Thoracic and Cervical Herniations

I am an 18 y/o female, almost 2 years ago I was involved in a car accident(I was rearended by two cars at a complete stop). And after almost 2 years with no diagnosis and chronic pain I recently found out I have a cerivcal herniation at C5/6, thoracic herniation T9/10,annular injury and protrusion at C6/7, annular bulging at T7/8 and other cervical bulging discs.The doctor told me me they didn't understand how all of that can missed fo so long after seeing more than 10 doctors and having more than 6 MRI'S. I have had every conserative treatment suggested ....rest,ice and heat therapy, physical therapy, massage therapy, traction, ultrasound therapy,various medications,(I currently do not take any pain meds or have in the past), 2 sets of triggerpoint injections, cervical epidural, acupuncture, and now facet block injections. I have exhausted every option possible. I had the thoracic facet block injections almost two weeks ago and I do believe it is time for surgery to be seriously considered. I would like to have a thoracic discogram to confirm the pain is coming from the discs itself, but I was told by the doctor it was to risky.They wanted me to have the facet block injections first, and now its time for the discogram. I have already had a cervical discogram and that showed I had a cervical herniation opposed to a bulging disc. Im assuming surgery will be the next step. Are there any new minimally invasive surgeries available? Any suggestions will be greatly appreciated.

[J T Junig, MD PhD]

As far as minimally invasive surgeries, it will depend on how many levels are involved, the degree of stenosis, and other anatomical factors.  If you have a single area of nerve compression you may be able to have a small discectomy; if you have several areas of compression and multiple levels involved you might need a fusion including hardward insertion.  

I am a little concerned when I hear a doctor say what your doctor said-- I worry that the doctor is pulling a fast one-- why WOULD he see something that everyone else didn't see?  I'm playing a bit of 'devil's advocate', so don't take me too seriously.

I don't know if there is the equivalent of a 'lumbar microdiscectomy' at the cervical spine.  I can tell you, though, that different surgeons leave drastically different scars for this type of work.  At my old hospital, the neurosurgeon made a one-inch long incision and had one cc of blood loss; the orthopedist doing the same surgery used an incision about a foot long and lost a liter of blood!  OK, so I am exaggerating just a little... but for spine surgery you really need to do your homework.  Get opinions from other patients if you know of any-- ask about his bedside manner, his post-op care, and most importantly, how does he handle the cases that don't work out perfectly?  Does he keep seeing the patient and try to find an answer... or does he stop returning calls and pretend they aren't there?

I'm not sure what else I have to suggest on this one.  Good luck!