Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Can postponing surgery hurt?

WarrenPFJrWWarrenPFJr Posts: 2
edited 06/11/2012 - 8:50 AM in Back Surgery and Neck Surgery
Hey All,
I'm new here- just got a bit freaked out from my doctor and trying to do some research....
I saw a few docs about a month ago for my neck pain that had just started. My neurologist ordered an MRI then sent me over to see a Neurosurgeon he recommended.
Turns out i have a herniated disc C7-T1. Was in a lot of pain and had weakness in my right tricep with pec and tricep twitches. No tingles, grip was fine. The neurosurgeon prescribed physical therapy and wanted to see me in a month. That month happened today.

When we met he asked me how i was doing..... I felt great, pain is nearly gone, just a bit stiff when i wake up in the morning but at least i sleep through the night now, have been doing PT 2x a week, arm is still weaker but i feel like its getting stronger every day. Haven't needed any ibuprofen in almost 3 weeks.

He tested my arm and said its very weak... He proclaimed himself a pretty conservative surgeon and said most docs would have pushed for surgery when i last saw him, he's telling me we should think about it now. He could tell i wasn't so psyched on it so said lets meet back in 2 weeks, if the arm is still weak we should schedule surgery- he talked about the anterior fusion thing where he would enter through my neck, scoop out the disc and replace it with bone from my hip.

From what i am reading, surgery is mostly from pain and weakness can still take months to get back. Why would a doc be so eager to push for surgery if Im not in pain? If i postpone surgery am i risking anything, any permanent damage? I'm 37, right handed and very active. I am in the middle of physically building my own house right now and expecting my first child to arrive in mid March. Timing is not so great and i feel like i want to give PT more time. Am i crazy or just avoiding the inevitable?

Any insight from you veterans would be much appreciated!


  • Warren,

    First off, Welcome to Spine Health!! There is a search box at the top of the web page that might help in so far as researching the types of surgeries and such. As to "damage" if you wait. Your doctor is the only one that can answer that one.

    I'm guessing here (based on what I've gone through, and am going through again), his concern isn't the pain, but the function, and more so the weakness! My C7/T1 is going (fused above), and I've lost most of the feeling, function and strength along that nerve route. Can I get it back? It depends on the condition of the nerve. Since this one has been evolving slowly, my hope is yes. I had a hard herniation at my C6/7 and those nerves were permanently damaged - surgery for that was 3 weeks after the hernia! My surgeons *big* concern was the weakness, next the numb areas, and *lastly* the pain.

    Think of the pain like when you hit your elbow, the nerve is upset sure, but the function is still there. Throw in numbness, but can still function, the nerve is still irritated, but functional, toss in weakness, and the nerve is losing the fight? Kind of like a person being choked (simile here). When the hands first tighten on the person, it hurts, and maybe you can still breath, the choking continues, the pain backs off, and now your breathing is becoming less effectual, continue choking and you start losing feeling as your brain is no longer getting sufficient oxygen....Let go, and the person recovers! So pain isn't high on the risk list most times, it's weakness.

    See what he says in 2 weeks, bring all your questions (written down) with you. Your surgeon is the only one that will know if waiting is good, or going to chance damage. Sorry for the long post, was just trying to relate to what I've been through and what I've been told. Please let us know how it goes, and again, Welcome aboard!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • The muscle could also get smaller.

    Is a microdiscectomy not an option?
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Your pain is getting better, and you are feeling stronger every day. If it were me I would get a second opinion, and not from a Dr that he referred me to. It just seems shady to me that a Dr would push for surgery whenever you are having improvement, but some Drs are only happy when they are in the OR, or have a friend there.. that is only my opinion.
  • I am not an expert, but from my research I think it is probably the weakness that is worrying him the most. It could be a sign of pressure on the spinal cord which needs to be dealt with.
    Get another opinion if you can, but it sounds like this doctor has already waited to see if things will improve. If the weakness is getting worse, that is not a good sign.
    Have you read the articles here on cervical problems? That might help you to understand why he is concerned.

    Do let us know what is decided and how you get on.

    Ooooops! Forgot to say, welcome to Spine Health! :0)
  • Thanks all for the warm welcome, personal stories and support. Brenda, Jelly, you are correct in that it is the weakness that has my Doc worried. Paul- I have been told that they do not do micro discectomy's in the neck because of access restrictions....

    I met with my PT today and discussed surgery in further detail. My herniated disc is actually C6-C7. Taking this all with a grain of salt as this opinion is coming from a different discipline- i do think some valid points were made.

    My PT reinstated that surgery typically is for pain, loss of control- bladder, ect and progressive muscle weakness. He then pulled out a model spine and asked me what i think happens after they do a fusion. He warned me that often times since motion is now limited at the fusion the disc above and below take on the bulk of the extra work which over time results in herniation also- more surgery.

    My PT thought I was too young for fusion and suggested I look into disc replacement. He knows of the surgeon i was seeing and knows this surgeon does not do this type of operation. He said in any case i should at least look for a second consult before jumping right into surgery. He also mentioned and EMG or something that could accurately point out the nerve damage and suggested i look into this before surgery also- something he thought my surgeon might/should recommend. If i went the surgery route.

    PT also emphasized the progressive weakness part. Which i do not have. I have not gained a lot of strength in the one month that i have been seeing him but there is improvement. Not as much or as quickly as he would like but he does not sense digression either. PT put my strength on a 4+ out of 5. He said my surgeon could be right, but also felt that giving me 2 more weeks is not quite fair either because how much strength will i actually build in 2 weeks?

    We went over the odds- that i only have a 3 : 4 chance of getting strength back after surgery and thats after months of therapy. Plus the minor risks associated with surgery. The big question- Is it worth it? My big question is can it hurt to post pone surgery- I plan to consult with another surgeon to find out.

    I will keep you all posted.
  • Your PT sounds pretty smart.

    The majority of the time, the arm pain from a cervical herniated disc can be controlled with medication, and conservative (non-surgical) treatments alone are enough to resolve the condition.

    Once the arm pain does start to improve it is unlikely to return, although it may take longer for the weakness and numbness/tingling to improve. If the arm pain gets better it is acceptable to continue with conservative treatment, as there really is no literature that supports the theory that surgery for cervical disc herniation helps the nerve root heal quicker.


    All treatments for a cervical herniated disc are essentially designed to help resolve the arm pain, and usually the weakness and numbness/tingling will resolve with time.

Sign In or Register to comment.