finally met with neurosurgeon

Posted by birdman518 @birdman518, Nov 11, 2021

I will try to keep this short. After having my nerve testing done by my neurologist (EMG, CT without contrast), who then referred me to a neurosurgeon, I met today to go over the results from the myelogram (with contrast) I had about 2 weeks ago.

My worst disk issue is *not* C5-C6, as I thought (from my arm and hand numbness and pain, esp. my thumb and index finger), but C3-C4. This is the only place where there is compression of the disc against the spinal cord. There is some moderate stenosis in C5-C6, which means that there are potentially 3 places where I could have a cervical spine infusion. We discussed the option ("moderate") of doing only C3-C4, but given my symptoms we could end up going back later. The "aggressive" option would be to do all 3. NOTE: HE DID NOT PRESSURE ME TO DO ANY OF THESE.

We did discuss other options such as PT, acupuncture, shots et al, but because of the imaging he did not think these would provide anything but temporary relief and not fix the root cause.

We discussed in some detail what the surgery would involve and what the recovery would be, as well as potential complications. He actually spent at least an hour!

I would certainly like to hear what people think. I have been living
with this arm/hand pain and numbness for about 3 years. I do not want
this to continue to become a permanent disability..I already have difficulty
picking things up and even holding a pen.

Thanks!

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@birdman518

Yesterday I had my 2nd opinion with an orthopedic spine surgeon. He had reviewed my myelogram images and showed me how my problem was not just radiculopathy (although that is definitely present), but myelopathy. IOW, my spinal cord is being compressed. These two facts, I believe, account for almost all of my symptoms (pain, numbness, tingling, gait/coordination problems). Previously I was told that my biggest issue was C3-C4, which did not necessarily correspond to my hand and finger (thumb and index) numbness (usually attributed to C5-C6).

He indicated that I have some ossification of one of the ligaments: Ossification of the posterior longitudinal ligament of the spine (OPLL). I would love to hear what people know about that.

The other good news is that both his diagnosis and proffered remedy matched the other doctor's: triple ACDF for C3-C6. I am 99% sure that I will be going forward with this after getting clearance from PCP and Cardiologist.

I want to thank all of you who have responded to my other posts, especially Amanda and Jennifer…
Oh, my PCP prescribed Celebrex for me the other day (3 days ago) to see if it would help at all. So far I don't see it being better than plain Ibuprofen.

Mitch

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@birdman518 Mitch, It sounds like you have a plan and will be looking forward to a new year of healing and recovery. It's great to hear from you! Did your surgeon indicate any remedy for the ossified posterior longitudinal ligament? In my case, I didn't have radiculopathy, just myelopathy from spinal cord compression. When my doctors couldn't assign my pains to involvement of a specific level, they didn't know what to think. Spinal cord compression can cause weird pains just about anywhere which can't be tested and proven. When you have a combination of both nerve root involvement (radiculopathy) and spinal cord compression (myelopathy), it's probably hard to figure out which pain comes from where. Pain at nerve roots will always be the same area, and pain from the spinal cord can change areas when the spinal cord changes position within the canal. It's good that your doctors were in agreement, so you can trust the opinions. That must reduce the stress of not knowing because now you know and have a plan of treatment.

You might want to ask your surgeon that you choose if you can stretch your neck skin & fascia to help make surgery easier for them. It's easy to do just by using a hand to push and hold it. The looser the tissue is, the easier it will be on you too. My incision was on the left front side of my neck as the surgeon's preferred pathway. The amazing thing about spine surgery is you can wake up from surgery and all that pain is gone and you are left with the pain caused by the surgical incision. That was my experience. I was also kind of nauseated by the anesthesia and pain meds. If that bothers you, they can put an anti-nausea patch behind your ear before the procedure. That worked great for me when I had a different surgery when I broke my ankle a year ago.

You might get some relief with a heat wrap on your neck. I used to do that and lay down and relax. Have you decided which surgeon you want to have surgery with?

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@amandajro

@birdman518 I moved this post back into the original discussion to allow for those who joined you to get this update as a notification if they have them turned on.

@jenniferhunter will, no doubt, be glad to hear this update as well. Wishing you all the best and look forward to continued updates!

When are you hoping to proceed to the next step?

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I have to get clearance from my PCP and cardiologist, but they said they are scheduling out to January now.

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@jenniferhunter

@birdman518 Mitch, It sounds like you have a plan and will be looking forward to a new year of healing and recovery. It's great to hear from you! Did your surgeon indicate any remedy for the ossified posterior longitudinal ligament? In my case, I didn't have radiculopathy, just myelopathy from spinal cord compression. When my doctors couldn't assign my pains to involvement of a specific level, they didn't know what to think. Spinal cord compression can cause weird pains just about anywhere which can't be tested and proven. When you have a combination of both nerve root involvement (radiculopathy) and spinal cord compression (myelopathy), it's probably hard to figure out which pain comes from where. Pain at nerve roots will always be the same area, and pain from the spinal cord can change areas when the spinal cord changes position within the canal. It's good that your doctors were in agreement, so you can trust the opinions. That must reduce the stress of not knowing because now you know and have a plan of treatment.

You might want to ask your surgeon that you choose if you can stretch your neck skin & fascia to help make surgery easier for them. It's easy to do just by using a hand to push and hold it. The looser the tissue is, the easier it will be on you too. My incision was on the left front side of my neck as the surgeon's preferred pathway. The amazing thing about spine surgery is you can wake up from surgery and all that pain is gone and you are left with the pain caused by the surgical incision. That was my experience. I was also kind of nauseated by the anesthesia and pain meds. If that bothers you, they can put an anti-nausea patch behind your ear before the procedure. That worked great for me when I had a different surgery when I broke my ankle a year ago.

You might get some relief with a heat wrap on your neck. I used to do that and lay down and relax. Have you decided which surgeon you want to have surgery with?

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Thank you for the recommendation about the stretching. I will ask about it. I will probably go with the ortho guy, because although we felt comfortable with both, we personally have a recommendation from someone about the former.

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Hi, I had ACDF C4-C7 and within a year post-op I started experiencing adjacent segmented disease (ASD). After 10 years of repeated temporary therapies – Chiro, PT, Acupunture, Injections, etc., had posterior C2-T2 cervical fusion. I am now 6 weeks post-op and still experiencing radicular pain in upper extremities (I dealt with this pain for nearly 2 years and was told it may be permanent). I am praying all will resolve at 12 weeks post-op! You may want to discuss ASD with your surgeon.

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@sprasatek

Hi, I had ACDF C4-C7 and within a year post-op I started experiencing adjacent segmented disease (ASD). After 10 years of repeated temporary therapies – Chiro, PT, Acupunture, Injections, etc., had posterior C2-T2 cervical fusion. I am now 6 weeks post-op and still experiencing radicular pain in upper extremities (I dealt with this pain for nearly 2 years and was told it may be permanent). I am praying all will resolve at 12 weeks post-op! You may want to discuss ASD with your surgeon.

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Thanks for sharing this.. I will do so.

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