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Watchful Waiting or Proceed with Surgery

AnonymousUserAAnonymousUser Posts: 49,322
edited 06/11/2012 - 8:36 AM in Back Surgery and Neck Surgery
I have been diagnosed with advanced cervical myelopathy secondary to congential stenosis associated with both anterior and posterior degenerative changes to C3-C4 and C4-C5 based on MRI. I already demonstrate signs and symptoms consistant with progressive spinal cord dysfunction. I will likely require anterior and posterior cervical fusion and decompression. Over the past few years my right leg would get numb when driving a car more that 45-60 minutes. Two years ago I would loose feeling in my legs when I stood too long without movement (usually 10-15 minutes.) Once I sat down feeling would return in 2-3 minutes. I had an SSEP study which demonstrated slowing of conduction within the central somatosensory pathways. I have no pain and some stiffness in the neck and rarely have to take any pain medication. I have seen two neurosurgeons, one who advocates immediate surgery as a preventive measure for further cord injury; the other says I could do it now or wait for more symptoms I presume. One would do it as one operation the other as two. I would prefer the one operation if there is no greater risk.

Having read many posts I am unsure in which direction to go. It seems most of the posts talk about surgery to alleviate pain, which in some cases does not go away. There has been suggestions that for some they may have waited to long and there as been permanent spinal cord injury. I inderstand the risks for falls or accidents but it seems to me to be the same risk whether or not I have surgery. The other issue is no pain now but what is the outcome with surgery? Advice from those who have had to face the same issue would be appreciated.


  • The folks here who suffer from cervical myleopathy will tell you that it cannot be undone, but that surgery can prevent further advancement of damage and symptoms.

  • Brek, I can't suggest what you need to do, but I will tell you what I told my NS and my arm surgeon with my Ulnar nerve entrapment issues. I had ulnar nerve transposition surgery based on the following criteria: What are the chances of it improving on its own? and Is the damage permanent? In the case of the arm, the self-improvement or PT improvement chances were very slim...improving symptoms at best and not slowing damage. The damage could be permanent. I had the surgery without looking back.

    My cervical spine issues didn't offer as clear of an answer. My NS kind of waffled, so I opted for more time. However, the symptoms and pain have ratcheted up so much in the last 4 days, I am ready to get something done.

    Ask your Doctor(s) about long term prognosis for waiting and/or having surgery. Ask Dr. #2 about any real advantages/disadvantages to waiting. Looks like Dr. #1 already made up his mind.
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