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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Orthopedic surgeon vs. NuerosurgeonForum: Neurology Forum
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2 years ago I had x-rays and a MRI that confirmed that I had acute degenerative disk at c3-c4 and c5-c6 and from c3-c6 the MRI show the vertabrae to be resting on the spinal cord (no nice white space as I have above and below those. My orthopedic doctor called in a nuerosurgeon to consult with me and I opted to avoid surgery until the pain worsened or I saw a more substantial weakness in my left arm. Unfortunately both occured. I also had moved and needed to find a new doctor. I was referred to an orthopedic specialist who has done a fellowship on the spine. I have two basic questions at this point as both doctors (2 yrs ago and now) have given me the same story - (I am a strong candidate for surgery and they recommend a 2 or 3 level fusion. 1. Should I be seeking a nuerosurgeon to do this procedure or can I expect my orthopedic doctor to be equally qualified? It's the c3-c4 that has me nervous ... that's getting a little close to the brain stem isn't it? 2. Given that a fusion is recommended the two problem areas are easy for me to accept. However, c4-c5 doesn't look too bad, although not perfect. Does the strength created by the fusion in the vertabrae above and below c4-c5 create a natural weakness or put at risk? If it is optional, should I avoid the additional level or will I simply be deferring an action that would actually be better for me? Any comments or thoughts to consider would be appreciated.
Dear Tim: 1. Both orthopedic surgeons and neurosurgeons are trained and qualified to perform anterior cervical fusions. My personal preference (for anterior cervical fusions) would probably be for a neurosurgeon. I repeat that this is my personal preference only, and does not reflect the opinions of other neurologists, and certainly does not imply any lack of competence of orthopedic surgeons. Some surgeons are better than others. I am sure that there are several orthopedic surgeons who are very excellent spine surgeons, and that their results surpass those of several spine neurosurgeons. I see no harm in seeking another opinion from a neurosurgeon with special experience in the spine. 2. What surgery to do should be left to the surgeon you trust. This is usually not a very "negotiable" issue. Good luck!
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