Surgery time-frame??

I am a 25 year old graduate student in psychology.  I've had unexplained pain since Jan 2005, when I returned from South Africa with an unspecified febrile illness, and I've consulted numerous specialists of various sorts since then.

Most recently, I began having sharp, shooting pains intermittently in November 2008.  I had Xrays and then MRI of C-Spine and was referred to a spinal neurosurgeon, whom I saw this week.  Apparently, my C5-C6 disc is greatly degenerated and a large disc osteophyte complex that is deforming my spine.  He said the disc space is collapsed enough that  he couldn't put in an artificial disc, which would normally be preferable in someone my age.  He also told me that they usually would do more conservative treatment due to my age and such, but that I had a positive Hoffmann's sign, which indicated that the spinal cord is compressed.

So far, he said, it doesn't look like I have any permanent damage, but he wanted to do surgery "the sooner the better" -- within the next 1-2 weeks.  This seems rather rushed, especially because my pain and hand/foot numbness/tingling are intermittent.  I've always had an exaggerated knee reflex, but I think this might have also worried the surgeon.

I'm planning to get a second opinion (at least one), before doing anything drastic.

So I have 2 questions:
1.  I was told I'd have to wear a cervical collar for at least 6-8 wks. following surgery.  I have no way of getting to my practicum site if I cannot drive.  So, am I putting myself at serious risk if I wait until the end of April, when my practicum will be over and I will be able to walk or take public transportation to everything I really need to be at?

2.  What would cause such a severe condition in someone who's 25, relatively healthy, etc.?  Especially given that I have had 2 other cervical X-rays since 2005, for which I was never referred to any neurosurgeon or orthopaedic specialist.  It's just so confusing, because I'm young and it happened so fast.

[Nassim Abi Chahine, MD]

Don't be confused your case is too obvious
First of all of course you had a severe accident in the past ! remember
2- x rays has nothing in your case, it just shows bones whereas your case comprise just neural tissues and cartilage (disc)

3- Cervical collar an excellent treatment ! start from now to wear it only at night if you wake up at night with pain or limb numbness.. dont exagerate with wearing a soft collar now for more then the night (and thats when sleeping patient loose his muscular tonicity and subsequent support !) and during rides (travels).

4- dont wait to the end of April, you will be nervous unconciousely untill you do your surgery.

5- the surgery + with 4 weeks rigid collar (or 2 weeks) and 4 weeks soft collar (or 6 weeks) will your final treatment and prevention treatment against catastrophic deterioration of your state.

tell me about all your news lateron
best of  luck
Dr Nassim

[Amygala9]

1) I've never had a severe injury.  Definitely never to my head, neck, or spine.  The only injury I've ever had was a L patellar dislocation several times.  I don't understand your answer.
2) In my case, the Xray was the thing that actually showed the slight cord deformation better than the MRI did.
3) Ordered collar, awaiting arrival.

Thank you for your answer.  I'm not sure I understood the first and second points, but thank you again.

[Nassim Abi Chahine, MD]

ok I understand that you had never any accident or even a fall.
remember the x-ray can only visualize bones but never the spinal cord (even the new generation digital x ray), I also can advice you to do a ynamic views cervical x-rays. it shows the vertebral positioning on Flexion and Extension of your neck
best of luck
Dr Nassim