Neurological Surgeon for Cervical problems

[BabyMine]

I have to see an Neurological Surgeon next thursday and I am a little uneasy. I have been in pain management for 6 years and physical therapy for 2 years. My cervical and thorasic areas are getting worse. My pain Dr. told me that with the RFA injections that he is doing is only a bandaid and that I need to look at surgery. I don't want surgery but I don't want it to get worse. Does anybody know somebody who has had surgery or any information?

[vludmilla]

My father just had cervical spine surgery on the right side several weeks ago. He had nearly completely degenerated vertebrae and if he did not have the surgery, the doctor said he would likely become paralyzed on one side of his body in the next few years. That made my father want to have the surgery and so far he has been very happy with it. He can't work for 6-8 weeks and he has to wear a neck brace but the pain and symptoms he had been experiencing are now completely gone. He stopped taking pain medicine a few days after the surgery. I think he thinks it was very much worth it. I don't know if I can answer your questions, but please feel free to ask or PM.

[AnnieW625]

I work in workers comp and honestly have seen people get really screwed up after surgery. Pain management for six years also scares me, and I honestly think that it's pain management doctors who push the surgery to keep you as a patient longer. Yeah sure drugs are going to help conceal the pain, but they also cause underlying problems like addiction. I don't know much about RFAs, but we let people have ESI (epidural steriod injections) and they are just a band aid. Surgery should be your absolute last resort esp. with two young children, and even then if it were me I'd find something else to do instead. Can you ditch pain management all together? See how you'd handle things without drugs (if they are big part of your pain mgmt. treatment)? Good luck and just be as honest with the neuro surgeon as you can be. If you are in California feel free to PM me.

[elephantmeg]

get many, many, many references. let me say that again. Check references. Check their record on line with your state. Check for any lawsuits. They can be really good and really bad. You want someone who does lots and lots, that is their specialty and has good results. What procedure exactly are you looking at?

[brittone2]

get many, many, many references. let me say that again. Check references. Check their record on line with your state. Check for any lawsuits. They can be really good and really bad. You want someone who does lots and lots, that is their specialty and has good results.

:yeahthat:

Also since you have a relationship with a PT already, talk with them about surgeons in your area. They may gently steer you toward some they've seen with better patient outcomes. Talk to anyone you can really in healthcare and ask around. And then ask some more. Talk to other PTs if you can do so. Definitely, definitely, definitely get more than one opinion.

[MontrealMum]

Based on my mom's outcome, I would only consider surgery as a last resort. And also get many recs as pp mentioned, and really listen when the surgeon talks about possible outcomes.

My mom had a different issue than you do, but did have cervical surgery about 5 years ago now. In addition to fusing several vertebrae, they also inserted a metal plate behind her larynx. She cannnot turn her head much anymore (don't even get me started on how this affects her driving!) and she can't sing as the insertion of the plate affected her voice and she's never gotten it back enough to sing. Which for her is a big deal as she's been in professional choirs her whole life. In her situation, I don't think she had much of a choice about having the surgery (she was in a lot of pain and dropping things), but it's not something she's been happy about. She's also much older than you, which I'm sure affects outcomes/recovery as well.

[Melbel]

I have BTDT but with the lower spine (L5/S1). Not trying to be critical of a PP, but I do not think it is fair to expect someone who is in chronic pain to simply ditch pain management. It is not easy being in pain day after day, year after year. That being said, I have refused to take narcotics because I do not want to risk addiction or impair my driving. So long as I can get a reasonable amount of sleep, I manage to tolerate pain with Lidoderm patches and OTC pain medications.

Definitely work to find the best surgeon possible (i.e. the surgeon that doctors and lawyers use). Also, do not hesitate to get second or third opinions. I found it helpful to get at least one opinion from a salaried surgeon (i.e. at an educational facility) where there is no fiscal motivation to recommend surgery. In addition, I would explore using minimally invasive techniques (less scar tissue to cause other problems and shorter recovery time). Considering your history, I think it would be prudent to explore surgical options, but to only have surgery as a last resort.

Good luck and please keep us posted. :hug5:

[BabyMine]

Thank-you all for the replies. It took me a long time to find this pain Dr because of the research and consultaions with other pain Drs. I have been with him for 4 years. I had a previous consultation with another pain Dr. and he wanted me to have a pain pump or use methadone. The Dr. I had prior to my current one kept trying to push narcotics down my throat even though he knows I am extremely sensitive to them. I do take a pain patch and a bucal pain med but they are children's doses becasue of the side effects I get. I do wean every once in a while or take less becasue I am scared to be addicted. I went to PT about 5 years ago and tried it for as long as I could. I tried out a couple of PTs. The only things is that my back and neck are very sensitive to be touched. I also have arthritis and sacrioilitis.

I am definately going to check this Dr. out. I did pull his record to find any violations and where he has worked and what he has written. I haven't found anything bad about him. He has been practicing for 19 years. I did check out an Ortho surgeon a year ago and he told me my neck and back were normal for a 32 year old. When I got back my report he had all of my hx wrong. I took the MRIs/Xrays to 2 Rheums and 2 Pain Drs. and they showed me what was wrong and couldn't believe what he said. That Ortho is even the Ortho for one of our well known sports team.

The thing that is scarring me is that for the past couple of week I have been getting tingling of my hands and feet. Not all at once. Just the hands then the feet. I had my heart checked out and that is fine.

I will not know until late Thursday but I am putting all of my questions together. Thank-you again for all the feedback. I hope you wouldn't mind if I posted after Thursday to get more advice. You all are wonderful.

[jerigirl]

You can also ask to the surgeon talk to some of his other patients that have had the same surgery you are considering. My MIL did this for her back surgery.

I would definitely get second and third opinions and talk to everybody you can.

The tingling hands and feet could be pinched nerves. I would get that checked. Especially if that is a new symptom for you. Long term damage can be done.

[AngelaS]

Have you considered chiropractic care? I'd try that route before surgery.

[BabyMine]

Have you considered chiropractic care? I'd try that route before surgery.

Thank-you for the advice. Unfortunately, I tried a chiropractor and a massage therapist for 1.5 years and it didn't do anything. I also tried the Tens unit and accupucture without any success. I made sure I tried what I knew was out there in hopes that I could find something that would work, would be without using meds, and didn't require surgery.

[MontrealMum]

The thing that is scarring me is that for the past couple of week I have been getting tingling of my hands and feet. Not all at once. Just the hands then the feet. I had my heart checked out and that is fine.



This is actually what led to my mom's surgeries. The cervical one was preceded by another lower down, which did not require fusing or a plate. Obviously I have no idea what's causing it in you, but for her it was the cushioning between the vertebrae having worn away, causing pinched nerves. Numb hands and feet were followed by numb arms and legs, and eventually dropping things unexpectedly. It's a family thing. Her cousin and brother had the same problem.

I'm not saying don't have the surgery at all, but just go into it well armed with information. I think the reason my mom is so bitter about this 2nd one (the first she's totally happy with) is that she did not do a lot of research, and probably didn't listen too well about the "possible" outcomes - which in her case actually happened the 2nd time.

Good luck to you! It's horrible to be in pain, and I can't imagine having dealt with it for so long. :hug:

[vludmilla]

This is actually what led to my mom's surgeries. The cervical one was preceded by another lower down, which did not require fusing or a plate. Obviously I have no idea what's causing it in you, but for her it was the cushioning between the vertebrae having worn away, causing pinched nerves. Numb hands and feet were followed by numb arms and legs, and eventually dropping things unexpectedly.


:hug:

This was the case for my dad too. His neurological symptoms included tingling in his feet and legs and it was not pinched nerves but the degenerated vertebrae. Not to scare you but this is what the doctors said was dangerous for my dad and necessitated the surgery. Please get that checked out very soon.

[randomkid]

I'm a PT and work on the Neurosurgical Unit in my hospital. I have seen people have tremendous success with cervical surgery. I just had a 78yo patient on Thursday who was one day post op, had no pain and was no longer taking pain meds. That is a little unusual as most do have surgical pain, but for many their pain that they had before surgery is significantly less or gone altogether. Many of my patients are up walking around and go home the day after surgery. I have seen a few that do not get great results right away, but those are usually the patients who had severe problems for a long time. I'm not sure what happens with them down the road. They might get better, I don't know.

It seems you have tried all conservative measures and surgery just might be the next step for you. Definitely research the surgeon and look into more than one. As Beth said, talk to any PTs you know. They will definitely have opinions on which surgeons have the best results. However, they will not likely come right out and tell you or say anything bad about a surgeon - our livelihoods depend on them and we have to remain professional. Have the names of the surgeons you are considering and ask about those in particular. If you can, see the PT in person. Their body language and facial expression will likely tell you more than their words. I absolutely have opinions on who I think the best surgeons are in our hospital and have told DH that if I ever need emergency neurosurgery who he should ask for and who is absolutely not allowed to touch me. So, PTs are very good resources. If you can find someone who has had this surgery, that would also be a good reference.

I would not recommend an Orthopedic surgeon I have not seen good results from them. They may be good at joints, but for some reason, they don't seem to do well with spines. Besides, if someone is messing around near my spinal cord, I would want that to be a neurosurgeon.

It won't hurt to go see the surgeon. Listen carefully, take notes and ask questions. If you already have questions, write them down and take them with you. If questions come up while he is talking, write it down and wait. He may answer it before you have to ask and if not, then you won't forget it. Don't leave without getting your questions answered. I have found that a lot of neurosurgeons may not have the best bedside manner and can be quite arrogant. Don't let that influence your choice. Go with the most skilled surgeon and forget bedside manner. I recently had a young female pt crying because of what the surgeon said to her. I told her to ignore it, that she had one of the best surgeons in the country and to not let what he says get to her. The most important thing is the surgeon's skill.

Lastly, the approach the surgeon takes will definitely impact recovery. If they go in through the front (anterior approach), the recovery is much easier. These are the patients that are up and around and going home the next day. If they have to go through the back (posterior approach), this is more difficult and these patients do progress a little slower. They might be in the hospital 2 or 3 days. See what this surgeon thinks, ask around about other docs and get a 2nd or even 3rd opinion.

I would recommend that you do something right away because the tingling in your hands and feet indicate nerve involvement and compression of those nerves over time can lead to serious problems. Be sure you let the surgeon know that this has started.

Good luck and don't be too scared. Do your research, take your time and you will make the best decision for you.