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Stenosis c4-c5, c5-c6, c6-c7

I have had 2 consults for chronic neck and back pain that has progressed to weakness and numbness in the upper extremities, and borderline incontinence. One surgeon wants to go in anteriorally, in a single level procedure, and remove a disc to get at bone spurs resulting in a fusion. He did not seem impressed with the foramin narrowing in adjacent vertibrae. The second surgeon wants to go in posteriorly and preform a decompressive laminectomy and foramanotomy of c4-c5,c5-c6,c6-c7. While the benefits of not having a fusion is obvious, and the second surgeons' willingness to take care of all the issues in the cervical area at one time is appealing, I have to question the wildly different approaches to the problem. I understand, to the extent of not having experienced it, that recovery from the laminectomy / foramanotomy is more painful and prolonged. I would prefer not to try to get a third opinion, as neurosurgeons in my area do not seem to want to give consults if they know you have seen someone else already. I could use some advice on this matter. Any additional information from MRI's to reports can be provided upon request.
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1093617 tn?1279302002
MEDICAL PROFESSIONAL
Thank you for your question. Although without being able to examine you I can not offer you the specific advice on diagnosis and treatment that you need, but I would try to provide you some relevant information about your health concern.

Usually, recovery from a laminectomy procedure takes time (standard is six weeks) and as everyone is different it may vary as well.  Most of the times, one may experience neck and haed pain during the recovery period. However, essentially you should avoid prolonged sitting, lifting heavy objects, bending, twisting and excessive exertion for the first three weeks. It is not like that you restrict all activities but you should gradually increase your physical activities over this period. Additionally, common complication of the procedure is that there is a possibility that another fragment of disc will herniate and may cause similar symptoms. Therefore, endoscopic microdiscectomy is appropriate in some specific situations, and you may check this with your treating neurologist. Hope this helps.

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Avatar universal
I can give you a general answer.  Just like people, docs have different ideas on what they should do to help a patient.  Some want to "go all out" for the touchdown and fix everything.  Others want to go the moderate route and only fix what is absolutely necessary.  You have to decide which kind of person YOU are.  I go to a vet who subscribes to the moderate route, he's relaxed about the dogs and their various and sundry problems, and so are we.  I did go to the other type of vet that wants to make it EXACTLY right, on down the line, to the bitter end, but I had a dying dog and couldn't accept it, so I went to them as a last-ditch effort, to no avail.  So, I still stick with my moderate vet.  I would say this, that the bone spur situation is interesting, and if you go with the all or nothing doc, mention that to him.  Could be the other doc knows something on that issue that he doesn't.  Wish I could give you more details, but maybe another poster can fill you in... you could search our community for similar posts, just put in pertinent words in the rectangle to the right of the blue bar above this thread.
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