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Surgery without Symptoms?

amosaamos Posts: 18
edited 06/11/2012 - 8:50 AM in Back Surgery and Neck Surgery
Hi Everyone -

Great to have a community of people out there - thanks for the support.

Has anyone had surgery based on a concerning MRI alone? I am in no pain, and have had very few symptoms typical of the severity of the stenosis/disc herniation I have in C 6/7. I've seen four different neurosurgeons, 3 want to operate, 1 is on the fence, and 1 says 'not right now/check back in 6 mos'. (It would be a two level ACDF. My C 5/6 is not looking great either.)

Here's the scoop - they all agree that the MRI is concerning. The ones who want to operate say that the problem will likely get worse, that there is no real benefit of waiting - just risk of a bad fall/accident, etc. The ones on the fence say 'let's wait for more symptoms' to make the call.

I originally got the MRIs done b/c I was experiencing intermittent leg numbness when picking up my 2-yr-old. No pain, just weird - my knees would buckle and I'd have to sit down. That eventually led to an MRI of the neck. In the last month, I've had 2-3 times total where I've felt a very low grade electric shock down my arms, usually after working on the computer nonstop or bending down to clean, etc. Rarely happens. (Some doctors think the leg numbness is related to the c-spine, some don't. At this point, it's more about the compression itself - regardless of the leg numbness.)

Another plot twist - my husband and I also want to get pregnant in the coming months. That adds a whole new curveball on everything, a I'd clearly like to avoid surgery while pregnant.

What to do? I've stewed about this non-stop, can't sleep at night - anxious about making the call one way or the other. Any insights out there would be GREATLY appreciated.

Wishing all of you a healthy outcome. God bless!




  • Hmmm....I'm surprised that neck issues were causing leg problems but I'm not a doctor. I also would question a recommendation for spinal surgery with no symptoms, but that's me.

    Have you seen a dermatome map? It helps you understand what levels impact what extremeties. I found it interesting.

    Do you have a GP that you trust? I would consult with him/her on how to approach surgery. They will not know about spinal surgery but I would guess your GP & you have similar approach to medicine and how conservatively to treat things.

    Things I would think about and ask:
    1 - what if I don't have the fusion? What are my options (there are anti inflammatories, steroids orally, steroid injections, less invasive surgeries such as discectomies)

    2 - Mechanically how will this help me? Their answer will likely make sense b/c they'll tell you they will 'free' the nerve that comes out of the spine and then remove the disc which is likely the culprit for putting pressure on the nerve.

    3 - The one that says "No way"...can you ask him if there is a speciality group that could do a remote opinion based on your records? I know of one group in the mid-west that does a remote opinion as long as you have a doctor who is treating you. I would also ask him if there is PT or other things you can try before fusion. Since he's the most conservative, he'll likely share other options.

    4 - Studies have been done (I'll try to find the name) where they randomly pulled people off the street and conducted an MRI. Many folks MRI's in the group look terrible and when they spoke to them, they expected to hear horror stories of the pain. These people didn't have any symptoms. Most doctors I spoke to say the MRI alone is not a good indication of if you need surgery. They said they combine the MRI with the patients history & symptoms.

    5 - There are risks of fusion. Cervical is 'easier' than lumbar but fusing means changing your body mechanics. It is removing a shock absorber from your system which means the other levels do have to carry extra load. There are pro's to it if your spine is unstable.

    6 - Technology is evolving. Fusion is permanent. In my case, I want to avoid fusion as long as possible b/c I hope that ADR (artificial disc) and other advancements give me more options.

    7 - If you want to get pregant, I think that's a huge factor. I would check with your doctor's but nothing you told me indicates this condition is "life threatening" but surgery puts you at so many risks.

    8 - I do think PT would be a great thing to see if you can get. Why? It's all about proper body mechanics and exercises that are safe to do while keep the core around the damanged area 'strong' to protect you of an unexpected 'hit' (such as fall, wrong lifting of your child, etc.).

    I think you are wise to be asking questions to understand pros/cons/risks/options.

    Surgery is very personal. It sounds as if you have some time to research this so that if you opt for a fusion and things don't improve the way you expected, you have no regrets on the choice, the surgeon, or the long term plan.
  • One more thing...I like plans.
    My surgeon and I have a plan. We didn't just talk about my immediate issue. We talked about my future and my back's future. We talked about what could happen best and worst case scenario. He took me through a few key decision points that we may be faced with in the future and the options I'd have depending on if/when these things happened. It helped me feel confident that he was looking out for my quality of life beyond the immediate issue. It also gave me assurance he wasn't just looking for a quick fix.

  • Thanks so much, DNice. Appreciate the time and thought you put into it, and I'll definitely take your advice to heart. I like 'the plan'.

    I can't believe I'm even saying this but I'm leaning more toward surgery, to get it done with already and not be in this state of 'what if'. I met with another doctor today (I know, a lot), and advice was not to mess around with this and wait for something irreversible to happen. Also checked in with my GP - very helpful.

    Again, thanks.

  • I sent you back a message too.. I am surprised you do not have any pain yet. What is concerning I am sure is that 3 out of 4 DRs recommend surgery .. most will say there is no crystal ball to tell if and when you would begin to experience additional symptoms. I have to tell the pain is severe and dehabilitating if you ever get to that point. I hope not! The recovery from this surgery is not really that bad and probably would not be for you since you are not in alot of pain now. The big question to the Drs who want to do the surgery is how soon would have to wait to then become pregnant - not sure if you already asked them that... I sent you all that happened to me in reply to your message - so let me know if I can help you any further .. Good Luck and keep us posted!
  • Yeah, I know. Everyone is surprised that I don't have more symptoms based on my MRI, and of course, I'm glad I don't. I think a big reason is that it's not pressing on my nerve - just indenting the spinal cord directly. Anyway, I just cleaned the house, picked up my son, hauled stuff in and out of the car - nada. Maybe I should just wait until I feel something that screams 'GET SURGERY'. It just feels so unnatural to walk into surgery feeling so normal. (And I'm so sorry you had to experience such pain!) Anyway, thanks so much for your input.

  • You say you have no symptoms, but then you tell us what made you go to the doc in the first place. Are those not symptoms? No, you don't have screaming pain, but you do have symptoms. I would question having surgery unless you have no other options, but I do think you should take this seriously and watch for signs of worsening.

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • SpineAZSpineAZ WiscPosts: 1,084
    Should you choose not to have surgery and do become pregnant alert your ob/gyn to the delicate situation in your neck. You may want to opt for a c-section in lieu of moving your neck through labor positions and pushing.

    Having and ACDF later will be more difficult when you have a child to lift, carry, take care of, etc. If your ACDF goes well you will be ready to have a family and not risk facing surgery while you have an infant or toddler.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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    Post edited, solicitation is not permitted on Spine-Health

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  • I remember those days where I would have a leg just collapse - actually the numbness/loss of leg is a more concerning symptom than pain.

    I know my NS does not operate based on pain levels but on nerve issues - ie: that loss of function in your leg.

    That is nerve damage and that is what back surgery can help. Surgery is not a cure for pain, but is to relieve pressure on nerves, whether or not they are sending pain messages or not.

    Oh - and those lightning-shock pains - YES - that is exactly what i would have, particularly after sitting at a computer (just the same). It did progress to where I would get that shocker and I would lose my bladder. I had no control whatsoever - it turned out to be the beginnings of CES. Nasty stuff that is.

    I did have surgery and am VERY grateful to have had it done. I can't imagine what my life would be right now if I'd kept on like I was.

    Good luck

    oh- and regarding pregnancy with back issues - you are just asking for your condition to worsen - and then you are stuck, no surgery without very high risks. I say get it taken care of before hand.
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