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Neurology (Expert Forum)
large herniation of c-7 disk orthopaedic surgeon suggests ACDF C 6-7
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large herniation of c-7 disk orthopaedic surgeon suggests ACDF C 6-7
by Becky, Jul 21, 2000 12:00AM
six weeks ago I awoke with severe pain in my right side and severe arm weakness. I went to the E.R. they gave me valum..no results, I went to my family doc. the next day he thought it was tendonitis, and prescribed vioxx 50 mg a day. THis did help, but i have slight numbness. the pain is pretty well gone, I have been off all pain medication for 7 days, are strength has returned, but not all of it. I had an mri and it did show a large herniation in the c-6 to c-7 area. I do have a dull pain in the area of my lower shoulder blade. The numbness is severe when I look up. My question is : Is surgery needed? are there other ways to deal with this? I have read the posts and it is not looking like surgery is a definate cure all. I am 32 years old and in good shape. I am an active person who has never been sick for an extended period of time.
Doctor's Answer
by CCF Neuro[P] MD, RPS, Jul 21, 2000 12:00AM
Dear Becky:
Sorry that your symptoms have given you such problems. As you have probably read in the other postings, we feel that surgery is the last resort for cervical problems, unless the problem is due to a mechanical problem (such as severe compromise of the spinal cord, or abnormal vertebral fracture). You are not alone in your symptoms as you probably have gathered from the other postings. We feel the best thing to do is rehab with a rehab specialist and PT/OT. This will help with giving you excercises to strengthen the muscles surrounding the column and ways to alter your habits of structural stresses from improper sitting, standing, and/or walking. If this doesn't help, then the question of surgery should be answered.
I hope things get better.
Sincerely,
CCF Neuro MD
Sorry that your symptoms have given you such problems. As you have probably read in the other postings, we feel that surgery is the last resort for cervical problems, unless the problem is due to a mechanical problem (such as severe compromise of the spinal cord, or abnormal vertebral fracture). You are not alone in your symptoms as you probably have gathered from the other postings. We feel the best thing to do is rehab with a rehab specialist and PT/OT. This will help with giving you excercises to strengthen the muscles surrounding the column and ways to alter your habits of structural stresses from improper sitting, standing, and/or walking. If this doesn't help, then the question of surgery should be answered.
I hope things get better.
Sincerely,
CCF Neuro MD
I had the same problem in January of this year. I had slight tingling in my right index finger last year but I lifted a heavy marble coffee table by myself and apparently caused the C6-7 disk to rupture. The symptoms started about a week later and got worse. My thumb,index and middle finger were in varying degrees of numbness. My tricep muscle was virutally useless. The pain was severe throughout my right back, chest and arm along with constant cramping. My head was cocked down and I couldn't lift my head.
Before my condition got really bad, I first went to my GP who gave me a cortisone shot and some pain killers. When things didn't get better I tried a chiropracter who proceded to crack my neck and diagnosed that I had blocked gallbladder?? Whatever!!?? I went back to my GP and he sent me to PT and a orthopedic specialist. I had to fight my HMO to approve the orthopedic specialist. The ortho sent me to get an MRI which showed the rupture. I then went to three neurologists. The first wanted to do a spinal fusion at C6-7. The other two said to just relax and take it easy and avoid any exertion or strain. They explained that the ruptured disk material should be reabsorbed by the body with scar tissue forming at the rupture. They said that the pressure at the cervical disks is less than that of the lower spine so chances of recovery are much better. I was also using some strong anti-inflammatory prescriptions to help reduce the inflammation on the nerve root. I also used a soft cervical collar to keep my head stable.
Well it's July and I'm feeling great. The recovery took about about 4-6 months from the onset. I'd guess that I'm about 97% back to normal. The only symptom left over is slight numbness (more like a dull feeling) at the tip of my index finger. I avoid lifting anything heavy and I can feel the consequences in my finger if I do lift something heavy. I think slight numbness is a lot better than having your spine fused with the possible complications involved. One of the neurologists said that you should always give time a chance to heal your spine and only after several months should surgery be considered if things don't improve or get worse. Also, surgery should be considered only if the injury is debilitating.
Good luck, take it easy and give it some time to improve on it's own.
Peter
What kind of antiinf. did you take? How large was your rupture?
Thank you for replying. I am so scared. Nothing like this has ever happened to me before. I don;t have a lot of pain, mainly just in my elbow and the tingleing in my fingers. but when I wear the soft collar, My entire arm goes numb...about your head being cocked down...same here down and to the left. I feel great when I am flat on my back. My herination is quite impressive according to my DR. He can't believe that I am not in severe pain. HE sais that if iI don't have surgery soon, I will loose use of my right arm...but the arm is getting stronger not weaker. I did go back on the vioxx yesterday. but not because of pain..just because I was hoping it would help the swelling of the disk. Thank you again Peter.
Hey I really feel for you. I know what you're going through. I was also really scared. I'm only 37 and have a family with 2 kids. You have so many plans and things to do and then somthing like this comes along. You're pissed off, depressed, afraid of what may await you and constantly thinking "why did this have to happen to me?!".
My head was also cocked down and to the left because the rupture was on the right rear quadrant of the spine. I couldn't raise my head or tilt it to the right. I wore the collar as much as possible because with my head hanging down all day at work, the muscles in my neck and back would get very strained and tired. But with the collar on the pressure on the nerves was greater so I tried to find a balance and would also take the collar off and on.
I had a bad problem of even sleeping. I had to lay on my back with my chin at my chest. Sleeping on my sides was definitely out of the question. It was almost impossible to find a position where my head was tilted at the right angle. Eventually when I fell asleep I would move and wake up with severe pain