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How to choose a surgeon when it's complicated and urgent?

Went to the neurologist with complaints of hand numbness spreading slowly but surely from the thumb out; trouble typing and manipulating small objects; balance issues; feeling like I'm drunk when I'm walking; a weird leg tremor (apparently it's officially clonus and spastisity); and all over body shocks when I move my neck suddenly - all developing in the last month.

He ordered an MRI of the head and cervical spine. Which found (most notably) congenital spinal canal stenosis, bulging and herniated and torn disks at C3/C4, C4/C5, and C6/C7 with T2 hyperintensity at C4/C5 and C6/C7 "compatible with injury". EMG testing showed C5 and C6 radiculopathy. Oh and arthritic disease, osteophyte complexes, hypertrophy of this and that, and so on and so forth. Neurologist's recommendation is to see a neurosurgeon right away due to the severe spinal cord compression, existing damage, and overt symptoms I exhibit.

Here's the thing - I'm 29 so any surgery done now is just going to be the 1st of many because your spine naturally degenerates over time, mine's just made a head start. So I really want to make sure that I get going in the right direction. Add to this that I was born with a birth defect of an underdeveloped left arm, hand, and shoulder as well as fused and missing ribs that are balanced just right to only cause minor scoliosis. But it is a very delicate balance. I also have had type 1 diabetes for 21 years with mild polyneuropathy that hasn't really progressed in years, but it's there.

So I really really want to get the "right" doctor for me, but I have no idea how to evaluate someone's technical expertise for something like this. But the neurological deficits are continuing to worsen and I'm really screwed if I hit a bad bump - so I'm being told it's urgent but not an emergency. So how long does that mean I have to make a decision? I also, oddly enough I'm not in a lot of pain, just feels like I slept on my neck wrong so any surgery is going to initially make things worse and possibly permanently worse pain wise, but currently doing nothing is guaranteed to cause worsening neurological problems. And as the NS I saw yesterday noted that at this point the purpose of surgery is not to correct the existing damage but to stabilize the spine and prevent additional damage.

So I guess any advice on how to choose? What to consider? How to make sure that all the other issues are taken into consideration? And anyone else under 30 or who started out under 30 with recommendations for dealing with it from that perspective?


  • dilaurodilauro ConnecticutPosts: 9,859
    For me, it was important that I had to have immediate trust and confidence in the surgeon. Perhaps since I have had so many surgeries, I sort of know what to look for. Spinal surgery has come very far in the past 5 to 20 years. What used to be a very difficult surgery, today while still difficult are becoming routine.

    Spine-Health provides some guidelines you might want to look at: Guidelines in evaluating Spine surgeons

    There are other resources on the Web, but many of them you have to pay for to get details. You can always start by just search on your doctor's name and see where that brings you.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thanks dilauro, especially for the link. Any additional things/gut instincts you depend on when looking for a doctor?
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