c4 c5 disk extrusion

[pettry]

Had a Mri done, showed several problems on being c4 c5 disk extrusion with spinal cord flattening.  Went to neurosurgeon, he said I need surgy asap.  disk fusion in fron of neck.  Going for second opion next week.  Need to know if I can get worst if I don't have the surgey?  Pain can be very painful at time in shoulder blad area and down left arm with numbness.  Also, I have had lots of headaches and some dizzness, can this be from the the Disk or not?

[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.
   Yes, your symptoms can get worse if you do not have the surgery.  When a patient has symptoms of pain and numbness down the arm and a disc flattening the spinal cord, then most people will consider surgery.  Developing loss of bladder or bowel function would indicate progression of your disease, and would require immediate attention.  An EMG of the upper extremity could assure the surgeon that your arm symptoms are related to the cord/nerve compression and not something else (if the symptoms are not related to your spine, you will not get better with surgery).  Another test that can be helpful is a SSEP somatosensory evoked potential.  Headaches and dizziness can also be related to the neck (cervicogenic migraines) and may be helped by the surgery, although more common causes of headaches/ dizziness should also be investigated with an MRI of the brain.
I hope this has been helpful

[Linda09]

I have a herniated disk at c4&c5 but mine isn't as bad as yours. Mine is pushing on the spinal cord a little and I have headaches and dizziness. I also have numbness in my hands and head. Hope you are feeling better soon.

[caregiver222]

You know you run the risks of paralysis if the recommendations are not followed. How probable is this event? It is impossible for me to say. You do need a second professional opinion, and perhaps a third. For the record, such a procedure was recommended to me decades ago, and I elected not to have the operation, and my right arm and hand became temporarily paralyzed. I was scared out of my mind, but found another physician who prescribed alternative therapy, which was successful. You may have more damage than I had, and I would not want to push you into a decision one way or the other. I do suggest very strongly you get a second opinion from a physician and institution unaffiliated with the one providing your care.

[Joface]

Well....I have a bit of experience with this....I just had cervical spine surgery at levels C3 through C7 to relieve spinal compression caused by a calcified posterior longitudinal ligament taking up all the space in my spinal canal.  In my case, the surgeon I finally decided on did a posterior (back of the neck) laminoplasty (did not remove the lamina...just opened it up on one side and pulled it back like an open door, securing it with titanium disks. That gives relief to the compression and allows the nerves to "float" within the canal, taking away the numbness.)  I had FOUR surgical opinions before I made a decision to have the procedure I did...and I'm glad I did as much research as I did before the surgery.  I even went to the Mayo Clinic (I live fairly close).  I decided against any anterior surgery - first of all, it is more risky, because they have to operate near your vocal chords and it may cause future problems with swallowing, etc. I didn't want a "fusion" because it compromises the disk above where the fusion is and below where it is, making them primary candidates for further problems. I went with the procedure that would accomplish a decompression, but would be safer than other suggested procedures. If it works, so much the better.....but I wanted to at least try it before going to an anterior procedure.  One thing I will say....every neurosurgeon will think his or her procedure is the best.....because that is the one they perform more often.  You have to do what you feel is the best for you.  

Just like you, I got the "must have surgery right away or you will be in a wheelchair" talk.....I have to admit that I quickly became a much safer driver, not wanting to get rear-ended by another car until I had surgery......but I did take a month or two to decide what I wanted to do - and that worked out fine for me.  Your problem sounds fairly severe, with the disk resting on or close to the spinal canal. My only suggestion is to get two or even three opinions before committing (your health insurance will generally approve of that, but check with them first to be sure they'll be covered).  Also...try to see if a posterior entry could accomplish what needs to be done, instead of the more risky anterior surgery.

[pettry]

Thanks Joface,  I did go for 2 opion today, he want to the other approach like you did.  This procedure he said is less invasive and not as much time to heal or even in hosp.

Thanks

[fenceguy]

I am currently dealing with severe stenosis in c4 and c5 with moderate in c6 and c7.  As well as a heretitary degregration of the disks (4 and 5 and leaning to my left side and sporadically pinching a nerve.  I have gone through two 'neck stretching' devices, muscle relaxants, a series of three steroid injecions into my spine (the longest period of relief was 4 weeks) which I cannot repeat for another 8 months.  I suffer from frequent (4-5 mornings a week) headaches, which if un-treated (with Excedrine Migrane) lead to migranes and Imitrex.  I have had various perscriptions of pain medication with medium to sufficient relief but hate 'living on pain med'.

I have been told to by Neurosurgeon's (Seattle and Tampa) that surgery to relieve the pressure on my spine (have accelerated and increasing reflexus in my legs) due to the pressure.  Other than headaches, limited motion of my head without pain, the tinkling and numbnus down my left arm if I tilt my head to the left and the reflexes... I'm fine.

I have been told that if I have c4 and c5 (the worst) fused, I will accelerate the degredation of c6 and c7, but no one can estimate the timeframe.  I'm also told that there is no assurance of relief from the pain.  Plus the results of the anterior surgery.

My question is... is - or has - anyone been in this particular situation, and if so, what choices were made with what results?  I am seriously considering getting a third opinion from an Orthopedic Surgeon that specialized in neck surgery.  Any comments.

I am extremely anxious to hear from the population out there.

[bev62]

I went through a two level cervical fusion 8 weeks ago.  My pain has been 10 times worse since my surgery than it was before.  Prior to surgery I had pain in my right arm and my right hand was numb and I had some neck pain. Now both hands are numb, I have pain in both arms, my neck and between my shoulder blades burn like fire.  I have hardly any strength in my hands and it's like I have no control of my ring finger or my pinky on either hand. I have very limited movement of my neck, I can't even drive yet for fear of not being able to turn my head to look for other cars. The doctor did another MRI and he said everything looks wonderful.  It sure don't feel wonderful.  I still have a hard time swallowing. If I lay flat in the bed, even with enough pillows to elevate me, both hands are so numb I can't sleep, so I have been sleeping on the sofa since my surgery.  The doctor put me on nurautin and PT about 3 weeks ago, and I have not yet had any relief.  I take muscle relaxers and Percicet 7.5 every 4 to 6 hours.  Maybe I'm not giving it enough time but I really thought after having surgery I would have had less pain not more.  Im just ready to get on with my life, I have a six year old son and a three year old daughter and I can't even tie thier shoes or turn the pages in a book for them. I don't mean to sound so discouraging but I wish I had never done this.

[torinoguy]

A related discussion, Disk Decompression was started.