Percutaneous Microdecompressive Endoscopic Cervical Discectomy anyone?

[kenbrant]

I was hit by SUV at high speed 7/05...Right sided neck pain, EMG showing rhomboid being affected, MRI small bulge, nerve block done at C5 C6 took away pain temp..unstable spine with chin on chest view with platuea in the vertebrae. Mylogram and CT scan negative some foraminial narrowing.  Pain and numbness intermittanly with  mild weakness to right arm..pain to right thumb sometime to middle finger...numbness off and on that went as hight as forearm right arm and one time on left arm.  Saw neurosurgeon 2 weeks ago and said I needed a spinal fusion single disc with the hardware.  

What is your experience with Percutaneous Microdecompressive Endocscopic Cervical Discectomy with laser application?  I have an appointment with a Dr. John Chiu in Thousand Oaks CA....I believe there are only 5 or 6 surgeons worldwide that perform this.

Can you tell me anything if eventually I will still need an old fashioned fusion??  It scares me to think about it...

Thanks so much for your insight an opinion in this...I actually am from Cleveland, Ohio and miss the winters...not the driving...

Michele
in San Diego

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
    The symptoms and story that you provide are consistent with a radiculopathy (pinched nerve) related to your cervical disc disease and foraminal narrowing.  When the nerve roots exit the spinal column they pass through a narrow space called the neural foramina. These nerve roots can be compressed if the foramina is made smaller by arthritis, trauma, fracture, etc, or if compressed by a disc that is herniated (bulge).  When compression occurs the nerve losses its insulating exterior (myelin) that causes it to dysfunction (often tingling, pain, and some weakness).  In more severe injury/compression there is loss of the actual 'wires' called axon loss lesions, that result in weakness and atrophy.  To prevent more minor injuries from progressing to more major injuries, the compressing force is removed (in a surgical procedure).  The standard surgery is to remove the disc and to fuse two vertebral processes together, which relieves pressure on the nerve, and maintains a stable spine.  A more cutting edge surgery is Percutaneous Microdecompressive Endocscopic Cervical Discectomy with laser application, which involves removing a portion of the disc and shrinking the disc with laser and is done endoscopically (through tubes with cameras etc, instead of an open procedure with a large skin incision).  Endoscopic approaches and minimally invasive surgery are the direction of the future, but currently it seems best for more 'minor problems' involving pain and compression, but does not help to stabilize the spine.  I think that discussing your options with both surgical teams, will allow you to make the best decision for you.
I hope this has been helpful.
PS Cleveland currently has around 16-25 inches of snow on the ground, enjoy the San Diego weather

[simonekahn]

Be very carefull in your decision.
I had one of the best neurosurgeons and still
wound up with loss of use of both my arms for about 4 months.  I had 4 levels done for stenosis and osteoarthritis, but it was the c5/6 nerve that if even bumped can go into shock, or get sick, and cause you problems.  

[mike1105]

i am not a neurosurgeon or even an MD-- just a dentist with my own neck problems and have done alot of research. It is my understanding that clipping off the extruded bulge of the involved disc will not correct instability, although it may relieve pressure on the nerve root. If the disc needs to be removed, and the vertebrae fused, and if only one level (c5/6 as it seems in your case) is in need of cervical intervention, you may want to research artificial discs, which are still experimental in the US-- but there are indeed afew different hardware systems and more than a handful of surgeons using them. As far as I know they are only experiomenting with single levels. I know of a guy here in my hometown who had one placed and is doing vey well. Again, I am not sure, considering the instability, if the surgery you are asking about is indicated for you.........