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To Surgery or Not To Surgery?

Hi everyone,

I am a 37-year-old athletic and generally healthy male who was diagnosed three months ago with a herniated disc at C6-C7 after years of chronic neck pain.  I have received three cortisone injections and the pain that was once debilitating in my neck and radiating down my arm and hand has been reduced to more of an annoyance at this point.  There is clearly still compression of the nerves occurring, but I am in a much better place than when this ordeal began (and I won't bore everyone with the awfulness of my pain manager and the clinic's support staff!). 

I have consulted several times with a tremendously helpful and knowledgeable neurosurgeon who I have great confidence in, and based on my responses to the injections he recommended against surgery at this time (his original inclination after the first injection was ACDF, though that changed), suggesting rather that I wait and return to my active lifestyle to see how I feel running, cycling, and hiking.  Right now I have fairly consistent pain in my neck when looking down or up, numbness in my right index finger, and occasional nerve pain in my right arm, mainly around my elbow.  Sleeping on my right side does cause some mild discomfort as well.

My surgeon has said the decision for surgery is, of course, completely up to me.  Unfortunately I'm an indecisive person!  Obviously the injections worked to an extent, though I am certainly not 100 percent.  I plan on beginning light cardio exercising soon.  Has anyone else faced the dilemma of having made good progress from cortisone injections but not complete recovery and the decision of whether or not to pursue surgery?  I'm just not sure what to do at this juncture and would appreciate the wisdom of others on this forum.  Thank you so much for your time!

Cheers,

Narn Ceredir

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Comments

  • Hello

    Well, I haven't made good progress from cortisone injections; I have never had them, but I did have successful treatment with other methods. I herniated my c5c6 badly, 5 years ago. At the time medication, physio and hydrotherapy worked well and I was able to continue with my life for 4 years. Injections were an option at the time but not required. I was told the injury site would always be a weakness and that one day I would probably need an operation. A year ago it went again - exactly the same way, getting out of bed. 

    This time the pain and numbness didn't go away and worsened progressively until I elected for surgery, which I had 10 days ago. I made the decision based on my reduced quality of life in relation to activities, sleep and general well-being. The risks outweighed the benefits in my opinion and I had been told that earlier intervention rather than later increases the chance of a successful outcome. Also, surgery at just one level normally results in little to no change in range of movement.

    I can honestly say I felt the difference immediately after the op. I had read that others had experienced this but found it difficult to imagine. Despite the obvious surgery related pain/discomfort, which has been varied, all my original issues are gone.

    I hope this helps 

    Best wishes 

  • WLLadyWLLady Ontario CanadaPosts: 1,331

    hi NarnCeredir

    i am a completely different case from you, but i just wanted to give my point of view.  I had a 10 level fusion for problems that would never fix themselves.....

    If you can live with it, think very hard about doing so.  once you do surgery it changes your mechanics forever.  if you can live with it, my advice (having been through surgery) is live with it as long as you can-with one caveat.  As long as you are not risking permanent nerve damage.  if it's just pain (just pain.....i don't mean "just" pain...but livable pain) i honestly would advise you to wait until you cannot bear it anymore. and then do surgery.  The recovery from these surgeries is not easy, not fun, take forever, and are a challenge to say the least.  you WILL have pain after surgery, you WILL never be back to what you were when you had no problems in your spine whatsoever.  If you are risking permanent damage to the nerves the sooner you fix it the higher the chance is that you will regain full function.

    i faced a good possibility of being in a wheelchair after my surgery.  my surgeons were amazing, and i'm walking.  but i will never run again.  i will likely have permanent nerve damage on my left side, but thankfully it's not as bad as it could have been.  i'm 6 months out, and doing lots, but still not half of what i used to do.  there's still a lot of pain (but less than before surgery for sure!)....but before surgery i could barely use my left leg, walked with a cane, and lived on tramadol to get through the day.  i cut hours at work, and literally lay on the floor for hours waiting on my back to stop screaming at me.  i would honestly recommend that if you cannot live with it, and you are not permanent damaging those nerves (your dr can tell you that), then wait and deal with it conservatively, until such time as it has to be done.  i consider myself a complete success story, because i was given an 80% chance of needing a wheelchair after surgery (110 degree scoliosis with nerve impingements bilaterally from L2-L5, and left L4 and L5 were being crushed by bone on bone)....i'm walking, i'm in PT, i'm back to work full time and doing great!  would i do this surgery again?  only if i were in a very similar position to last time, in totally irretractable pain, and losing function fast. 

    good luck in your decision!  i'm very glad you have a dr you trust!  if you decide to resume your daily activities, do so slowly.....and who knows, maybe you can push your surgery out for a good long time.  

    Kathy
    Spine-Health Moderator
    ---------------------------------------------------------------
    Dec '16 T10-S2 fusion with pelvic fixation. Laminectomies L2, L3, L4, L5, facet removal, cages L4-5, L5-S1, severe scoliosis, arthritis and stenosis repair. 

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