Impending Surgery - Conflicting Views

[aussie2]

Guys any advice would be very appreciated right now. I am scheduled for an ADR at 5/6 with M6 on the 14th June. I have been looking forward to getting this done and the prospect of being out of pain. Tonight I had a phone call from another Neurosurgeon I saw after he reviewed my recent bone scan (I saw him to get a second opinion and he ordered the bone scan). He said after looking at the scan he cant identify exactly where the pain is as there is evidence of inflammation at many levels so he would not recommend surgery? This is in direct contradiction to what the Neurosurgeon (who is performing the surgery) this week recommended. He looked at all of my scans and said it was a "no brainer" that he perform surgery at the 5/6 level and do an ADR? So my question is, has anyone else been faced with surgeons all looking at your MRI's, bone scans etc and diagnosing different things? It appears DDD is a very grey area and the conflicting views, advise etc is scary considering my surgery is only days away. I thought getting a few opinions from different surgeons would put my mind at ease but it has only confused me more. Arghhh!

[jss]

aussi,

What a bad situation to be in.

Many a patient has come out of surgery with a perfectly placed ADR, but had the same pain because it was done at a level other than the one that was causing the pain. No one wants that for you. Were it me I would be as sure as is possible that the correct level were being addressed before scheduling surgery.

Before my last surgery I had six opinions, all agreeing on the levels that needed to be addressed; five of which agreed on the procedure that needed to be done. You probably don't need six opinions, but I'd be concerned that the two that I had disagreed.

Good luck, Jeff

[Harrison]

Aussie, can you tell us what your radiologist report of your spine says, verbatim?

[aussie2]

Harrison thanks for your message. My reports state the following:-

MRI Feb 2002

C5-6 Mild diffuse posterior disc bulge flattening the thecal sac although the central spinal canal appears adequate. Mild right C5-6 foraminal narrowing due to what appears to be early osteophyic lipping of the uncovertebral joint. The exiting right C6 could potentially be irritated.

MRI May 2013

T2 Hypointense disc desiccation changes are present at the upper four cervical disc levels.
Degenerative C5-6 disc disease with braod based central and left paracentral disc protrusion which is non compressive in nature. Small central C6-7 disc bulge which is non compressive in nature.

Bone Scan May 2013

Low grade active arthopathy anteriority at C6-7.

One Surgeon who reviewed this scan disagreed with the written report and after going off the source document said it should have read C5-6?

Love to hear your thoughts Harrison.

[Jen93312]

Inflammation can be seen from a bone scan??? If so, couldn’t the inflammation be from the bulge irritating your nerve roots?

[NJ Gene]

Aussie2,

I agree with Jen. I'm not a big fan of epidural steroid injections. However, if you had one, that might reduce whatever inflammation you had (at least temporarily). If you felt better as a result of it, there would be a pretty good chance that your first surgeon who said ADR was a "no brainer" is correct.

Gene

[Harrison]

Hi Aussie,

Pls understand that I know nothing about radiology. But I love DEXA scans, as they reveal a great deal of information about bone health. They are usually decisive in terms of supporting or contra-indicating disc replacement.

I try to help patients clarify their next steps, working towards complete wellness. My bias is helping the patient find a doctor they trust. I spend inordinate amounts of time focusing on the origin of DDD, which most patients and doctors ignore: pathogens like bugs.

That said, pls clarify and embellish here...dunno what you mean by this statement:

One Surgeon who reviewed this scan disagreed with the written report and after going off the source document said it should have read C5-6?

Any more news since then would help. How are you feeling these days?

[aussie2]

Hi Everyone,

Well I am day 1 post surgery! Hopefully the worst is over with lots of nausea and vomiting last night. Harrison the day before surgery I was getting very nervous about the report from the radiologist conflicting with the level recommended by the surgeon. I asked the radiologist to review the films again and confirm his findings. He did this, and ended up writing a new report that confirmed the surgeons suggestion that the disc to be replaced is at c5-6! Needless to say I was a lot more comfortable going into surgery! It's seems to have all gone really well not a lot of pain and the X-ray taken today shows the disc in action so all good so far. Thank you all for your posts on this forum, they are a valued source of information and comfort!

[Harrison]

Phew! Sigh of relief! Peace, deep breathing and healing to you....