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herniated cervical discs, conflicting opinions from doctors

dman777ddman777 Posts: 4
edited 06/30/2015 - 6:24 AM in Neck Pain: Cervical
Hi everyone,

This is my first post here. I'm a 44 male, have been experiencing intermittent tingling and mild pain in my left hand, forearm, and shoulder blade. My GP suspected pinched nerve and originally sent me to PT, which didn't really help. Went back for an MRI, which shows fairly large cervical disc herniations at C5-6 and C6-7. One is pressing on the left nerve root, which is likely the cause of that arm tingling, but the other is larger, and pushing against my spinal cord to the side (with some signs of cord flattening).

I have no apparent symptoms from the larger herniation.

After the MRI, I saw a random physical rehab doctor at a local hospital. He almost immediately brought a neurosurgeon who happened to be there into the room. Both suggested I consider two level fusion or disc replacement surgery, and warned me about paralysis risks if I don't do anything about the herniations. They did not advise PT given the size of the larger herniation.

I was floored, as I was not ready at all for such a diagnosis from what seemed like fairly minor symptoms.

With my head spinning, I did some research and decided to get more opinions. Got an appointment at a reputable orthopedics center, associated with a university hospital. The doctor I saw is a very experienced orthopedic surgeon that specializes in neck and spine.

He gave me a much more comprehensive physical examination, including a number of neurological tests, which were all negative.

His assessment is that because I have only mild symptoms, and no signs of neurologic deficit, I should not consider surgery. He also downplayed the risk of sudden paralysis, and said that it's possible that the herniation will remain asymptomatic or shrink over time, and the best thing to do is to just avoid activities like kickboxing and keep an eye on symptoms.

He did request a follow-on MRI with contrast, as the first MRI shows some "streaks" on my spinal cord, and he wants to eliminate some remote possibilities of other issues. So, I'll be seeing him again later this week for a more final/conclusive assessment.

I thought I'd share, in case anyone finds this helpful with their situation, or has any advice based on similar experience.

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  • Did the surgeon explain to you that the shrinking is from your disc falling apart? Once they are torn they do not repair, they continue breaking down until they finally collapse.

    Best wishes.
  • In my case I was told the same thing and even had an EMG study which was within normal limits. Within a year and a half I slowly deteriorated. Pain became worse, 20% weakness in grip strength, quality of life deteriorated. I had pain in my neck, burning in my shoulder blade, hand numbness, debilitating headaches. Went to PT to see if discs would heal, shrink,etc....a year later, symptoms grew worse. 19 months later ended up having a discectomy and fusion. I wish I had done the surgery sooner, rather than later. Because my nerve was compressed for over a year, it will take a good year to recover. Had I done the surgery a year ago, I would lrobably be fully recovered by now as nerves and muscles have memory. I am now 9 weeks post op.
    Also, my MRI didn't begin to show the severity of my neck. What looked like a mild to moderate 5mm herniation turned out to be an obliterated disc and disc matter was smeared all over spinal cord, causing pain. I also had a torn ligament which MRI didn't show.
    I would listed to the neurosurgeon long before listening to an orthopoedic surgeon. The NS understands the nervous system and spinal cord. My Ortho who specialized in neck and spine surgery wanted to keep me on narcotics and wasn't willing to further order tests to investigate where all my pain was coming from. On the other hand, my NS was like a detective, investigating everything before finally deciding ACDF surgery was my last hope.
    Just my personal opinion. But like you, I am a young 41 year old (woman ) with a very active life. And I wanted to return to that life. I couldn't continue to watch my quality of life deteriorate any more.
    Good luck, and keep us posted.
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