Disc Rupture - Micro Diskectomy

[brian]

Hi,

I'm 32 and I have recently had a cervical disk herniation and rupture (C6/C7 Posterior/Lateral).  I have some lack of motor control/strength in the tricep as well as numbness in the right thumb, forefinger, and middle finger.  An additional complication is pronounced congenital spinal stenosis in the cervical region.

MRI show that the rupture has placed pressure on the nerve trunk between C6/C7 which is consistent with the neurological symptoms.  Additional symptoms include a sporadic weakness in the legs.

I have been considering surgery to have the material from the rupture removed. (micro diskectomy)  Success rates have been reported between 75-85%.  However, I have seen little discussion of recovery time for these patients and less discussion of the symptoms of the remaining 25-15% of the population.

What is the recovery time for numbness and muscular control/strength?  The duration between rupture and potential surgery will be two to three weeks.  What is the possibility that the motor nerves have been sufficiently damaged that they will need to regrow from the nerve trunk to the tricep area?  Is it likely that sensation and motor control will be restored within days/weeks/months/years?

What are the possible negative aspects to the operation?  All surgical procedures carry inherent risk.  However, what is the risk of further nerve damage by carrying out this procedure?

Age factors and the congenital spinal stenosis suggest that future herniations in the cervical region are possible.  In addition, the micro diskectomy suggests the potential for premature arthritic conditions at the C6/C7 joint.  Given a positive surgical outcome and these factors, what is the possibility of rupture in the remaining cervical discs?  How common are multiple ruptures in a single patient over a lifetime?

[CCF Neuro[P] MD, RPS]

Dear Brian:

As a rule, surgery is the last resort.  The outcomes, although seemingly good are really variable and very, very surgeon dependent.  Outcomes vary and what is sometimes considered a success is in fact something the patient would not consider a success.  Stability of the spine without further degeneration can be considered a success even if the pain and disability are not changed.  So, go into surgery with your eyes open and with the best surgeon money can buy.  The best outcomes are usually with those people who work hardest at rehab and have a good rehab team to work with.  The PT/OT make a big difference in outcome.  There is really not good predictive way to tell you about motor and sensory function.  This is especially true when I do not have the EMG studies, done the physical exam, seen the MRIs etc.  Sorry to be so vague. Multiple ruptures depend on the etiology of the initial rupture.  If your a pro football linebacker than the chances are way up.  If you are a pro typist, the chances depend on your related diseases (osteoarthritis, obesity, etc).  So, again it is not possible to tell you.  What might be best is to sit down with your neurosurgeon and neurologist who know you best and have this discussion.

Sincerely,

CCF Neuro MD

[Deborah Brown]

Hi Brian,

I have been diagnosed with the identical problem only mine herniated to the left side.  I understand exactly how you feel and wheteher to have surgery or not.  I was diagnosed in June and have dealt with the pain but now want to cover all my bases before agreeing to surgery.  I have found limited information in regards to the unsuccessful operation.  I do know and have corresponded with other people in regards to the possibility of rupture in the remaining cervical discs and the probability seems high and very common. My left hand and arm have weakness and severe numbness.  Please feel free to e-mail me and we can share findings. Deborah.***@**** Our diagnosis is almost identical and I'm also trying to identify all the risks involved with the surgery before agreeing to have it done.  It is possible that the disc will receed and relieve pressure but how long will that take.  I already feel like a very enjoyable part of my life has been taken away.  I'm only 30 and still want to have children but only if I can hold and play with them.  Anyway feel free to e-mail we are in search of the same answers.

[a fellow disc sufferer]

Brian,

Sorry to hear about your situation.  I had a microdiskectomy in 1995 on L5-S1.  My S1 nerve root was totally decompressed and the majority of my symptoms were nerve related.  I am almost four years post surgical and still have symptoms that include numbness and leg pain, due primarily to a loss of stability from the removal of a very large herniated piece of that disc.  Short of fusion, there is not much to do about it other than wait until my symptoms either improve or become debilitating.  I am close to your age (was 32 at time of initial problem)  Though not excruciating or significantly limiting, it is fairly chronic and anywhere from annoying to painful.  The cervical discs are different in many ways so I'm not sure of the comparison.  The initial recovery fromt he surgery was quick, up and feeling good within a couple months.  The significant improvement in symptoms came within a year to 18 months, although off and on it still plagues me.  With your outlook for continued problems, I am curious why they are recommending microdiskectomy over fusion, particularly in the cervical region.  Good luck with your situation.

[CCF Neuro[P] MD, RPS]

Dear Deborah:

Thanks for the comments.

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Thanks for the comments.

CCF Neuro MD

[Susan Logue]

Dear Brian,
I was diagnosed with a rupture at C5-6 with bulging and spurring above and below it 2 1/2 years ago, and had alot of the same symptoms you're having. I had anterior cervical fusion surgery. The numbness, pain, and virtually all of the arm and shoulder symptoms were gone the minute I woke up from surgery. As soon as the pressure was off the nerve in the spine, those problems went away, never to return. I must tell you, I also had carpel tunnel release during the same operation (the surgeons just took turns), so I can't be sure which one fixed that part. Unfortunately, the debilitating neck, trapezius, and mid-back muscle spasms never went away. I continue to be unable to work or do a whole lot of anything else, I can't even stand to ride in the car. In addition, since the discs above and below the fusion were already in bad shape, fusing that one puts alot more stress on the other discs and they are deteriorating rapidly. As far as actual surgical recovery, a couple of months is all. I would get a couple of opinions from the best surgeons money can buy. The only thing I'm pretty sure of, is that they won't operate on you just because they can, they do what's best for you're overall situation. Good luck! Susan

[CCF Neuro[P] MD, RPS]

Thanks for your comments.

CCF Neuro MD

[Bill Mullins]

I had severe pain and "pins and needles" feeling in my left arm and hand for months.  It got steadily worse.  My family Dr. tried musle relaxants and anti-inflammitory meds but nothing helped and things were going downhill rapidly.  My Dr. ordered an MRI and it showed the disks at C5-6 and C6-7 ruptured with the 6-7 disk significantly impacting my spinal cord.  The MRI showed the spinal fluid at 6-7 was shaped like a letter "C" instead of a donut.  Additionally the left neural foramen at 6-7 was drastically reduced in size.  I had anterior disectomy and fusion of C5,6,and 7 and was symptom free when I woke up in recovery.  There was a minute amount of numbness/tingling in my left thumb and forefinger due to swelling where the neurosurgeon worked on the foramen but that was gone in less than 3 weeks.  I am 4 weeks post op and feel better than I have in years.  I had almost stopped sleeping on pilows due to numbness in my hands.  

Don't rush into surgery but don't be afraid of it either.  Get someone you trust to recommend a good neurosurgeon or orthopod specializing in spinal work and check it out.  I was scared spitless of somebody approaching my spinal cord with anything sharp but I'm glad I did now.  The trick is to find someone well recommended and whom you can trust.  I trust my family Dr. and he sent me to the man he'd want to work on his kids if one of them needed it.

[CCF Neuro[P] MD, RPS]

thanks for your comments.

CCF Neuro MD

[Tony Evangelous]

i am have micro surgeryon C6 c7 on Dec 27th.  I am really terrified of the surgery.  The one qwuestion that i have is not with the surgery.  Do they have to put a catheda in my penis.  I think this is worrying me more that the surgery!!!!

[CCF Neuro[P] MD, RPS]

Dear Tony Evangelous:

Yes they do.  However, you will not notice as you will be asleep from anesthesia.

Sincerely,

CCF Neuro MD

[Liz]

This site is very helpful to me, because it is concentrating on the exact area of my problems as well.  I'm 35 years old and was just diagnosed with a C6 C7 ruptured disk.  Apparently,  fragments of it are there, and it's basically trashed.  It's also messed up in a way that's throwing my spine off.  The pain I have is excruciating from time to time, but is basically a dull ache for the most part.  I have had some numbness and pain in my arm, but it's all been somewhat manageable.  The neurosurgeon says I need surgery (anterior diskectomy).  I'm TERRIFIED of surgery.  I'm also terrified of doing something (avoiding surgery) that's going to endanger my spinal cord or my health down the road.  I love sports and lead and active life and feel like this is so early for this to be happening..ugh.  
     The more I can read, the more informed I will be.  Thank you for your comments and if you have any  more advice or experience it would be helpful.  
Liz

[CCF Neuro[P] MD, RPS]

Dear Liz:

Sorry to hear about your disc problems.  Surgery is usually the last resort and the outcome for surgery not due to mechanical induced pain is a **** shoot.  I would seek a second opinion and see if surgery is the only possibility.  If you disc is as bas as you describe then the surgeon may be correct.  

Sincerely,

CCF Neuro MD

[KELLI SUTHERLAND]

HELLO ,IM 31 AND ON THE 11TH WILL UNDER GO MICRODISKECTOMY W/FUSION ON C4/5 AND C5/6.HAVE HAD ARM AND HAND PAIN FOR THE LAST 15 MONTHS.FINALLY AFTER A CT THEY FOUND THE TWO DISKS.HOPE THIS TAKES AWAY THE PAIN AND WEAKNESS I'VE HAD TO DEAL WITH FOR ALL THIS TIME.I WILL UPDATE THIS MESSAGE AFTER SURGERY.                      KELLI SUTHERLAND

[Mark Ponciano]

My mother has a deteriorating disc in her back that really hurts her very much.  If you any information on disc problems or doctors around the U.S. that can help.  Please e-mail me at ***@****.

Thank you,
Mark

[dave barton]

hi!
im post op 4 weeks now L4/5 lower lumbar diskectomy i only wish
i had read all the information on the internet before i had the op. So far i am still in a lot of pain and ihate to say it but it's getting worse by the day. The surgeon said it may not be the way forward but was quick enough to book me in.it's not too bad over the pond in U.K.the N.H.S. although heavily crittisised do give you the quickest responce possible,and though i wish everyone waiting for an op my very best wishes for a speedy recovery,don't go into it with your eyes shut.If i had known the
outcome i would never have had it done.
    yours sincerely
           Dave Barton

[dave barton]

hi!
im post op 4 weeks now L4/5 lower lumbar diskectomy i only wish
i had read all the information on the internet before i had the op. So far i am still in a lot of pain and ihate to say it but it's getting worse by the day. The surgeon said it may not be the way forward but was quick enough to book me in.it's not too bad over the pond in U.K.the N.H.S. although heavily crittisised do give you the quickest responce possible,and though i wish everyone waiting for an op my very best wishes for a speedy recovery,don't go into it with your eyes shut.If i had known the
outcome i would never have had it done.
    yours sincerely
           Dave Barton

[krishan398]

A related discussion, Rupture of C4, C5, C6 spine discs was started.