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My main concern at this point is how much real risk my (currently) asymptomatic herniation poses to my spinal cord. I've read that this "advice" that neurosurgeons typical give (that you're one fall away from paralysis) is somewhat unfounded, based on some studies and the prevalence of asymptomatic and undiagnosed herniated discs in the general population, compared to the actual # of reported spinal cord injuries. But, I also don't want to live with that risk, real of hypothetical, so I have to balance that against the risks associated with any spinal surgery.
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I've been in a similar situation for over a year.
Statistics are useful, as a general guideline, but may or may not reflect your case.
Some factors you should understand here:
1)
Neuroplasticity (See Link) - The brain and spinal cord have the capacity to rewire themselves over time, in particular due to slow changes. We don't know exactly why, but some people are more "plastic" than others, and we tend to slowly lose plasticity as we get older.
One person can have a brain tumor the size of a tangerine, and be walking around just fine (some just live with it), and another person can have a tumor the size of a grape, and have noticeable impairment.
Extend the same principle to spinal cord compression....
2) Trauma vs. Compression - The former can cause permanent damage that the latter would recover from. Compression symptoms are more likely to relieve than trauma symptoms, although the longer compression is present, the more likely the symptoms may become permanent.
However, remember that
Neuroplasticity factors in - some people will experience less symptoms due to compression, since their nerves adapt better to it, and subsequently will recover better.
Trauma recovery also depends on the patients' plasticity.
3) Physical Therapy - The saying is
"neurons that fire together, wire together, neurons that fire apart, wire apart." This is one of the big reasons why post-op physical therapy is so important for spine patients. Performing coordinated exercises
stimulates plasticity by encouraging the nerves to work together and in coordination with the brain. It's not about the
physical exercise, it's about the
nerve exercise!
A well-designed and consistent routine makes a huge difference in your recovery.
A respected Neurosurgeon with 25+ years of experience explained to me that he's seen some patients exhibit no recovery at all post-decompression, and other patients still recovering function over 5 years after a spinal cord injury. It's
very difficult to predict anyone's recovery.
The "standard guideline" is that most function is regained within 6 months or so, but your mileage may vary.
Another reason why a post-op physical therapy routine is so important!
It's frustrating, but there is no exact answer to the problem you're trying to solve (If you find one, let me know!). Everyone's different.
In the future, research will likely find genetic and/or epigenetic factors, and potentially drugs/stem cells/gene therapy techniques to predict and enhance recovery.
A lot of this is beyond modern medicine. It's also very difficult to do this kind of testing for ethical reasons.