@bondar Many surgeons don't want to operate on levels as high up as C3, so you need a good one for that level for surgery. At the C3/C4 level, the nerves that exit the spinal cord there service the neck and shoulders, not the hands on the dermatome maps. If you have central canal stenosis causing myelopathy, that can affect anything below that level in your body. I had central canal stenosis at C5/C6. and I had trouble controlling my arms and weakness in holding them up to push a shopping cart or drive. It was exhausting. I also have thoracic outlet syndrome and some carpal tunnel syndrome, those also affect my arms and hands by compressing the nerves in other locations such as under the collar bone and in the wrist. Do you also have arthritis affecting your hands? Do you feel like the finger joints kind of get stuck and don't move right or is it more a coordination problem and weakness in the hands or arms?

When you bruised C5/C6, was that a spine injury? Did anything change on your imaging that may show some damage at C5/C6? That can affect the hands and arms if there is a problem at C6 through C8 compressing the nerve roots. There really isn't a C8 vertebra, but the way they name the nerve roots, there is a C8.

How did your imaging reports describe the problems.. mild.. moderate, etc? And where did it say the problems are? Why does one doctor advise against surgery? Does he believe it will make you worse and why? How active are you? Are you a 78 year old who likes to get outside and walk or does that tire you out? Do you have other health issues that pose a complication for surgery?

There just isn't a chart that says when a person is too old for surgery, but doctors do have statistics for people in your age group who go through various procedures. Some people are smokers with poor oxygen levels in their bodies and don't heal well or have diabetes and don't heal well. The heart and lungs have to be able to handle anesthesia. Sometimes it comes down to your own gut feeling about how well you would recover. I know I've heard that surgeons may consider a person too old for surgery in their 90's. (I asked once.) They have to consider quality of life and how long a person's life expectancy is. At 78, you might be a person who feels younger than another 78 year old who hasn't take care of their health.

As for the harm in waiting with myelopathy, it depends on how fast things are changing. A surgeon needs to answer that and base his answer on how fast things have changed already as evidenced by your imaging. Sometimes they can't predict it. I saw my bone spurs double in size in 9 months on consecutive MRIs, and was loosing coordination of my arms. I knew I would be disabled if I didn't have surgery, and I got to the point if I bent my neck, I sent a big electric shock down my body because the bone spurs were contacting my spinal cord. Myelopathy doesn't always cause pain. It caused weird pain for me, and 5 surgeons turned me down because they didn't understand it, but one very smart one at Mayo changed my life. Here is my story.

A lot of aging has to do with our choices and if we eat foods that reduce inflammation instead of increasing it. I kind of sense that since you are asking these questions of several surgeons, you may consider yourself as a person who's life can be improved with surgery. My mom went through surgery on her ankle tendons at 87 and she did fine. She was really sleepy and out of it for an extra day because of the anesthesia, and we got the hospital to keep her for another night with oxygen because of that, but otherwise, she recovered and went through some rehab. The problem with her ankle was the result of a fracture, and her not walking because of bad balance, and the tendons shortened up so that her foot was in a twisted position and could not be placed flat on the floor. By cutting and lengthening the tendons, she could have a more normal foot position. She doesn't really walk now, and uses a wheelchair, but she can transfer OK. If she tried to walk on her own, she would end up falling again and has bad osteoporosis. She had a spontaneous spine compression fracture a year ago at age 92 related to severe osteoporosis.

What are your thoughts?