Multiple problems on MRI of cervical spine

[Darci329]

I had an MRI scan done several weeks ago and was referred to a Neurosurgeon.  He basically told me that I was at high risk of quadraplegia if I were to fall or be involved in a motor vehicle accident, however, because I would need a such a "large fusion procedure" - a cervical fusion from C3-C7 with decompression, he recommended physical therapy and referral to a pain clinic.  Findings on the MRI were multilevel cervical spondylosis with loss of normal lordosis at the lower levels and minimal kyphosis at C3-4.  Multiple levels of disc protrusions/herniations.  At C3-4 there is a central disc protrusion that effaces the spinal cord at this level.  At C4-5 there is a disc protrusion that effaces the dural sac at this level.  At C5-6 there is a broad-based left paracentral disc herniation causing contact with the spinal cord and severe neuroforaminal stenosis on the left.  At C6-7 there is a central disc protrusion that effaces the dural sac and contacts the spinal cord.  Due to spondylotic degeneration, as well as the disc herniations, there is severe spinal stenosis from C3 through  the superior end of C7.  There were no intraparenchymal signal cord changes noted.  There was an incidentally-discovered hemangioma eccentric to the right at T1.  When the neurosurgeon walked into the exam room the first thing he asked was how old I saw.  When I told him 44, he said "Well, you have the spine of a 80 year-old."  I left his office that day completely confused and scared to even move.  Does anyone have any suggestions regarding what I should do next - seek a second opinion perhaps?  While physical therapy and pain clinic referral may help control the pain, which was my main concern when I went for the consultation, my main concern now is the possibility of paralysis from a spinal cord injury due to the MRI findings.  Although I am having a lot of neck pain that radiates down into the scapula, as well as some numbness in my left hand, my main question is what I should next to ease my fears over this whole thing.  I felt that the neurosurgeon was completely insensitive and didn't address any of my concerns.  I'm 44 years old and have three children, ages 10, 9, and 5, and I'm scared to do normal daily activities because of what I was told.  Any suggestions would be greatly appreciated.  I've was also recently diagnosed with osteopenia and am worried that this will result in more degeneration of my spine.

[bev62]

I agree, I wouldn't have the surgery until you just can't take the pain anymore.  I had a cervical fusion C5-C7 two years ago. At the time of surgery I wasn't in very much pain, but like you the doctor sort of scared me into it. After the surgery I was in much more pain than before and it has only gotten worse. I haven't been able to sleep in a bed since before the surgery, so when I am able to sleep it's in a recliner. I have not been able to return to work nor will I ever be able to.  My problems were the result of an injury I received at work.  I am in pain management, but it really don't help much. I'm on Duragesic patches and oxycotin. They just did another MRI, because I'm having pain in the other arm and hand now.  They said that the disk above and below the fusion are now herniated and will require another fusion. This was caused by the first fusion. Will it ever end, the fusion only puts more preasure on the disk above and below it.
I also have two young children, ages 8 and 5.  Sometimes I just wonder how long I could have waited before I really had to have the surgery. So now I'm waiting to get approved for social security disability, if I ever do.  Mikey I know exactly what you mean.  I have an excellent attorney working on it so hopefully it will be soon.
Darci I would by all means get another opinion, I wish I had gotten three or four. Good luck and keep us posted.

[Mikey626]

I agree with midasrex. Unless you absolutely cannot stand the pain any more, or have some chord compression, I'd hang out on the pain meds. I had a fusion of C5-C7 (Removed 5-6) about a year ago and the problems are re-curring. I have numbness in the hands and arms again and can't move my neck like I use to. I also have numerous levels of DDD with IDD (internal disc disruption). The discs annulus fibrus is torn at multiple levels in the thoracic regions (T3 - T11) and my whole Lumbar/Sciatic regions of the spine are almost bone to bone with pressure on all nerves. The doc says I am not even a surgical candidate and am on minimal pain killers (15 mg oxicodone, 150 mg Lyrica, 6 mg, Zanaflex, 7.5 mg Mobic). It helps very little, but at least I get by. I am going for a second opinion with another doctor who specializes in the spine just to make sure the meds can't or shouldn't be upgraded.

I barely make it too work everyday as I can't sit for more than 15 minutes before I get numb from the buttocks down to me feet, and I can hardly walk any more. I use a cane to stabilize myself, but have fallen a few times if there is nothing close by to grab on to. And to think that I don't qualify for Disability is just @#!!!!!'d up. Sorry about the last sentence, but it just makes me sick that some people can get on disability for a simple single disc problem and I can't get on and still have to try to earn a living in my condition.

Hang in there though as things only get worse as you get older. Technology is getting better, so In a few years (I know it sounds like a long time) they may be able to fix us all.

Mikey626

[midasrex]

Hi,
You obviously feel very upset now, and evidently the news you heard was unexpected and for that reason it's reasonable to feel annoyed overall with your doctor. But that said, all the advice you have been given sounds very reasonable. If you have got severe stenosis at the age of 44 then you are almost certainly going to need an operation at some point, it's really just a question of when. If you have neck pain only and absolutely no symptoms of spinal cord compression, like numb clumsy hands, balance problems, stiff legs in the morning and so on, then it might be reasonable to sit it out with painkillers if needed and maybe physiotherapy (although that won't make much difference). But your doctor is right to counsel you about the risks of a major problem in the event of a severe flexion/extension injury like a bad fall or a car crash, and that is one argument for surgery sooner rather than later. I would probably leave the surgery until you have symptoms of some sort, especially if you don't have any signal change in the cord on your MRI, but you should be aware of the risks of an accident. And if one of your hands is numb - especially if it's a bit weak - then you should seriously think about having it done.
The issue about fusion is different and unless you have evidence of instability or forward deformity (kyphosis) of the area being operated on then fusion is probably not indicated. If there's doubt then flexion/extension xrays should be done before the surgery to establish the need for fusion.

Good luck.