Hi, Newly diagnosed C3&C4 nerve impingment

[Mike L.]

Hello and thanks alot for this great forum. I am a 53yr old male with a newly diagnosed (3 months ago) neck probelm. I haven't had any cervical surgery yet.

My MRI and xrays show an "unusally large bone spur" My previous 40 year I actively pursued surfing, body surfing, skateboarding, biking and one accident in 1994. Which I had prolotherapy and PT for neck stiffness. My symtomsare 24/7 neck anover to the shoulder numbness and tightness along with medium headaches. Moderate stenosis is evident.

The first neuro surgeon, I have seen twice, wants to do fusion anterior because the large spurs is growing in front almost around my throat.

Questions:
1. I have a visit with Dr. Delamater at the Los Angeles Spine Inst. 11/19/08 as well as a neuro at UCLA the same day. Any recomendations for ADR in LA?

2. Is C3 and C4 a unusual place for ADR? And is there any concern for the surrounding vertabraes after ADR?

3. Which device should I pursue?

4. Any PT or preventative measures to keep this bone spur in check for the next few months untill it gets removed?

5. WHat about the Laser Institute (Arizona)for my condition?

6. Any helpful directions to look into?


THANKS!
Mike

[Mike L.]

Well I have been to all 3 neuros here in my town. Looks like a posterior approach framinotomy to remove bone around the spur is what they offer. I have moderate stenosis and numbness in shoulder. C3 & C4 is the problem area. Recently it has been feeling really weird with some auditory sounds in my head. Swimming is getting worse and looks like I have to make a decision. Dr. Regan (Los Angeles) will do the framinotomy(?) but highly recommended prodisc-c ADR. I have Aetna insurance.

I am 5 months out from a PE and can go off my blood thinners. I also am scheduled for a ulner nerve release surgery this next week. I was just wondering the wisdom of doing my neck first or the elbow? The elbow isn't painful but can get numb when I sleep on it. My general MD wants me to wait on the neck and do the ulner first but with these neck/head symptoms I am wondering what you all might suggest?
And...

WHich procedure would you rather have ADR or framinotomy? If there ae any negative outcomes or side effects from framinotomy please let me know.

Here's wishing us all a healthy healing New Year!
Mike

[Adrienne]

To my knowledge, a framinotomy is much less invasive than an ADR. My husband had on on L5/S1 not long ago and he was practically waltzing out of the hospital the next morning after surgery. The ADR is a different story.
Maybe I'm missing something but why did they suggest ADR when there is an obvious bone spur they can just whittle away?

Don't know about the order but I think (simply intuitively) that I'd go for the major problem first to see if the other doesn't resolve, particularly if the elbow and shoulder problems are on the same side.

[Mike L.]

My right shoulder has the nerve numbness extending to only my shoulder. because C3C4 do not radiate down the arm. Perhaps Dr. Regan is recommending the prodisc-C because I do have DDD in many other segments but hopefully will not get too bad for surgery.

All 4 Neuros wanted to deal with bone spur going into my cord at C3-4...Warning: Do Not have Chiropractors rotate your neck. This is how it happened!

Thank you for your reply I need to get this neck fixed and am fortunate to have found alot of INFO that I just might learn enough from to help me make this surgical decision clearer.

Hello

Study all the options. Do all the reading on this site. C spine has great results on ADR.

Get all the test MRI, CAT SCAN,NERVE TEST ETC ....

See several DR.

Send information To Germany.

Do everything to get the best results.

Read and Read some more, Study...

Keep in touch and all the best we care

Send me a PM

GIL

[Toebin]

MikeL,

It sounds like you are seeing some of the most practiced experts in your area. Dr Delemarter and Dr Regan have been discussed a lot here with very favorable input by many members.

I too am a bit confused and it may just be the way you've presented your case. My understanding is that a posterior surgery with osteophyte reduction/removal and a framinotomy are usually performed when nerve impingement is evident by bone on the MRI. You can certainly have this condition without a bad disk and this sort of repair would remove the trapped nerves. Stenosis is a different diagnosis from DDD.

But you also say there is an ADR recommendation at the same level. And that you thought it was due to DDD in surrounding levels?

If the disk isn't bad at C 3/4 why would they do an ADR placement? And if they are doing an ADR , don't they usually do an anterior approach?

The only reason I ask is that when I first started down my cervical spine issue path, my neuro was undecided on the surgery he would perform. I too had HUGE bone spurs going directly into my spinal column at two levels that actually rotated in counterclockwise, but I also had herniated disks that were adding to the nerve root compression on MRI.

I was told then that if the majority of my issues were bone related, a posterior surgery would allow for the best outcome, but that the anterior surgery would allow for better clean up of the disk issues.

In the end we went with the anterior approach for better disk removal, and cleaned up the bone spurs as best we could... however the mild stenosis I have can only be fixed by doing a posterior repair and I would have to deal with that at a later point if it came to be a real problem.

I "think" from what you have posted that you have more than one diagnosis. Getting the the heart of that diagnosis is the MOST vital part of deciding what sort of repair will serve you best.

DDD is one thing and you can certainly have that along with stenosis, but the repair of each needs to be addressed.

[Mike L.]

Hopefully I can get this nerve pain done with minimally invasive forminotomy.
My surgeon is going in the front. Is that the preferred way? There is another neuro who will go in posteriorly. I have another 1 inch long spur at c7 He doesn't think it needs removing. I sometimes feel it. He saqys it will make post surgery swallowing problematic. Any thoughts, friends? I also hope that my arthritic neck can last another 5 or 10 years after this for ADR. I hope his bone whittleing doesn't preclude ADR later.

Happy Healing to us all!
Mike

[Grumpy]

Mike,
I've had 3 neck surgeries..2 in the front and one going in the back. Trust me , front is ALWAYS better.
I have Atnea too-they were great. BUT-our insurance pays 80-100% of the national average. So if my doc charges double than other doctors, I would have to make up the difference. And our insurance level is the cadiallac level so I would check ahead of time to see what your doc charges and compare it to others. My spine doc in Maine charges 1/2 what the Florida docs charged, and she did the better job!

[Mike L.]

Well had my 5 week checkup today with my local (santa Barbara) nuerosurgeon. The 1" surgery site is healing nicely. A little pain up towards the jaw. But.......

My sensory nerve is just as bad if not worse than before the surgery. The affected area is my right shoulder, not down the arms. In the morning it isn't too bad but after a few hours of general use it starts its aching.

I have heard of compressed nerves being permanently damaged and I have also heard of nerves getting better after months. I waited 4 months before getting the Anterior surgery and now wished I would have gone with the ADR after only a few weeks after initial chiro induced bone spur stenosis.

Please lend your advice:
- will ADR relieve this pinch?
- time to recover from this one. patience needed?
- time to reconsider ADR?
- Stenum has a new ADR with nerve support structure?

Hope you're all are healing well!
MIKE
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