Hey Zymergist -
I'm a fellow Southern Californian who just spent the summer with docs in San Diego and LA - and elswhere. Although one suggested a less-invasive approach (e.g. foraminotomy), most believed it would not likely solve the underlying problem if compression of the disc spaces is already severe as it was in my case - and can also negatively impact the surrounding region because posterior access (while attractive in many ways) also involved affecting part of the facet joint to gain access and space - something that could come back to haunt later on.
Another consideration that moved me to more rapid action and ultimately ADR is that for reasons that aren't really known, weakness in the arms caused by impact to the cervical nerves is of even greater concern than pain from a long-term perspective because the associated nerve injury tends to be much less reversible than if it were just pain, or if it were in the legs.
I've also since met a lot of folks, and talked to a number of docs (nine different surgeons in California and Europe), who relate the potential shortcoming of waiting or going too slowly with fixing something such that adjacent structures (e.g. facet joints) are already affected - and it then becomes very difficult to effectively treat the situation in a way that really works because there are then multiple problems not just one.
I agree that surgery should generally be treated as a last resort - but, where weakness and other indicators are already significant, I wanted to move through the earlier 'resorts' pretty quickly if they really didn't solve the situation (as opposed to pushing it off).
In my case, the problem was addressed before any substantial 'collateral' damage had developed, and I woke up from ADR surgery literally cured - the nerve completely bounced back, I had regained all sensation and had no significant pain. It'll soon be three weeks since surgery, I have no remaining pain for the first time since a cycling accident in May, and have been off of pain meds for almost the entire time since the procedure.
Attached are threads on the surgical outcome and one with some of my reasons for going with the disc I ultimately chose:
http://www.adrsupport.org/forums/f47...6-tyler-10743/
http://www.adrsupport.org/forums/f51...istance-10767/
Of course every patient's different - and it definitely takes an effort to meet with the docs and press through it - but absolutely worth it.
If I can be of help in any way, please don't hesitate to ask.
Best,
Tyler