Severe Neck Problems

[barb122]

For several months I have had trememdous pain and stiffness especially in the back of my neck.  Previous MRI's indicated irregularity of the anterior aspect of the spinal canal extending from the C4-C5 interspace distally.  Protrusion of disc material is identified centrally at the C=5-C-6 levels.  Some irregulatiry on the right causing possible nerve root compromise at the C-4-C-5 level.  , and slight signal intensity involving the inferior endplate of C-6 and the superior endplate of C-7 caused by sclerosis is noted.

I had a neurosurgeon at a major medical center tell me he didn't want to put me through the pain of surgery.  I didn't believe this, but would like your opinion.

On October 27 I had a lumbar fusion, had rods and screws to stabilize the spine and some other repair work.

If I decide to go to a neurosurgeon to have my neck corrected, would it be too soon?  I have noticed a rise in bloodpressure, which is not good either.

Also, I get very nervous spells when my neck starts hurting, which is very frequent and painful.  Probably this might be attributed to an unfortunate fall which I am sure didn't help it one bit.  I have also had 3 different sessions of physical therapy and visits to a chiropractor.  

Any advice?

[Dr Sharma]

Hi there. I understand your predicament and that you are in much pain despite regular sessions at physical therapy due to the upper back pain.  Surgery the option available for you but I wouldn’t advocate the same since you had a recent lower lumbar spine fusion done in October 2010. I suggest that you consult a pain physician who is an anesthesiologist trained in various regional techniques involving nerve blocks etc. if he could help and some respite offered with cervical epidural steroid injections. If this is not possible or of not much help, you need to be considered for surgery. Your previous neurosurgeon Is the best guide and judge in this regard. Take care.

[ggreg]

If the neuro at the major medical ctr is the same one who did your lumbar repair, then listen to his advice.  If he's diff, then go back to the surgeon who fixed your lower back and get his opinion.  In either case, you can get a second opinion from any neurosurgeon OR orthopedic surgeon you want.  And no, it's not too soon to get your neck fixed as relates to your lumbar spine repair, but you will have to be "released" by that lumbar surgeon first.

You report you have had some physical therapy, don't know if that was ordered for your neck or lower back.  But in any case, since you have pain in your neck and the MRI shows some irregularities there, the physician in charge of your spine care should consider moderate treatment until you decide what to do about surgery.  This can include physical therapy for your neck, possibly wearing a neck collar for a while when you're out and about, some effective medication to knock that pain back, like Lyrica and/or an opiate derivative, and perhaps a monthly shot into your neck to block pain, like steroids or some other drug for that.

If that moderate treatment does not improve things for you, then you can revisit the surgery route.  Also, even tho chiropractic assistance helps some people with spine problems, I am concerned that with your somewhat unstable neck situation right now, that it might be better to ask him to refrain from fooling with your cervical spine area...you don't want it moved around in some awkward way that may make it worse.  I am not a doctor, but what I am telling you is pretty standard advice for someone in your situation.  So, ask to get a moderate treatment plan going and you should get a second opinion.  I cannot tell you what to do and this would be all the advice I can give you.