need the height to be restored.
Stenum added that C6/7 is herniated which is not noted on my MRI report which is a important note to me as it would mean the nerve root C8 below would be getting irritated which is what I had wondered about - as that would explain the TRUE TOS arm issues & shoulders & scalanes. Rather than what one USA Spine doc said was the TOS was the issue. The C5/6 disc is prolasped also not mentioned on my MRI - but it all MAKES sense as you cant have moderate stenosis & osteophytes taking place unless you have disc weakened or being lost - I know this from my lumbar - so this wont be going away - since I am narrowed to 7,8.9 mm's & normal foramen is 15 to 20 mm's i will have to address this - I am getting the subclavical axillary arteries & a US Venous Doppler in various positions done this week - so I can be sure the TOS which i believe is a 2ndary that the above doc's are right, has not caused a clot or artery compression as i have 2 arteries compressed in my L hand I just need to be assured this issue is not up higher so i am basically tracing the origins of this. The Artery doc had me do a simple test - one that should be done & it shows definitely there is a issue so tracing this is smart - & something I have wanted to have done - once i have this I can know if i can just do my neck or if i need a arterial repairs 1st.
I am going to try to avoid doing any TOS surgery - but want as i say to be sure I dont need any emergent artery repairs. I think that is prudent & then I can proceed. All about having a plan & hoping you can then put it into motion. One that needs some thought to it based on common sense & understanding of anatomy and i believe in my heart that some of the doc's also understand this as well. My GP pulled out his thick book with the Dermatome map to agree in looking in my saying I feel the C8 nerve roots are being irritated by the C6/7 above & causing true TOS issues due to the time this has gone on. Rather than TOS as a stand alone. He has nothing to gain by giving his input as he does neither surgery but he drew his circles for my MM's as he was thinking it thru - he said the neck needs addressing you are at risk for more damage if you wait - he said TOS surgery is hard & difficult & alot of complications and you still have the neck - he feels as long as we check the arteries out well - the issue is coming from C6/7 irritating the nerve root that is below it. I am willing to bet the farm & am putting my money literally & my life on it. But i need to feel i have addressed the arteries so we dont have something hit me out of left field.
Jill
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