Neck Pain: Cervical
Posted on: Fri, 09/26/2008 - 09:09
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2ND Opinion, Now what?
Greetings to all. I went and got a second opionion from a leading Ortho spine specialist. Boy was his interpitation different. My NS if you recall thought my problem was a medical mystery and disputed every radiologic and EMG finding. He wanted to do a foraminotomy but wouldn't guarantee that it would help with my weakness. I see this new Dr and his interpitation was very frightening.He was very alarmed by the weakness and said my tricep,deltoid and bicep muscle were all involved. He stated it wasn't a mystery to him and that I needed surgery ASAP to prevent any further nerve damage. He wants to do a 2 level ACDF, flip me over and do a foraminotomy. I had a horrible time digesting all of this information because I had hoped for better news. He went on to explain that the C5 6 had a large central herniation which was causing compression. There were also large osteophytes pressing on different areas. What a huge difference in opinions!!! Do I have time for a 3rd opinion? My instincts about the NS was correct. I almost feel like he is hiding something. Why he would continue to deny there was a problem is a mystery to me! However the Ortho Spine scared the heck out of me !!!
Who do you beleive? Any suggestions? He told me straight out that surgery was emergent to save the arm muscles. When will this all end??? Any input is appreciated because my faith is failing in these Drs ideas. Bethy
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Personally I would do nothing without a third opinion because the other 2 were so different from each other.
good luck.........Paul
Cervical myelopathy, 16 surgeries to date, Severe OA, bilateral knee replacements, DDD, 13 MRI’s, 4 sets of spinal cortisone procedures and dozens of cortisone shots in other areas for OA. Upcoming scheduled surgeries include laminectomy and removal of synovial cyst located at left facet joint of L4-L5 (may require fusion); Right resection of A-C joint (left was done 12 years ago, by far the most painful of all my surgeries)
I would definately seek a 3rd opinion, preferrably from another NS. This would scare the heck out of me too. I am currently also seeking our a 2nd opinion from a NS. My OS said I need cervical decompression. Woudl you mind posting your MRI results so I can see what they say? Thanks a lot and geez, good luck to you and keep us posted.
Sandra
Sandra (39) ACDF C6/C7 with PEEK cage system - Nov. 6, 2008. Disk was found to be severed in half-NS said it was good we did this when we did.
Osteoarthritis/DDD. Spine is a mess Cervical MRI-C6/7 significant herniation impinging spinal cord-impingement on left C7 or C8 nerve and bone spurs; Thoracic MRI - Small protrusion T7/8 impinging spinal cord; Lumbar MRI -2 protrusions sitting on R&L S1 exiting nerve roots. YIPPY!
While one is sitting there touting medical mystery and scratching his head, you've got a specialist who seems to have knowledgeable information. I'd say if you can, get a 3rd opinion. I know he's saying he wants to do it NOW but if it's as major of a situation as he says it is, personally if this were me, I'd want confirmation from another party that yes, this is exactly what needs to be done. Good luck to you and keep us updated!
I am in the process of getting an appt for a third opinion. My husband is freaked because he thinks its such an emergency that I don't have time for another opinion. The opinions were so far from each other that I will not feel comfortable until I see another MD.The OS was warning me that the longer I wait,the more chance of permanent injury I may have.Thanks for your input.
Bethy
This is so familiar to me.....I went to a neruosurgeon first who sent me for PT and said everything would be fine....my right arm pain increased and 8 months later I went to my pcp with the pain who sent me to an ortho spine surgeon who took one look at my MRI and said I needed surgery asap....I think it was the right choice even though I still have pain and many other things wrong which I contribute to waiting too long for surgery.
Sharon
Just to make sure that this doctor isn't trying to get you in to surgery, for the sake of doing it.
Your second opinion seems a lot more informative, which I would probably be more willing to trust. However, when I started my journey, I was told a lot of times that surgery is what these doctors do. Think about that when getting the advice to have the surgery done.
On the one hand, they are trained in this field. On the other, this is their business... their way of making a living. Just make sure that this doctor isn't overstating the facts.
Good Luck
~My name is Amanda. I am 27 years old, married, and mother to a wonderful 2yr old boy =)
~Baby number two, due May 30, 2009
“If children have the ability to ignore all odds and percentages, then maybe we can all learn from them. When you think about it, what other choice is there but to hope? We have two options, medically and emotionally: give up, or Fight Like Hell.”
~Lance Armstrong
Amanda, I agree with you. I guess surgeons make their money by doing surgery. This guy is a specialist in spines and I am sure that surgery keeps him busy. While I do not want surgery, I would certainly love to keep my left arm as a functioning part of my body. I will not go into surgery until I have another opinion.The surgery sounded way to involved and serious . The question also is how conservative and how aggressive do you allow the Drs to get?
Bethy
Wow what a difference in Doctors. I would get a third and see what they say. Wow I cant believe how bad the second doctor is saying you are. Good Luck
to hear you're looking to get another opinion. I think it'll be worth it and give you the peace of mind that if you do end up with surgery it will have been warranted.
So many of us with similar stories!
I had one NS who told me my problem was I was too tall, thin, long neck and big boobs and TOS.
I got a 2nd and am scheduled for surgery on 10/15. He was completely horrified by the 1st's comments and Thoracic Outlet diagnosis. He said, it didn't take a brain surgeon to be a brain surgeon with my MRI and EMG.
I felt so much comfort with the 2nd NS. He was such a pro and had such a caring attitude.
I guess that's why they call it practicing medicine!
Multi-level Cervical myelopathy with radiculopathy
MRI: DDD C4-C7, Moderate central stenosis C4-C5, Severe central stenosis C5-6/C6-C7, Severe foramen stenosis C4-5/C5-C6/C6-C7
*SUCCESSFUL* Surgery 10/15/08: 3 level (C4-C5, C5-C6, C6-C7) ACDF with titanium plates/screws
My first was with an Ortho who I think if he had a scalpel would have done surgery that day in his office! No thanks! My second was a neuro who gave me 50/50 chance of relief but the then 85% after my discogram. I then got another NS opinion who would do anterior approach, the first posterior. I then got my 4th opinion another Ortho spine. Gave me 97% chance I would be better, recommended the ALIF.
I could tell this was the right doctor for me. I knew from a friend that he had a great reputation as she worked in the hospital that he worked in. I had exhusted all options at the point I saw him. I scheduled with doctor number 4 and have not regretted my decision. My point is you need to feel comfortable and safe with whoever is doing your surgery. Keep looking for that person, they are out there somewhere! Good luck!
2 level ALIF L4/L5 L5/S1 March 11, 2008
for Spondy, DDD, stenosis
ESI's PT, Meds and everything else to try to avoid surgery!
My PCP is attempting to get my 3rd opinion this week at a University.I was called today by the NS who said he would cooperate fully with providing all documents for another opinion. I told him that I already got my 2nd one and that it was a far more serious opinion. He listened and told me my case was very complicated. He asked if he could see the 2nd opinion and I told him i would give it to him when I get it to look over. I wonder if he will go back and look at the films again. He did tell me that ortho spine surgeons LOVE to reconstruct spines. I am not doubting that either. So here I have 2 highly reputable surgeons with very different opinions. I would ideally like the easiest procedure that will give me the use of my arm back. They tell me the clock is ticking,and I don't want to make any hasty decisions because someone has frightened me into making a quick one.
I hope you are able to get this appt this week. Is your arm un-usable? Does it hurt, or just tingle, numb, and drop things? All of these are signs that the nerves are being affected. The longer you put of having the surgery, the more chance there is of not regaining full use of your arm. (IMHO) That doesn't mean you wont' be able to use it, it may just be weaker than other arm. Mine is still clumsy after a year post surgery. Good luck, and please post next opionion!
Hugs & Prayers, Maggie
Type 2 Diabetes. Peripheral neuropathy, fibromyalgia, carpal tunnel both wrists, right shoulder acromioplasty, appendectomy, hysterectomy, Septoplasty, Sinus surgery.
laparoscopic nissan fundiplication (surgery for GERD)
C5-6 Discectomy, fusion with cadaver bone, titanium plate and screws
1 4mm left frontal white matter lesion.
MRI Report: April, 2008
C1-2 mild degenerative changes. C2-3 Posterior disc/osteophyte complex and facet degenerative changes resulting if mild canal stenosis. Mild to moderate right and left foraminal stenosis. C3-4 disc/osteophyte complex assymmetric to the left and facet degen change rsulting in mild to moderate canal stenosis. moderate right and severe left foraminal stenosis. C4-5 moderate canal stenosis. moderate right and left foraminal stenosis. C6-7 mild canal stenosis. bilateral foraminal stenoses.
Thoracic T9 hemangioma. Mild Schmorl's Node endplate deformities. degenerative changes , most significant at T6-7 with right paracentral disc protrusion. associated canal stenosis.
Lumbar MRI Bed 2007
Lumbar degenerative dis desiccation and degenerative disc narrowing especially the upper levels.
L4-5 broad based disc bulge combined with facet hypertrophy and ligamentum flavum hypertrophy resulting in central stenosis.
Lots of pain. Leg Weakness on neurological exam. Tramadol, Baclophen, neurontin, magnesium, potassium, Toprol XL, melatonin
Thanks Maggie, I can still use it but there is severe weakness in the deltoid,bicep and tricep muscle. The pain is made worse as I increase my activity level. The EMG shows severe active denervation with ongoing time course(not sure what that means)at C7. The pain is now moving into the right arm but there is no weakness there. I have been attempting to get this problem solved for 5 months now. The process has been painfully slow and if I do have permanent damage it would be the fault of the HMO provider groups that have not taken my complaints seriously.
Thanks, Bethy