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Cervical Spondylotic Myleopathy. Surgery now or later?

lynnllynn Posts: 6
edited 06/11/2012 - 8:45 AM in Neck Pain: Cervical
I have been diagnosed with cervical spondylotic myelopathy, have 4 disc in my neck pressing on my spinal cord causing numbness in both arms/hands and some pain in my neck. Neurosurgeon says it's my choice. I may opt for pysical therapy & traction now & wait for the surgery or I may have the surgery now to prevent furthur damage to the spinal cord. I was all for let's just fix it now, but it's a little scary after reading your posts.
Here is my thoughts/problems. I am in retail mgmt. I work physically hard. I need to work & want to work. I'm looking at being promoted & moved out of state within the next 3 months if I stay with my current employer. My current employer requires constant physical work even at the MGR level.........or I'm looking at getting a better paying retail mgmt job in a different state within the next 2 months where I will be a Mgr that delegates most of the physical work but has more stress mentally.
My insurance now will pay for the surgery because I have no pre-existing condition. However, I am afraid if I put the surgery off & have it say 1-2 years from now, my insurance I have then with a new employer will not pay since it will then be considered a pre-existing condition. Also.... I am concerned my symptoms will get worse quickly. The things that could happen & the rate of which you can deteriorate , I read, are uncertain. Some people deteriorate slowly, others fast.
Any advice>?????



  • Myelopathy is a pathology of the spinal cord itself, as opposed to radiculopathy (pathology of the nerve roots) or neuropathy (pathology of the nerves outside the brain and spine).

    You haven't told us anything really except details of your current job, possible new job, insurance coverage, etc. What exactly are your symptoms? Why did you consult with a surgeon in the first place? Does this surgeon perform a large number of spine procedures each year? Is he a neurosurgeon or orthopedic surgeon? Is he fellowship-trained?

    If I were you, and assuming you have some symptoms in your neck and/or arms, I would consult with another surgeon as soon as possible. I had a four-level ACDF (anterior cervical disc fusion) with removal of half of two vertebrae included. The time between diagnosis -- and my neck was pretty far gone by that time-- and surgery was about 2 weeks, and that was only because I was a brand new nurse in a new town and needed time to get some things arranged.

    Your condition may not be nearly as advanced as mine was. Then again, along with a diagnosis of cervical cord compression, if you are experiencing symptoms like pain, numbness, tingling, loss of sensation in your neck and arms, you need to speak to the best surgeon you can find. If you feel a sudden loss of sensation in your arms or any part of your body, you need to get to an emergency room ASAP.

    All three types of nerve pathology can cause intense pain, but direct pressure on the spine, which myelopathy is, can in severe cases lead to paralysis.

    I'm not writing this to alarm you, but your quote of yyour surgeon disturbed me. For the surgeons I have worked with and who have operated on me, the "your call" statement is reserved for people who have some radiculopathy causing dysfunction and who meet the criteria for surgery, but who are on the fence about surgery.

    It was a hard decision for me at the time -- new job, new city, no family -- but I was fortunate enough to have the help of someone I had been dating. I returned to work 3-1/2 months after surgery, to a very physically demanding role. I feel I probably should have taken more time off to heal, and my surgeon didn't want to discharge me yet, but I was forced to return to work.

    If you find you do need surgery soon and you can pull your family together to help you before you try to move out of state, you would be one lucky person.

    I hope you will get another opinion from a surgeon who tells you what you need to know -- how many levels are compressed,, where the worst compression exists, what type of surgery they would recommend for your condition, and whether you should try to continue in a physically demanding job before (and maybe after) you have treatment.

    BTW, a new employer's insurance cannot use a pre-existing condition clause against you unless you have a lapse of insurance between jobs.

    I hope you'll keep us posted.
  • I feel i have to put my two cents in here.If your discs are pressing on your spinal cord then any fall or slip could cause paralysis. I don't know if your having pain or numbness but i had three levels pressing on my spinal cord and because my doctor refused to send me to a surgeon i had to wait a very long time to see one which cause me pain probably for the rest of my life. When the spinal cord is involved its never a good thing to put it off ,what could possibly help your situation physically.A therapist would never be able to move those discs off your spinal cord and may cause you more pain and problems trying to do so.Just my opinion!!!
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  • babybubbles, you ask for more details in order to respond to my questions. 1st I must apologize for being more ignorant of the proper medical terminolgy but I'll try..... According to the MRI results, Reversal of lordosis w/ significant degenerative disc disease in mid cervical spine causing some cord compression, worst being at C5-C6, with some altered signal. There is also bilateral foraminal disease at multiple cervical levels."
    The details of the report break down each level and the problems, but this is the "impression" stated at the end of the report. I have a total of 4 disc at levels C3-C7 that have degenerated,bone spurs, arthiritis, cord compression.
    My symptoms are numbness in the hands and pain in the neck.
    I am seeing a neurosurgeon and my next appt is 7/27 to let him know if I want to have the surgery now or wait, try physical therapy & traction to relieve symptoms and have my surgery later. The neurosurgeon told me I would have to have surgery, but when I had surgery was my decision. The longer I put it off, the more symptomatic I would become.
    Your thoughts on the matter are appreciated.
  • Welcome to Spine Health!! At the top of the web page is a 'search box', and you might find more information on Myleopathy as well. When my C5/6 started to go, the disk was 'abutting' the cord. I too was told it was my decision, but when he added that he was not going to have me get shots or PT as that could damage the cord, my decision was easy, plus any impact (someone knocks you down, car accident) could be game over... - 2 weeks later I was fused and felt awesome!!

    You might want to make some questions up for your consult as to what the pros and cons are at your physical stage. Assess where you are at now personally and how your life is affected. If you still have doubts (and you will see this all over this site), go for another opinion as multiple levels in one surgery get tricky, hell adding a level later gets tricky as I have found out!

    I wish you well in whatever you decide to do, but remember unless you are deemed an emergency, try and keep your eyes and ears with you, and you will in your heart and mind know if this is something you need to do now or later. Does that make sense?

    Oh, and for me, when surgery was 'on the table' I always bring my hubby. Granted I make the decision still, but since it's not "him" being cut, he tends to hear more than I do! (G) We then get something to eat on the way home, discuss all that went on, and then I go from there. Not too many doctors would have a heartburn given multiple levels especially, if you check with other surgeons to see what they suggest. Take care, please keep us posted!

    Again, Welcome aboard!!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Hi lynn,

    First let me say welcome to spine-health. Have a look around and get familiar with the cervical spine with some of our doctor written and peer reviewed articles.

    As far as your situation I understand your dilemma with work and all. However, I think you should get some answers first before you choose either way. The most important being what are your risk by not doing surgery now and waiting? You need to be asking how serious is the cord compression? Also ask about your reflexes and how they are working? Also do you have any leg issues? Before you make a decision on surgery get all the evidence.

    With that said most insurance companies won't approve surgery without following the protocol of therapy, injections and meds, but typically if it is cord involvement that protocol is out the window. I am not trying to scare you in surgery or tell you not to do surgery, just be prepared for that appointment. Also find out how many levels are a must be done situation. In the cervical spine more is not always better as surgery goes. Keep in mind that the surgery to correct that issues will forever alter the way the spine functions. So it is just not as simple as fusing 4 levels and going back to work in a few weeks to a phyiscally demanding job.

    Look at the top of the main page under the FAQ section and there is a article preparing to meet with a a spine surgeon and then another of 38 questions to ask a surgeon. From there you can formulate a list of questions to aid in answering some of your questions on the appointment.

    Just thought I would stop by and welcome you to spine health. If I can be of any assistance don't hesitate to contact me. Take care.
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