Herniated cervical disc

[Shipp]

I am a 53 year old male. I have left cervical radiculopathy. My family doctor noted absent reflex in the left arm and ordered an MRI. She prescribed Lodine and I have seen a Chiropractor for spinal manipulation with no relief.
MRI CONCLUSION:
1. Left foraminal HNP C4-5
2. Right C3-4 bony spur
3.Mild degenerative disc disease C5-6
I am considering a percutaneous micro-decompression cervical discectomy with laser thermodiskoplasty. Do you have an opinion of the efficacy of this procedure? My symptoms seem to be coming from the herniation at C4-5.

[Frank]

HERNIATED CERVICAL DISC:  My MRI Conclusion:C6-C7 broad Herniated Nucleus Propulsis; C5-C6 retrolisthesis*** and suspected cord gliosis from myelomalacia; multilevel spondylosis and uncinate process degenerative change; multilevel mixed spondylotic and soft disc disease--as described in the "body" of the MRI as follows: (***Grade 1 only retro.)At C6-C7, broad H N P superimposed on spondylotic change causes cord flattening and moderate central stenosis, bilateral uncinate process causes high grade neural foramen encroachment and mass effect on the exiting bilateral C8 nerve root complexes; At C5-C6 bilateral uncinate process spurring causes high-grade neural foramen encroachment and effacement of the C7 nerve root complexes bilaterally;anterior spurs, most markedly at C5-C6 and C6-C7.The high level chronic pain radiates across my left shoulder,down the left arm to the end of the left index finger, with numbness on the underside of that finger and mildly to a small part of the left thumb.

I am a surviver of three surgeries at my L4-L5, L5-S1 only AFTER ALL of the various modalities of rehab therapies offered at "world class" Pain Clinics did not solve the low back  problem.
Surgery,  then, for my L-spine and is now a "last resort" for my C-spine, BUT this begs a question.

I was told a chiropractic physian in my community had a very similar C-spine problem like mine described above. He tolerated the pain for an extended period of time, the amount of time not known by me.They tell me HE WAITED TOO LONG until he had to have "plates" put in his neck. By waiting, his muscles shrunk so significantly that he lost the strength and use of his left arm and hand. I have been told that I have lost 10% to 15% of my strength in my left arm/hand with only a slight measurement difference of left arm/right arm. My relentless acute pain episode started in July 1999 and continues to date, without a break.

(AT LAST) MY QUESTION IS: What is the "range" of time one can use medicines, epidural shots and non-invasive therapies and still feel comfortable that the risk of "loss of use" or atrophy is in the low risk probability range?

Perhaps with your answer you could refer me to further specific information related to my problem or to a location that I can research. Please accept my sincere appreciation of your expected reply.

[CCF Neuro[P] MD, RPS]

Dear Warren:

Without seeing the films and doing the neurological exam it is impossible to tell you.  If you have read some of the postings you would know that surgery is the last resort, and many times things are better and many times they do not change.  Alot depends on the surgeon, the lesion, the patient's adherence to rehab, and ....  

CCF Neuro MD

[david]

I am a 32 year old male with mild HNP C4-C5 and moderate HNP C5-C6 (per MRI).  I was extremely active until approx. a year and a half ago when pain associated with running and jumping has forced me to slow down tremendously. Moderate to heavy exercise and job related stress trigger extended periods of pain and discomfort. I am trying to avoid meds although they have been prescribed. I am also hoping that the next 5 years will bring about surgical advances that will make surgery less of a crapshoot.  Are there any surgical procedures on the horizon that you can tell me about that might offer pain relief with less muss and fuss? Something less invasive and more effective?
    I would appreciate any help you can give?  If you can refer me to any med. journals that would be a great help also.

[CCF Neuro[P] MD, RPS]

thanks for the comment.

CCF Neuro MD

[Jo-ANN]

Dear Nancy,

I know the pain sometimes is unbearable..( i too have multiple
herniations (cervical) arthritis, bone spurs etc-one surgery
under belt) but pain medication seems to actually make the pain
worse-it's true!  I take hydro-codiene a couple times a day for
a month or two and then get right back off it again because of
constapation problems, addiction and it doesn't solve the problem.  Get off the medicine gradually and use it only when
REALLY needed.  What helps me just as good is the over the counter NYQuil type medicine for nights that  pain kept me up-
but don't overuse that either.  Most of all remember that your
pain can be put  to good use-offer your pain up for the conversion of sinners-unite it with Jesus's on the cross.
Thank you med help for all your help and may God bless you this
holy season.  

jo-ann (***@****)

[CCF Neuro[P] MD, RPS]

Dear Nancy:

I would see a pain specialist.  Viocodin is addictive and is likely the source of your bowel and bladder problems.  Micro surgery is a toss up and it depends on the surgeon and the lesion they are operating on.  I would also see your neurologist and see if there are rehab specialists in your area to help you manage your problem.

Sincerely,

CCF Neuro MD