Oh, Im sorry that your c-spine is acting up so bad, but it's probably time to look in to surgery now then, as you say yourself. It seems the time has come.
I spent 5 years in agony until I no longer could bear it, and went for the surgery.
I guess you go through the same fear and same pondering back and forth like all of us despite all your knowledge in this field.
As a fellow "neck person" I know how excruciating neck pain can be, maybe Norspan patches could help you a bit now...?
It's a low dose Buprenorphin, I have used it on and off for two years.
It seems it doesn't cause much physical addiction compared with other opioids, and it's real popular among PM docs here in Norway now.
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Peek cage surgery C5-6 may 2006 Norway
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