Cervical spine problem at c5-c6, c6-c7..Very depressed :(

[Sonata]

Hi everyone

I am a 39 year old female. Married with 8 year old son.

I am diagnosed with slipped discs on my cervical spine. I have been playing golf and tennis regularly since 2004 and had some symptoms. The worst was last year after an advanced yoga class. But that went away as well with medication and rest and no more yoga. I have had symptoms the last 3 years on my left arm may be 4-5 times in 3 years mostly some pain that went away after medication. The latest episode I have had, started 5 weeks ago when I felt some pins and needles feeling on my left arm just a little bit only so I ignored it since there was no pain. I went to the doctor last Friday we did the MRI. One neurosurgen said I should take medication and wear a colar and wait for 4 weeks. In my MRI report I see that the c5-c6 prolapsed toward the right side, and c6-c7 prolapsed toward left (more than the other one). I have had no symptoms at all on my right arm. Only on my left arm. I play tennis and golf twice a week each and at the moment I have stopped doing everything. Medication and rest for one week already. Today I saw another neurosurgen and he said that the results look pretty bad and it's only a matter of time that one of those discs might cause permanent damage. Even if I do rehab he said there will be a very high risk for me in the future and I should go ahead and have spinal fusion surgery right away. I am so confused and very depressed. The surgery is risky and takes a long time to heal, plus there's the risk of other discs to slip because there will be more pressure on them. I am really scared and have no idea which way to go. I have found alphaklinik on the net offering alternative solutions but I want to avoid any intervension.

Do you know anyone with a similar problem that have continued his/her life without any kind of surgery? Do you think I will eventually need surgery as I get older?

Sonata

Pretty desperate and down

[Maria]

Sonata,
Welcome and sorry you're one of the walking injured now however this website is a good find for you in terms of information.

What I'd suggest is getting more opinions and the AlphaKlinik sounds like a good place to start as well as a few other docs that may be able to offer alternative to fusion if that is possible.

I'm a long term lumbar spinal veteran and have had a few episodes of cervical probs with one that was really painful starting nearly 4 weeks ago I believe. Eventually I may have to do something tho hopefully not for a while. If the day comes my neck needs surgery and I can avoid a fusion, I'll do what's necessary because if I thought the lumbar stuff was bad/limiting... wow, the cervical pain and limitations are really bad..

Others with more info in this area will reply (cervical spine patients w/intervention and those w/more knowledge). Just wanted to say hi and hope your pain is under control at least while you check out your options.

take care, Maria

[sahuaro]

Sonata:
I have been dealing with cervical issues for over 6 years now and am about to take the leap to have surgery. That doesn't make me an expert but I can share some thoughts! I have a herniated c5/6 and bulging c6/7 with an osteophyte touching the thecal sac (which surrounds the spinal cord) and foraminal stenosis and some central stenosis. I have been dealing with the symptoms through conservative measures--physical therapy, massage and exercise--and have had epidural steroid injections. The recent concerns prompting the decision for surgery are arm weakness, a change in my EMG results and some signs that things are destabilizing in my neck.
So, I think that there are questions you need to ask re nerve impingement and especially central canal narrowing, further testing (EMG for one), and conservative measures to try before making a decision to intervene surgically. It is almost a given that different surgeons will have different opinions and even when they do offer surgery, they will offer different options. It is confusing and frustrating and you need to educate yourself and be your own advocate.

[KL Aguilar]

I would suggest that you post the findings from your MRI to get more specific advice. However, unless they told you that you need to have the surgery TODAY, which it doesn't sound like, you should learn about all of your options and get a few more opinions before you consent to surgery, especially since one surgeon is not recommending surgery at this point. You should also research as much as you can about your potential surgeon.

There are a number of surgical options: fusion, ADR, minimally invasive surgery, laminoplasty, etc. Which one is best for you depends on exactly what is wrong. ADR surgery for the cervical is rather new in the U.S. and thus you need to be very careful in choosing a surgeon.

Many of us have gone years without surgery, especially those without pain or significant other symptoms. Whether or not that is the right thing to do depends on exactly what is wrong. Your MRI may show simple bulges without spinal cord involvement or it may show major spinal cord involvement--the findings determine how urgent surgery is or what kinds of surgery are warranted.

As to whether you will eventually need surgery...some people recover enough to never have surgery....some people do not recover and go on to have successful surgery....some people do not recover and go on to have unsuccessful surgery. And a lot depends on what is wrong: bulges, herniations, osteophytes, etc.

[momoftwo]

Hi Sonata,

You and I are cut from the same thread! Sorry ahead of time for the long post, but what you wrote really resonated with me. I am 40, very active and have a 6 yr old and a 3yr old... "resting" is not a word in my vocabulary. Last August, I did something to my neck nerves while swimming and after a couple days of wicked pain, which went away mostly, I started having a bit of an achy neck and some tingling in my right elbow. Ignored it for a while and then went to my regular Dr who sent me for an MRI. That MRI has literally turned my world upside down. I was referred to a neurosurgeon who scared the crap out of me and told me I needed surgery ASAP since I had spinal cord impingement. I found out I had herniated C5/6 which hernitated straight back onto my spinal cord, where there is still some edema, and had herniated C6/7 to one side. I had posted here a bit ago as "MomofTwo - New Here and Freaking Out" if you want to read the actual MRI report from the first MRI on Sep 12th. Basically a diagnosis of DDD and canal stenosis as well as osteophytes were included. I had no idea I had any back or spine issues at all! This was (still is) all new to me and I am frustrated beyond recognition.

To date, I have been see by a Neurosurgeoan, and Orhopaedic Spine Surgoeon, and a Pain Mgmt Rehab Dr who all agree I'm pretty jacked up. I have been doing Physical Therapy 3-4x per week with something called McKenzie protocols and cervical traction amoung other general poking, prodding and pulling. I had an epidural steroid injection at C5/6 on Oct 29th. It hurt like heck and the concious sedation stuff they gave me did not work. I came flying off the table when the needle hit. It is now 100% more sore than it ever started out to be!!!! The Drs think the steriods have not yet started working to where I will notice it. I went back in on Nov 1st for another MRI, CAT scan to evaluate facet stability and found no degradation or improvement. I have seen the films, but not the written report.

There is still cord edema, but no evident nerve damage. Only an extremely high risk of having permanent damage. I am so frustrated and depressed I want to scream. I am not so bad off that I am dying for someone to operate on me and in the words of my spine surgeon, "the benefits do not out weigh the risks". The other surgeon gave me the speech about dangers of waiting until it was too late to treat spinal cord issues and having serious consequences.

As of this week, I have been sent back to the pain guy to be evaluated for another injection one level down to see if it helps. I go back in to be reevaluated the first week of Decemeber by the surgeons. I have been told now by both surgeons I am a prime candidate for disc replacement due to the high likely hood of adjacent level disc problems given my young age, activity level, and propensity for disc problems. Outside of this, I am a healthy, active and sporting sort of girl who is not dealing well at all with the few limitations that already been placed on me. I would have to go up to Dallas to have it done at Texas Back Institute, but I am told they can do a 2 level replacement there without joining the trial. ? Not sure what that is all about yet but I will find out!

I think the psychological acceptance that something this life-altering has affected me is like being hit by a bus from behind. I am not dead yet, but left spinning out of control in the middle of the street trying to figure out what just happened and how to get off the road.

I am the furthest thing from "expert" you will find, but from my research on my own issues, I was told, the "moderate" stenosis part of my diagnosis rules out any surguries with a posterior approach. Too risky given the impingement of the cord in my case. A laminectomy was not an option since the herniation is ruptured directly in front of the spinal cord. Anything else but fusion was ruled out in my case due to the locations of the rupture ad the spurs. I have also discovered that there is not a heck of a lot of information out there to assist people like us who are not living life in horrible dibilitating pain (THANK GOD!!). We fall into a weird catagory of not bad enough to warrant surgery, too bad off to continue doing nothing, and destined to eventually require surgery at some point in the future. In some wyas, I just want a decision so I can get on with it. The waiting game is maddening. While "waiting" I am not to have any exercise with impact. Hello.. has anyone ever had a 3yr old that didn't jump or pull on you without "impact". Having all the manipulation from shots and PT leaving morenow than there was to start, has led to a life of occational pain pills, rest, and little or no physical excercise. I want to hurl large objects off my roof at the next jogger I see. I know that is not rational (not to mention legal) but the anger and frustration can be suffocating. I am trying my best to stay positive, but it is not easy. I have started to read in my "down time". I mean an actual adult book, not "Skippyjon Jones Goes To School". I will say this was a refreshing change.

You are not alone on your feelings, I know exactly what you are going through. There may not be many of us out there, but I am here if you want to vent.

Mom of 2

[dshobbies]

Sonata,

Though I am sorry your circumstances brought you here, welcome to the forum. First, more often than not, different doctors offer varied advice on how to proceed with spinal issues. If your neuro doesn't perform or isn't very informed in ADRs, he is far less likely to tell you about this alternative. I'm not touting your rushing into any surgery, just telling you it's OK to slow down a bit and absorb all the information you can about your condition and remedies. Get second and third opinions. I sent you a private message with my personal advice.

I wish you the best and hope everything turns out great!
Dale

[Sonata]

Hello everyone

Just want to say thank you to all of you for answering me so fast. I live in Malaysia (half way around the world from you guys) and will be going to Singapore (very advanced in medicine) tomorrow to get another opinion from another neurosurgen. Cross your fingers..One neurosurgen told me that I should have another MRI taken after taking the medication and rest for 3 weeks to see what hapenned to the discs..Just wonder if there'd be an improvement through rest and medication/

Yesterday while I was surfing I have found the website www.rebuildyourback.com. This is a website started by a journalist who investigates into any health issue. He has written two books after consulting with many many doctors. He has 2 books about rebuilding your back and rebuilding your neck. Apparently a lot of doctors say that MRI results should not be the decision making criteria when it comes to surgery. It's your symptoms that shoud be taken into notice. I do not have any pain anywhere, I only have this mild pins and needles feeling (mildly) on my left arm. My father has the same problem and have made it (I am not sure about his details though) over 30 years with occasional physical therapy, collar, medicatian etc..He has a lot of bone spurs too and lumbar problem too. Please check www.rebuildyourback.com. I am not saying it works for everyone but it has a lot of information derived from othopedists and neurosurgens. The journalist's name is Dean Moyer. He says 90% of the cases are resolved with these neck and back exercises he has put together from various MDs and therapists. Ofcourse you always have to ask your doctor first before you start it. I will get the book and show the neurosurgen tomorrow.

Here is my MRI report
T1W and T2W sagittal sections at 5mm intervals
T2W axial sections at 5 mm intervals.

There is loss of the normal cervical lordosis. (I've had this for ages already)

A right postero-lateral disc prolapse at c5-c6/ Part of the prolapsed disc is seen to encroach on the neuro foramen on the right. There is compression on the exiting nerve root on the same side . (I HAVE NO SYMPTOMS ON MY RIGHT ARM THOUGH!)

A left postero-lateral disc prolapse at c6-c7/ Part of the prolapsed disc is seen to encroach on the neuro foramen on the left. There is compression on the exiting nerve root on the same side .

Posterior osteophyte is seen at the level c4/c5 encroaching on the neuroforamen on the right.

The cervical spine cord appears normal. There is no cord compression nor space occupying lesion seen. There is no change in signal intensity of the spinal cord.
Anterior and posterior osteophytes are seen at he levels of c4-c5, c5-c6 and c6-c7.

Changes of the end plate disease are seen at the level of c5-c6.

There is no change in the signal intensity of the bone marrow of the rest of the cervical vertebrea.

IMPRESSION:
1. C5/C6 right postero-lateral disc prolapse
2. c6/C7 left postero-lateral disc prolapse
3. Cervical spondylosis

They say if people even without any problems would go and get MRIs done to their cervical spine they will find a lot of things that could put them in worry. Like I said my dad managed somehow and his bone spurs were really bad. He is 78 years old today. Lucky guy he did not go for surgery and a lot told him to do so.

Have you heard anyone with spinal fusion surgery that went over 20 yrs or so without other discs slipping and no serious complications. I cannot find a success srtory on the web.

This is really confusing, When I feel fit enough to go and play golf or tennis or run..I am told to take it easy, take medicine, wear a collar and stay home for 3 weeks.

Please let me know about your impressions..

Thank you all so much again..

Hugs to all

Sonata

[KL Aguilar]

I read your MRI results. Here is my PERSONAL OPINION, from an experienced cervical spine injury patient WITH NO MEDICAL TRAINING at all. Please realize that no one can give you true medical advice on the internet. However, having been through this myself, here is what I THINK.

Your situation is not urgent at this point. Your symptoms are minimal. The spinal cord is not involved. You have bulges or herniations that are pushing into the opening for nerves, hence the numbness and tingling. These may reduce somewhat with time, rest, physical therapy, or other similar treatments.

Eventually, your situation MAY get worse as bone spurs do not usually go away. I have had a bone spur at C5-6 for more than 12 years now and it is growing very slowly, but not doing anything that requires major surgery yet. (I have other symptoms that may force me into surgery, but it is not the bone spur itself.)

If I were in your shoes, I would seek out the best medical help I could and begin to research as much as I could. I would not have surgery at this point. The first surgery I would investigate is minimally invasive surgery, such as cervical endoscopic discectomy. Assuming that your symptoms do not get dramatically worse, do not make any life-changing decisions about things like surgery until you feel you understand all the options.

[mmglobal]

Sonata, in order to make an informed decision, you'll want to assess the risk of waiting. You doctors will advise you and get multiple opinions, but there are problems that let you make a 'quality of life' decision... do the symptoms rise to the level of risking surgery. If you have severe cord compresison, you might not have the luxury of making the qualify of life decison, even in the absence of substantial symptoms. However, If you have exiting nerve root compression, it may not be unreasonable to wait, even in the presence of substantial symptoms. As I said, you'll get different opinions from different surgeons.. it's tough to sort it all out.

Mark

[Sonata]

Thank you all so much everybody..

Your support makes me feel stronger mentally. I've just come back seeing another neurosurgen. He told me to rest and take it easy and take meds for a while and see what happens to my symptoms. I will start doing some neck strengthening exercises, light ones. This neurosurgen told me that if I want to go back to my active life (golf, tennis) I better have the surgery (fusion, but then with an active life like that you are putting yourself at great risk for making the other discs slip!! What kind of an advice was that? I really do not understand. He said the other discs look in good form so it shouldn't be a problem!!..If I would know any success stories like a double fusion with an active life for 20 years I would not have a hard time beleiving this guy). He added 300mg of Neurontin, one everynight, to my medication. I just surfed the web and found out that this medicine is given to people with much more serious indications. And everybody is complaining about serious weight gain in short periods of time even if they eat normal. Has anyone of you taken this and seen this side effect?

Thank you for letting me know about cervical endoscopic discectomy. It looks very promising as a non evasive technique. Any one of you know a good place to do this in Europe other than Alphaklinik.

I am required to send my results to the Alphaklinik in Germany for a diagnosis and treatment options. I will be sending everything by DHL this Monday. And see what they have to say. Although they are the best in the world (looking at their reference list and patients who got treated by them), I am keeping in mind that at the end of the day they are surgeons too and they might want to go ahead and do something right away. Ahhh..Ethics.. I hope they are ethical.

Looking forward to hearing from you all..

Thank you once again.

Sonata

[Sonata]

Dear Mark and all

Thank you very much for everything already. I have been away from the forum bec my meds are making me very woozy and I am told not to sit in front of the computer much. This is all so weird to me as I have no pain at all. The tingling (the very mild one) feeling on my left arm finally, occasionally started dissapearing during the day. I don't know if the meds are kicking in or I am hallucinating because like I said it was so little anyway. Today I finally did more research and found Stenum Hospital with success stories and horror stories like the surgeon ( Dr. Ritter Lang) being drunk the night before surgery at 2 am.( He was seen by somebody at the local bar) when he had to do 8 spinal surgeries the next day. There has been a lot of failures there apparently resulting in more problems and a suicide case that really freaked me out about ADR. Apart from that I read a big complaint from a Russian patient who lives in Germany that was operated by Dr. Bertagnoli. She had a single level ADR in the lumbar area. Prior to her surgery she didn't have pain but was restricted in movement, yet she was able to walk a few miles. She did the surgery and has been bed bound for over 2 years now in incredible pain. And Dr. Bertagnoli has been ignoring her case and avoiding her. After all these cases and especially the many complications and failures mentioned in ADR in Stenum, I am really confused and would really like to delay ADR (if I am ever offered) as much as possible (this is my personal view, considering my symptomps).

I haven't seen any complaints about alphaklinik though. But I just found out that Dr. Bertagnoli has joined the team there! My !! where does this leave us all with? I have a feeling fusion is still the gold standard. I guess if you take really good care of yourself after fusion, the chances are probably lower for adjacent discs to slip. (Cervical spine)

Any inputs please?

Thank you all so much

Confused
Sonata