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Went to surgeon:totally contrasts what physiatrist said r/o

truffleloverttrufflelover Posts: 13
edited 06/11/2012 - 7:37 AM in Neck Pain: Cervical
HI I have severe foraminal stenosis due to bone spurring from C3- C7. A slight disc bulge at c6 and DDD. The physiatrist said that he felt my pain was more myofascial and rec. nerve block or RF neurotomy. He said that he doubted surgeon would rec.surgery. I go to the spine surgeon today and get his NP instead!! I thought that was crap, given this was my initial consult. Anyway, she basically says that all my neck/shoulder pain is discogenic and I am looking at disc repl. with fusion.The next step would be a discogram. After reading all the posts on discogram I would not want to go there. Any thoughts from anyone would be greatly appr. BTW I can manage my pain with percocet now, had to recently inc. dose.Thanks


  • MetalneckMetalneck The Island of Misfit toysPosts: 1,786
    Was the diagnosis from an MRI? CAT scan? have you had an EMG or a zillion rounds of PT yet?

    What are your symptoms besides "pain" location, duration, level? Any loss of sensation or motor function?

    Funny with all the pathology and surgeries and tests I have had .... a discogram was one thing they never mentioned or thought would diagnostically significant.

    Funny .... Disco & and Gram reminds me of the late 70's and early 80's! Te He ...

    Best wishes for a painfree minute or two or ten? Maybe ... ok that's pushing it!

  • HiMetalneck-I had an MRI,been through 2months of P.T. therapeutic massage chiropractic, triggerpoints. The only thing that helps is steroids-takes pain away almost completely. But within a couple of weeks pain returns. I have pain and some numbness/tingling from neck to top of Left arm. Whenever I tilt my head to read or type on computer it immediately aggravates pain to about a 10. ROM has been limited, still able to function. Traction has helped with burning sensations I had on my right arm.BTW love disco,live in Buffalo area where the Worlds largest Disco takes place every year
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  • I personally do not want surgery, but I don't want to waste a lot of time and money on treatments that will only hide the problem and things can get much worse (like permanent nerve damage).

    When you go to a surgeon their job is to tell you if they think a surgical option will help you. Even if it is there PA who spoke with you. Often times the PA's will spend a longer time discussing things than a surgeon. You will probably see the surgeon on your next visit now that you have been deemed a surgical candidate.

    I would tell the NS that you prefer not to have the discograhm if you can help it. He may be open to not torturing you. My NS has never asked me to have one.

    Also even though your bulging disc is "slight" the neck does not offer alot of room for these kinds of injuries and some people have even smaller spaces.

    The forminal stenosis is not an easy fix-I have bilateral forminal stenosis (as well as disc bulges at c5/6/7) and my NS didn't think the injections would work for this.


    Unlike many other back or neck conditions, most conservative treatments for foraminal stenosis (such as pain medications or other modalities) are unlikely to be of much benefit. Traction may provide some pain relief.

    Most often, patients choose either activity modification or back surgery to relieve pressure in the nerve root from foraminal stenosis.

    What are your full range of symptoms? How is your quality of life?


    I recently went into a clinic on referral for an EMG test from my NS. The MD who administered the test literally tried to sell me on his services just from reading my MRI report. He told me to have injections and nerve blocks etc and that my problems did not warrant surgery.... Why? Because he wanted to bill my insurance for all those treatments.


  • MetalneckMetalneck The Island of Misfit toysPosts: 1,786
    Was she talking about ADR and Fusion?? They usually do one or the other but not both. How many levels did she say needed "work" done. You certainly have all the signs and symptoms that can lead toward surgery. The big question is usually ... SHOULD I HAVE THIS DONE?

    The big answer for me was when all the meds could not control the pain ... surgery was the only option.

    I live in Chicago ... where the worlds biggest disco demolation occured ... once ... a long time ago. Ok the Bee Gees made some ok muzak ... great in the elevator or the beginning of sedation!

    Keep us posted - get a second - third - forth - opinion(s)


  • MetalneckMetalneck The Island of Misfit toysPosts: 1,786
    I feel that you would need to be half crazy to "want" surgery. No one really wants to have surgery .... but for many of us ... it was the last and best option.

    I have been blessed with a failed 3 level ACDF ...
    I actually "wanted" surgery to correct the failure of the first procedure. I was in so much pain - distress that I actually was begging for help (another surgery) .... 4 surgeries over a 3 day period of time ... 3 days in the ICU and 8 days later ... I was discharged with my new $500,000+ neck.

    Would I do it all over again? ... damn straight (like my neck now) I would because I am better now than before the first procedure and more better than before the second (round)of surgeries.

    I wouldn't wish cervical problems on my worst enemy.

    G_d bless us all,


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  • Metal neck-The reason she was pushing for the discogram was to determine how many levels are involved. She did mention doing both the disk removal and putting in a rod(fusion?) She said they don't use iliac grafts anymore.The thing is, the physiatrist mentioned that this particular surgeon was "aggressive", but he said he would be surprised if the surgeon would want to operate. How can the 2 have such opposite opinions?!?! Of course I will get many more opinions, it seems like the more I read about even nerve blocks & RF it seems like it's more probable to end up worse than before you started. I feel the same way, I will have to be in agony before I go for surgery. Although, somedays I do feel that bad. It's mostly positional with me. Like typing right now, kills me. But if I'm standing or in neutral spine I'm at a 3 pain level. Anyway, thanks for all your input, I haven't had much response on this site up until now. BTW some neck you have there!!
  • I agree Metalneck - who would want surgery - especially hearing how llllloooonnngggg the recup time is....but when you have tried all else - you have no more options.

    I don't know if anyone can see (my pic), but my herniation pushes towards the right and the osteophytes below it push towards the left. I have done 2 1/2 years of physical therapy. Have had medical doctor from the er (ct scan) tell me I have a moderate herniation....but the surgeon I saw said no surgery. It is not pressing on the spinal cord - not needed. My pain can't be coming from this!

    I am in the process of getting the radiology report, since this doctor only looked at it for a matter of 2 minutes at the end of his "over booked by 10 patient day". I don't know what else to do.

    Honestly, if the discogram would provide answers to my pain, in my opinion, I would do the test tomorrow. If it lead to a decision, I would drop everything and get it done. I have been in way too much pain for the last couple years....I don't want surgery, I just don't know what else to do. Taking the meds is not a permanent solution....and I have tried all the conservatives....what else could be causing the pain? I have all the symptoms that say it is the disc, except a normal emg. My stregth is lessened on the right....but no touchy the spinal cord no surgery. So I wait until it leaks into the spinal cord!?

    sorry for complaning, but just getting frustrated and perhaps jealous - which I know sounds sick, but dang this has been going on for too long.

  • I have had all the surgeries as metal neck been through 5 times. One thing you have to remember is surgery is no magic bullet. Most surgeons will just give you odds on how it will turn out. As far as the disco both surgeons I have said they don't use them on the cervical spine. Said they are not as reliable compared to the lumbar. Now they have used selective nerve root blocks to isolate out the problem. I called the last doc, I had for them trigger. He would say ready, set, fire and stick the needle in. I almost thinking he was getting a thrill out of it. Would say cheap thrill, but they are not cheap injections. But there are other options than a disco. Agree with D, get more opinions and all your options.

    Baffled my best advise to you is to see another surgeon.
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