C6-C7 disc rupture with moderate stenosis and disc degeneration--surgery ??

[PrintGal]

I have been having neck/shoulder blade, left arm pain and tingling in my left hand since Jan. The tingling has gotten a little better but everything else is the same, and over the past 2 weeks my pain level has been at the higher end of my range more often than before. I have already tried anti-inflammatories, muscle relaxers, Prednisone, and 3 months of PT with no change.

I had an MRI and my family practitioner called me with the results: c6-c7 disc rupture with moderate stenosis and disc degeneration. I saw a neurosurgeon this morning and have to go back because the MRI center didn't send my cd like they were supposed to. From just talking to her, she said that surgery may only help the pain in my arm not the pain in my neck or shoulder blade. Also, since she didn't have the scans to go by, she wasn't sure if I'd be an option for artificial disc replacement (she thinks so). I have to go back once she gets the disc (hopefully Monday).

Has anyone had similiar symptoms and had them all go away after either a fusion or disc replacement? Has anyone had similiar symptoms and didn't have surgery?

[kay290]

If swelling is the cause of the stenosis then yes I would think that would not progress if the swelling goes down. I do not think chronic neck pain after the surgery should occur if the problem is corrected. I had PT for 2 months post-op and rarely have pain now. I do get the new disc pain occasionally, but overall I am much better. Get an excellant surgeon to answer questions about neck mobility, pain in neck, complications he/she has seen etc...

If the arm weakness has improved that is good. Have you had an EMG to assess for damage that may be permanent whether or not you have surgery? The longer surgery is delayed the longer your nerves will take to recover and some may be permanent.

[frack123]

My surgeon wants to do C7 disc replacement and fusion.  He did not want to prescribe PT, but did.  He said that at this point it would not help.  He said Surgery was the only way to get rid of the arm weakness.  He never really answered whether or not I would continue to have neck and Shoulder blade pain.  The disc has ruptured entrapping the nerve and the swelling is causing stenosis.  My question is, if I choose not to have surgery will the stenosis get worse.  It seems to have gotten alot better.  Harldly no pain at all.  If I work to hard or sleep wrong my neck begins to hurt.  The tricep weakness has also been better but not 100%.  I have not got a second opinion.  Should I?  I have two options really.  I must wait atleast 6 months with no treatment for same problem to get insurance through my employer and or Go directly to the hospital and tell them I can no longer stand the pain.  This is what My Neurosurgeon suggested because I have no insurance.  He also did not want to tell me if it was work related or not.  He did not seem like he really wanted to do anything because he knew I have no insurance.  I can understand that, but really just needed someone to answer all my questions.  Will the damage be to severe if I wait  to long?

[kay290]

Acdf surgery is not new-25 years now in the US. Artificial discs are new and only approved for one.I had cadaver bone with plates in 2 discs. My pre-op neck pain is basically totally gone with the exception of mild twinges. I do get NEW disc discomfort pretty regularly but nothing like before. find a good surgeon who has done alot of the ACDF surgeries. It does help the degeneration because they get rid of those discs pressing on the spinal cord. However, there is a 20% chance you may need sugery in 10 years or so due to stress on the other discs. Good luck.

[JadedSweetheart]

I just wanted to let you know that I posted in the Neck and Back forum.  I experience the same type of pain and so far have done nearly everything but surgery, ie: PT, steroidal injections, pain management.  I haven't done nerve ablation or facets, and I have also heard of "trigger point" injections, that a lot of people say work.  I also recently heard about a rhizotomy that occasionally causes relief.  I've had the nerve test (the one without needles) done and that was good.  My mother-in-law had the nerve induction with needles and was screaming in pain.

It's generally a good idea to get at least one second opinion, as well.  I have been told a few different stories about what's wrong with me by a few different doctors.  I'm currently pregnant so my surgery options are on hold, but from what I've read, I will be getting the disc replacement on multi-levels probably outside of the US.  (as, like others have said, it's not allowed in the US currently)

[sylvia92562]

Hi PrintGal,
I have similar problems on the right side and had posterior microforaminotomy in lieu of disc replacement/fusion in 08' to remove the bone spurs, decompress the nerves and regain use of my arm. The neurosurgeon wanted to do disc replacement or disection with fusion but the U.S. FDA had only approved disc replacement at 1 level (I needed 2 at the time), and we were concerned that my body may reject the artificial disc material and fusion instrumentation due to autoimmune disease.

The severe arm/hand nerve pain went away for about a year, but the neck pain never did and in fact has gotten worse. I now have degeneration/osteoarthritis at all levels in my c-spine, and have trouble walking.  

I would recommend that your doctor conduct nerve testing to identify source and severity (if they haven't already), and consider other less invasive procedures (e.g. nerve block) before committing to surgery. Over time, fusion surgeries tend to put alot of stress on the other discs, and if you have arthritis or some other form of degenerative disc disease it may not really pay off in the long run.

Cervical disc replacement is relatively new in the U.S. If you elect to go the surgical route, do the research on your doctor to make they have experience with this type of surgery.

Here is a link for more info:
http://www.webmd.com/a-to-z-guides/surgery-disc-replacement-fusion

Good luck!

[caregiver222]

I might add, I have had several cervical injuries, was in black-out level pain and the chancre mechanics recommended a spinal fusion. I was a week away from the operating room when I found a doctor who did not get his degree by sending in box-tops.

I was treated with this treatment by a French pain specialist and the problem diminished significantly. It never entirely goes away.

[caregiver222]

Before surgery, mild axial traction several times a day should have been prescribed.

If this has not been prescribed I would find another physician.

This is often done together with "range of motion" exercises, moving the head 360 degrees through the limits of pain.

"Common sense" tells you that pain means you will damage something if you do something that causes the pain. In the case of disc degeneration this is not necessarily the case. This is counter-intuitive.

Good hydration is also necessary.

[PrintGal]

Thanks so much for the response. I will post this on the Back and Neck forum as well and see what they have to say! I really appreciate it. :)

[Kalvin]

I am really impressed by the fact that your Surgeon had the decency to tell that the surgery might not help you neck or scapular pain. Most don't, mine didn't. Had I known, I wouldn't have had such high expectations.

I had a anterior cervical discectomy and fusion @ C6/7 five years ago, because of the horrible pain I was experiencing. It's difficult for me to answer your question per verbatim, because I have multiple levels of degeneration. After  surgery,when my recovery basically stalled, I found out from another surgeon that my C4-5 should have been done as well. At that time, there was no way I could handle another surgery. So I've been pretty much living with it, trying to get my nerve back up to have another surgery. I can function, but the pain is constant, severe upper back, shoulder and neck pain.

One thing I can tell you is that your Doctor's right, my arm and hand pain was gone right after surgery. My fingers are still numb, but I can live with that. Neck and scapular pain are very common in people that have had cervical surgeries. I don't know anything about ADR's, they weren't an option when I had surgery, but I would advise you to do some serious research on it before you commit.

Come over and post in the Back and Neck forum, we have lots of members that have had ADR's and fusions.