benefits of interior vs posterior
 

I have four herniated discs in my neck and one buldgin disc starting at c2 to c7. c6 to c7 i have a pinched nerve that causes burning in my arm and finger. I am doing pain management. I am tking vicodines 10 with tylonal. I have had the injections and they are not working. So i saw the surgeon and he advised a fusion. I am not sure of how many tiers it would be but i am really nervous about this. I have two ?'s one my meds have stopped working and the doctor will not prescribe anything else. Two which is easier to recoup from interior or posterior. I am a single mom with two little ones.

Hello cboncal
 

Welcome to Neuro Talk. I am glad you found this place. You will get some tips, and make a few friends. So sorry you are having spinal problems. I too had the same as you. I am fused C3-7. Please do seek another specialist, and make sure they agree on proceedure to help you. Also please seek another pain specialist. If your pain is anything like mine was, the vicoden is not enough. I was given alot more before my fusion, to keep me comfortable. With two small children you have your hands full, without being in constant pain. You need some more help even before you get surgery. I also think that second and third opinion is really important, as I did NOT do this the first time around. I was first fused C6-7. It is important to make sure the ones above the fusion site, and below are stong and able to take the implants. In my case I had the domino effect, that those did fail, having to put me in for more surgery. It is a precaution, and you will feel better about going forward with it, when multipal docs say you need this surgery. Did they try infusions on you? Not just an epidural? I hate needles, but the Katemine infusion worked good for me for a number of months. Just an idea. Neuro talk will be there for you. I will too. I do wish you all the best in what ever you decide to do. None of it is easy, but it helps when you have friends in your corner. ginnie:hug:

they have done muti injections on my lower lumber since i also have two herniated discs in my lower lumbar l5 and s1 with a pinched nerve. I had raido frequency done on that last wed and most of the pain is gone from my leg but the sciatica still bothers me and pain accross my back is still there. they did the veraset nerves. My right leg is also always colder than my left and constant numbness in it. he did the epidural in my neck and next is specific nerve injections to try and help the pain. My headaches are so bad along with the pain at the base of my neck. I have started to get a lump back there and when the lump increases the pain increases. they started me at vic 5's then 7.5s then 10's and now 10;s with tylonel. i told him today that the 10s are not working and i have had to double up on them. i still have pills left from my script since i refuse to take them during the day because of the kids and they just called in the same script telling me that they cant prescribe anything stronger becasue that is already a strong precribiton in it self. i really dont know what to do.

Hello cboncal
 

You really do have some issues in multipal locations in your back. All the more reason for more opinions. I know it is hard to run around and do. You need to research pain specialists in your area, while you are going though all this running around. You need more help with pain. the 10's arn't enough. I was on morphine. I do not recommend any medication, but I know that helped me through the years. I still am on a very low dose after my fusions. Would you want to post MRI results? lots of people can help you to read them, maybe give you some more suggestions.
I also had that huge lump right behind my neck at C6-7. Your spine has curved, or reversed as did mine. It hurt like the devil too. don't lift anything, nothing at all, only make it worse.
Where are you located? maybe someone will know of good pain specialist in your area. Ask your pharmasist, who knows you, what doctors are good. Often they know who the legitate ones are, that really help folks. My friend at walgreens recommended one in particular, who is also a Physiosist, rehabilitation doctor. she is also my pain specialist. She works with the whole body, not just the pain issues, though she has kept my very comfortable. I am on vitamines now, suppliments to help strenghten all over.
You can PM, or private message me any time you need to. I sure feel bad that you have to go through this with young ones in tow. I was 53 when this happened to me. I was an artist that looked down into a magnafier for 30 years, and that did the damage to my spine. Let me know if there is anything I can do to help you.
Different surgeons take different surgical approaches. Both my spinal fusions were anterior. Both probably hurt, but the docs. usually have a reason why they want one over the other. Ask them their reasoning. don't be afraid to speak up to the surgeon about your pain issues. He may be able to help you find a pain specialist that is more help to you. ginnie

i was off on the specifics.. i get confused. so here is my mri results
central broad-based disc herniation at l4-l5 with peripheral annular tear indenting the ventral thecal sac and contacting the bilateral descending l5 nerve roots in the lateral recesses.
central posterior disch herniations at c2-3 and c3-4 indenting the ventral thecal sac
broad based disc herniation at c4-c5 indenting the ventral thecal sac and the narrowing of the bilateral foramina
disc bulge at c5 c6 causing spinal canal stenosis and bilateral foraminal narrowing.
left foraminal disc herniation with peripheral annular tear at c6 c7 indenting the ventral thecal sac and left neural foramina
Straightening of the normal lordosis which may be scondary to spasm
there is straightening of the normal lordosis which may be sconday to spasm. Ther cervicomedullary junction is intact. There is no compression fracture or abnormal marrow edema. there is disc desiccation in the mid and upper cervial spine levels. Evaluation of the disc spaces demonstrates a subtle disc herniation at c2 to c3 measuring apporox. 1.0 cm in width by .2 cm sagittally indent the ventral thecal sac
at c3 to c4 there is a broad based sic herniation indent the venral thecal sac measuring appox. 7 cm x 2c.
at c4 to c5 broad based herniation extending 2mm posteriorly indenting the ventral thecal sac and casing mild bilater foraminal narrrowing at c5 to c6 there is a dusc bulge casuing mild spinal canal stenosis moderate right and left foraminal narrowing and at c6 to c7 there is a left paracentral disc herniation measurning 9mm x3 mm sagittally with peripheral annular tear indenting the ventral thecal sac casing mild left foraminal narrowing
at l4 to l5 there is a broad based central posterior disc herniation measuring 1.7 x .3cm sagitally with peripheral tear which indents upon the ventral thecal sac

Hello Cboncal
 

Did anything in particular set your back issues off like this? Were you in some kind of accident? I am going to look up some of the things on your MRI.
Just a quick review, I know for sure, that when there is a tear like at C6-7, and herniation, that is not something to take lightly. You don't have a reversal of the spine, rather straightening of the spine due to spasms. I know how bad that hurts too. Any thing thats compressing the spinal canal causes pain. I will look up particulars.
Leesa is the best to my knowledge on this site for reading these MRI's. I have not seen her on line lately, but if she sees this I bet she will respond.
What is a concern to me, is that your problems are over a broad area, or in many locations.
Has the doctor stated exactly what he wants to do???
Because most of your damage is posterior, that is most likely why he wants to approach from in back or posterior. My damage, was reversal of the spine, herniated more from the front.
You are very young to have this kind of trouble, and I am sorry this happened. I know that medicine has come a long way, and that real help can be had for most of our conditions. I will look up each thing to get a better understanding. I know the language, but I would like to look things up, line by line, and get the whole picture.
Are you seeing a neuro surgeon? Have you thought about another opinion?
I will start now, and do a little tonight, and tap back at you in the morning. I ran off a copy of the report to have it in front of me line by line.
Most of my damage was all in the upper part of the neck, C1- down to T1-2-3, which is left over problems. Definate cause of problems for me was due to my work.
Has your doctor mentioned anything like degenerative joint disease, or degenerative disk disease? Please don't take offence for me asking you. I don't want to scare you for sure. I know it is scarry enough to face these things. Is your husband giving you a hand lately, and being supportive?. We do need friends when we get in trouble medically.
This site, helped me get through all I had to do. I will try to do the same for you. I run back here all the time for help. I be here tomorrow.
I hope you get some good rest tonight. and that your pain is not overwhelming. off to look up a bit. ginnie:hug:

first part, first two sentances.
 

The spinal cord has 3 layers known as the thecal sac. If there is just an indentation is isn't so bad. But when there is a tear, and contact with the nerve root (you have bilateral contact) being touched, that is causing some of this pain. He will want to repair the tear, correct herniation. You may get a new disc inbetween.
Second sentance disc herniations at C2-3 and C3-4. just indenting
Broad based disc "just indenting"narrowing of the bilaterial foramina. At C4-5. This does not say compression of the nerve root. nor does it state mild or severe narrowing, not quite sure about that.
Buldge at C5-5 again bilateral narrowing but no compression of nerve root, not completely herniated, but squishing is a term I would use.(laymans term)
any time you do not have compression of the nerve root, that is a better situation. Also in the language, when "mild" is used, rather than "severe" you have a better outlook. Down at the end, where it says about C4-5, C5-6, and C6-7 says "mild" moderate in the language regarding the narrowing of the foraminal
You do have a tear at C6-7. I would assume this would be corrected as well.
I would imagin so there is not an advancement of the tear.

I need to look up more about Broad based central posterior (in back again) at l4-5, herniation.
Sizes, I do not know much about. In what I am reading it doesn't specify what is "mild" or what is "severe' regarding that. measures 1.7. again I am going to have to look more to see what that means.
All of the language in these things is difficult. I just am learnng the full range of what goes on in the spine. I will look more tomorrow. Hope others help you to read this too.
If you have time, jump on line and start looking at each word, to know meaning, then it kind of comes together in whole context. Talk to you tomorrow. ginnie

I was in an accdient on aug 3 2011. a teenage boy turned left infront of me i was traveling 50 mph. I did black out and when i came to i thought my kids were in the truck with me. i was driving a grand cheeroke larado and the officer told me i was lucky to be alive. i also have psd and post concusion syndrom. the nurologist did a emg and a eeg with showed two pinched nerves one in my neck and one in my lower lumbar. my neurologist has prescribed molpax for the headaches but only to take when i have one.. which makes me laugh i always have one. he also put me on cymbolta for depression said that would help with the headaches.. they tried topamax but that gave me really bad vertigo i spent a whole falling down i was also on amitripolyn but i gained 9 pounds in two weeks on it... i just saw my first nurosurgean who came highly recammended by many of my doctors and by a couple of friends. he is the one who told me to complete the pain managment first before surgery and see how bad i am when the pain managment doc says there is nothing more he can do for me. the surgeon did say fusion for upper and lower but did not get into specifics as of yet. i was really freaked out when he said surgery. i am a single mom i have a 20 year old daughter with a 3 yearold grand daughter andmy son is 19months old. I am home with the kids all day while my daughter works and when she gets out she helps as much as she could. the doc has not mentioned anything about degenerative joint disease or disk disease. you are definitly not scaring me.. the more you know the better you could help me and i truly appreciate that. i have felt very alone in this. i am also seeing a chiropractor once a week about 3 months ago they did munipulation under anesthia to help get some mobility back for me but i am losing it again. i am also seeing a biofeed back doctor who is also a psycologist. he is helping me emotionally for the most part and calls my other doctors to make recammendations for things he feels i need. again thank you so much

Sometimes they don't because the terms can be scary, after which some patients hear nothing because their brains have turned off (OMG, I've got a degenerative disease! :eek:) It's a part of aging (and the price we pay for walking upright) and almost everyone gets it to some degree, usually starting around middle age.
http://en.wikipedia.org/wiki/Degenerative_disc_disease

That's an excellent attitude/outlook. It'll help a LOT. Knowledge is power. You are not alone. :)

I like the conservative approach of the neurosurgeon who told you "to complete the pain managment first before surgery..." Surgery should always only be the last resort after all other alternatives have been exhausted.

I'd skip any more chiropractic due to the nature & severity of your cervical issues, even if they're limiting work to lower down. I'm a little surprised the neuros didn't advise against - mine did.
http://www.quackwatch.com/01Quackery...irostroke.html

I tried biofeedback. I wasn't able to get it to work, but I still think it's a great therapy for anyone who can.

Doc

Ralph Nader is not an automotive engineer either, and most watchdog sites & organizations are not unbiased; neither are pro-/endorsing sites, professional associations or the like.

Actually, Dr. Barrett is retired, and while he runs Quackwatch (and 23 other watchdog sites), content is contributed and reviewed (when appropriate) by an international network of people from all kinds of backgrounds/professions, including a former chiropractor who contributed:

Quote:

Reader Comment From a former chiropractor: I have been doing a vascular surgery rotation for the past month, which is part of my postgraduate medical education. During my chiropractic training, when the subject of manipulation-induced stroke was brought up, we were reassured that "millions of chiropractic adjustments are made each year and only a few incidents of stroke have been reported following neck manipulation." I recently found that two of the patients on my vascular service that suffered a cerebrovascular accident (stroke) had undergone neck manipulation by a chiropractor, one the day that symptoms had begun and the other four days afterward. If indeed the incidence of stroke is rare, one M.D. would see a case of manipulation-induced CVA about every 10 years. But I believe I have seen two in the past month! I therefore urge my medical colleagues to question their patients regarding recent visits to a chiropractor/neck manipulation when confronted with patients that present with the neurologic symptoms of stroke. I also urge potential chiropractic patients to not allow their necks to be manipulated in any way. The risk-to-benefit ratio is much too high to warrant such a procedure. —Rob Alexander, M.D. http://www.quackwatch.com/01Quackery...irostroke.html

I could have cited many many articles, but IMO, Dr. Barrett's was the most comprehensive, best written, and well-referenced I could find in short time. The article's sources are there at the bottom for anyone to follow-up.

I'm sure we could argue this and cite contradicting sources til the cows come home. If people are interested/concerned, they can read all sides of the issues....

Google: chiropractic stroke
Google: chiropractic quackery
Google: debunking chiropractic
(and related searches at the bottoms of these search pages)

...and decide for themselves.

Doc

About chiropracter
 

Hi, and I am sorry about the accident you had. I know you are scared. Anytime they want to do surgery on the back, it is that way.
My suggestion is NOT to do the chiropracter at all at this point. Pulling and pushing on a herniated back is not a good idea. From all I have learned on this site in the several years I have been here, points to NOT doing the chiropracter when surgery is being considered. I would not go in again if I were in your shoes, not until a neruo surgern agrees with this approach.
Too many things are involved with your back. You need top notch professionals to help you.
Also the fact your pain specialst said he could not do more for you. This is not correct. They can and often do more than what you are currently receiving. find a different pain specialist.
I am facing surgery, neither the surgeon, nor my pain specialist wanted to cover post surgical pain. WHAT???? Yep.
What is a pain patient suppose to do? I interviewed 4 different doctors is what I did. I actively looked for a new physician for a month before I found this new person. If one doc. doesn't work out, you have to seek another one. I hated to go out and do that too, but I need the help, so I will work for it. I turned down two of them too! You can say NO, you can decide for yourself, who is good for you.
Pain doctors are afraid to prescribe all the time. You have to find one that has some compassion. My new doc. actually gave me more than what I need. She lets me decide how many per day, and I always pick BELOW what I am allowed. She allowed me some control in my own pain level. That kind of trust ususally takes some time to develope. In this case, this new doctor did trust me, as I brought in all records, charts, MRI, all of it.
Hope you seek the help in all areas of this. Make sure you get a complete understanding of all surgical proceedures. My ankle specialist did not show me my MRI, even though I directly askedhim to do this twice. On the 15th I am going to another ankle specialist for another opinion, as I was NOT satisfied with what he told me. I don't understand, and until I do understand the proceedures needed, my answer will be NO to surgery. My PCP does NOT agree with the surgeon, another reason for another opinion. Yes I have trouble both in my akles and in my neck. I have degenerative joint disease of some kind.
Thank you for telling me about your situation. You have your plate full, and none of it is great. I will look up some more things later. I have a realtor in the middle of my mess, to put my house up for sale...long story.....will be back in touch. ginnie

I must say i did really well with the manipulation under anesthia. I got back alot of mobility. I am losing it now. I do walk to try to stay somewhat fit and i chase the little ones thats exercise in its self. the chiropracter also helps with my headaches. When i did p.t. my headaches increased to where i had to stop. i dont feel i was ready for it or the trainer did not know what he was doing. I really felt he could of done more and i will not go back to that one again. i saw another doctor today one of the car ins doc. ime. I was told by him that the surgeon i am dealing is one of the best and to trust what he says. I also agree because this surgeon told me to finish pain management first before he will do anything. I finally spoke to my nerologist today and he told me is ordering something tht i will spray up my nose for the headaches. i am not sure of the name yet.

Search them and see. You get a lot sites of chiropractic professional associations and chiropractors -- they are not exactly unbiased either.

The search criteria I suggested, when you include the related searches as I suggested, present both sides in their extremes, and some examinations of both sides. As with most things, there are always at least two sides to every issue (and often/usually more) and truth lies somewhere between.

Misinformation and misconceptions about medications, supplements, advertising, and other questionable therapies and practices (and safety thereof) are often pointed out on this site, and people are always free to examine the information and/or ignore it as they choose.

Doc

Do you have a diagnosis of the type of headaches (cervicogenic, migraine, cluster, etc)? Some nasal sprays for headache are Imitrex/Imigran (sumatriptan), Zomig (zolmitriptan), Butorphanol (Stadol) Migranal (dihydroergotamine). If whatever he prescribed doesn't work, it doesn't mean another might not, so let him know; there are others to try.

Doc

i was on molpax, sumatripiane, amitriptoline, already... amitriptoline worked but i gained 9 punds in two weeks with it. So now we are seeing what else may work for me

could you tell me about Migranal.. that is the med that was prescribed for me...

did you find out anything more about my mri..do you think it would be a multifusion in my neck..and with fusion do you lose alot of mobility

First, don't confuse it with an OTC migraine supplement called Migranol - they are not the same.

Migranal is not a pain medication. It is a migraine medication - a derivative of ergotomine, and while it works similarly to triptans, and has similar efficacy to Imitrex, there are different side effects, warnings, and potential drug interactions associated with it (some as long as 14 days apart):
http://www.healthcare.com/medication...asal-16497.php

You should get/have gotten a drug information sheet with the prescription; read it very carefully, and if you have any questions, consult your doctor or pharmacist.

I'm not finding the usual PubMed page on this medication; instead there is an archived drug label at:
http://dailymed.nlm.nih.gov/dailymed...archiveid=7093

The Wiki page is severely lacking, but I do find a MedLine page:
http://www.nlm.nih.gov/medlineplus/d...s/a603022.html

More can be found on the web; google: dihydroergotamine nasal spray

Doc

thank you so much for you help.. i have a new problem. i went to my pain management doctor today and told him how the surgeon recamended a different pain med for me since the vicodines stopped working. he told me that he doesnt do precscription drugs that he only does the shot into the spine. i thought this was rather odd. he tried to tell me that the surgeon passed me off to him. but what the surgeon told me was to finish my pain management then come back and see him when the doctor couldnt do anything more for me. well the pain man. doctor got mad at me. then i told him about this lump that has started at the base of my neck,.. he then toldme thats from the cortizone shots i was getting inmy lower lumbar and was too much to quickly and that he cant touch my neck till its gone.. then he said since your gonna go with surgery you mind as well do that instead and released me as his patient told me to get into the surgeon as quick as possible gave me a script for percocet 7.5 and told me he wont refill my script. he also told me he only does shots and doesnt handle the med portion of pain management.. is that what hes for i am so confused .. i thought pain management is what is says

Unfortunately, it can get complicated. Some approaches to pain management include prescribing pain medications and some do not. Those that don't are sometimes referred to as Interventional Pain Management (IPM).
There's nothing wrong with IPM. It's a good way to go at first, but it can also be confusing to patients who haven't received an adequate explanation of what's going on and why. It also seems a bit hypocritical to me that they won't prescribe pain medications, but they'll perform an invasive procedure and implant a pump that delivers the same medication. :Hum: :Dunno:
(I'm avoiding the political issues here or I'll be up all night.)

The problem comes if/when the procedures that IPM doctors practice don't work for a patient (for whatever reason) and medication is the only avenue left. Instead of going that way, they just throw up their hands and... well... tell that patient left in pain to go someplace else. Cuss you very much (to those doctors).

It appears that you got caught between two doctors with different theories about pain management and the result was you got dumped. It happens. I'm guessing the guy didn't treat you all that well to begin with, but that's neither here nor there.

I think you need to call your neurologist/neurosurgeon (are they the same guy?) and let him and your PCP know what has happened. Your PCP may or may not take up the slack (prescribe) until you can research & decide about the surgery or find another pain management doc/clinic. I also think it would be a good idea to get copies of all your records, especially from the PM doctor.

If you want to pursue getting another PM doc/clinic, your other doctors may be able to help (recommend/refer you), or your insurance company may have some ideas (they have lists of the doctors who accept their insurance), or your local hospitals may have clinics, or there are articles and sites online that may help you in the search.
Google: finding a good pain management doctor

Whatever you decide, I think it's important that you move forward (I don't mean rushing into anything - develop a plan and pursue it) and let your doctors know that you are going to move forward. You may need time to do some homework and decide what the best course of action (surgery, no surgery, pain management) is for you. PLEASE don't rush into anything or let anyone bully you into anything you don't understand or are unsure about. You want to be as fully informed as possible; this is your body that you'll be in for the rest of your life - you want to do the right thing for it.

We'll be here.

Doc

I am unsere what to do .. if i should find another pain doctor or if i should just move ahead with the surgery. I do want to have my neck done i cant take the pain.. and i dont like being medicated. What does cervical fusion entail

Yes, I sense that. It's because you are unsure, in pain, and don't understand these procedures and options, that I suggest you consider undertaking some pain management long enough to:

1. Get your pain under enough control so you can comprehend, think, and decide clearly and rationally,
2. Learn about the procedure and all of your options,
3. If appropriate, research and choose the right doctors/surgeons, get multiple opinions, or research/explore other options.

That might take some time. (Weeks - Months?)

I'm not suggesting pain management/control as a permanent solution at this time; just as a stopgap to buy some time until you can get your wits about you, think about and devise a logical course/plan of action, and implement that plan. Most people cannot do that while in that much pain. I know I couldn't, and many doctors would agree.

If you undertake pain management and later decide that surgery would have been better, you can always have the surgery.

OTOH, if you undertake surgery and later decide or find out it was unnecessary or a mistake, that can NOT be undone, and you may have no other choice than to enter pain management on a more permanent basis.

If it were me, given the risks and outcome statistics of cervical surgical procedures, I would want to keep as many options open for as long as I can and learn as much as I can in order to make the best possible decision for myself.

You have definitely decided to go through with surgery without even knowing what it entails? Is that what you're saying or am I misunderstanding?

NOBODY in pain likes being medicated. NOBODY. However, it's the only way some people can function and have any quality of life at all, and it's the only way some people can think, evaluate, and make rational informed decisions. After your surgery, you're going to need some medication for post-surgical pain, and possibly for several months to a year after that, depending on how your healing goes. Possibly indefinitely. Surgery can fix what's physically wrong, but it may not fix damage to nerves or end the PAIN. That's an important question to ask the surgeon: "Will this operation definitely cure my pain?" If he says, "Yes." he's not being candid.

You can learn what cervical fusion entails far better than anything I could describe by googling: cervical fusion

There are a lot of variables, and possibly some options/alternatives, surgical and otherwise.

Doc

That is because there is a mutual disrespect between surgeons and PM docs. It's the rule, not the exception. And ironically, you will find that many PM docs will not issue scripts for narcotics opting for more invasive procedures. Get a new PM doc (unless you are HMO; could be difficult)...

Hi cboncal
 

I kind of got caught up in my own issues. I have my house on the market, and not much time to look up things. sorry if I let you down. after re-reading the post, I do know that you have mulitpal issues going on. There was only one place in your spine however, that seems severe. Can you go get another opinion? Because you trouble is so spread out, I am not sure that surgery would be a good option. May I ask where you live, and if really good neruosurgeons are around you?. PM me if you want. I will try to get back on line. ginnie

About the shots/pain management
 

For sure you need a new pain management doctor. Not all doctors do just a shot in the spine. he should have recognized that you have problems in more than one area of your spine and had some more compassion. do find another pain doctor. He handed you off to the surgeon, and is trying to force you into surgery. My pain mangement did the same thing. he told me he couldn't help me anymore after Two injections. He sent me to my second neuro surgeon. I had the C3-7 done. I was FORCED to do the surgery, but even after that, I now have trouble and more pain. I am not having any more spinal fusions. I found a new pain specialist, and I am hoping that she will not hand me off to another surgeon for both my neck, and my ankles. Pain management does hand off to surgeons. Patients find themselves not wanting to do surgery, but have to in hopes of reduction of pain. I am not sure of anything anymore, and I worry about the same issues as you do. Please keep going to find new pain management, and don't get forced into surgery at all, unless you are confindent in your surgeon and the decisions that are made. This is way to important to be rushed into a situation, that may or may not help you. Keep in touch, I will be here as much as I can. I have second opinion tomorrow for ankles. My foot colapsed more or less. I do wish you all the best. Just keep going, and trying to get another pain doc. that has compassion. ginnie

i went to the surgeon today he is concerned my neck is too damaged to operate on. the are going to do a myeloscopy to see how bad the discs are and if he can actually do the surgery. could you tell me about this.

Hi Cboncal
 

Hi, of course I am concerned about you. If your surgeon is really worried that you are too damaged to operate on, I can't see a point in doing that test. I avoid those kinds of tests like the plague, unless there was hope that the diagnosis would lead to helping you. It is a painful diagnositic test. Usually with the MRI they don't have to do this test. He is trying I suppose to see just how far your damage is, and if there is hope for surgical correction. Because you have mulitipal areas effected, I would choose pain control with the very best pain specialist you can find. Ask your surgeon why this particular test is so important to him, and what the purpose is, if he doesn't want to do surgery anyway. I am so sorry that you have this condition, and I do know how scarry it can be. Weigh all your options before you choose anything. Definately ask your surgeon about this test. I avoided the EMG and the test he wanted to do to you. My surgeon was able to get all he needed from the MRI. I had also had a CT scan at one point. Please let me know what you decide. I sure will support what ever decision you decide upon. Google up that test for a description, it will tell you very clearly, how the proceedure is done. You are in my prayers. ginnie

i tried to google that test and i am not really getting anything baack on it.. i did ask y he wanted to so the test and he told me it was to see if he could do the surgery on me. i have very back head aches and there is a muscle spasm so bad at the base of my neck so bad it is bulging pretty far out now and i have been doing heat but it doesnt help. He told me he would like to do the surgery on my neck but the discs above and below may be too damaged to have the surgery and he wants to see in detail how bad it truley is. i did have the eeg and emg also as u know the mri. could you please explain exactly what happens during the precedure.

Re: yes
 

Yes, It is a proceedure to see if surgery is possible. I also found out that there are more things that can be done with this proceedure. It can also be a minimally invasive kind of sugery. If he is concerned at all of the verterbre above and below your damaged sites, I would not do the surgery. Your spine would have to be strong enough to hold the hardware. I think that is what he wants to do this for. Look up Endoscopic Epiduroplasty as well. It mentions the myeloscopy. There is a needle, and a scope involved, where he can see on a screen just what is going on. It is also a proceedure that would leave open the possilility of surgery down the line, or at a later time. This is investigative type of proceedure. I did not read anything on four sites, that addressed the pain issue with this proceedure. Maybe the Anesthetic used to numb will make this test not so bad. I will keep looking. ginnie

thank you soo much .. at this point in time i am petrified.. i also finally got a referal to a pain management doctor who handles the prescription part of the pain management.. my old doc. gave me percocets before he discharged me and again they do not work..

Hi, I had luck this way
 

Hi, and I sure don't blame you for being scared. It is scarry, and I wish there were something I could do for you. I did a bit more research. Google in " What is Myeloscopy', or 'what is Epiduroscopy'. I found out that very few physicians are doing this proceedure anymore. Several articles were about that. It is largely ineffective from what I read. Not much written about the pain factor either. If percocet does not work, Morphine does. I am on a low does, and use percocet for break though pain. I know that is a scarry drug too, but not if you really need it. I was on a very high dose before surgery, and it was lowered quite a bit until my current dose. I have no desire to up the medication at all! It is very hard to reduce this drug too. It all has to be carefully weighed, the pros, and cons of taking a med like this. I don't like being on these meds either, but I want a quality of life. I may again try to reduce the amount, as I found out RSD doesn't like narcotics. I am caught between a rock and a hard place too. None of your decisions are easy. Keep looking into that test. It was also stated because of poor results, that many insurance companies are not covering that test. You may want to check into that part too. take care, you are in my prayers. ginnie

i do know he is not doing the test for helping for pain. just to see if my neck can handle surgery. But i do think it would be good toknow how bad my neck actually is. So i know what i am looking at in the future. As far as the drugs i am finding myself doubling up sometimes due to the pain. What are the best ?s i should be asking my new pain managment doctor.

Hi cboncal,

I've been following this thread, and I'm in agreement with Ginnie.

If it turns out (whether you get the myeloscopy or not) that surgery is ruled out, then IMO pain management is your next best option. In some cases it may be preferable to surgery anyway.

Google: questions to ask pain management

I also have multi-level cervical issues deemed inoperative. I get the same headaches & muscle spasms. Some of the spasming is due to the stenosis, and some is due to the inflamation of the arthritis. One thing that my PM doctor sent me for was myofascial trigger point therapy, done by a CERTIFIED MTP Therapist (NOT a PT, chiro, or other massage therapist who claim they know the same stuff). It has done wonders for both my neck and other difficult muscle-related pain issues. In addition, I've had to strengthen my neck muscles, learn how to relax them (as much as I can), and re-learn some posture techniques and how to sleep to avoid strain on my neck.

I don't believe in recommending/suggesting specific pain medications, even in a peer-support capacity. I think that's best left between doctor and patient because not everything works the same for everyone, and there are many factors/medical issues to consider.

Your PM doctor may prescribe a muscle relaxer or anti-spasmodic along with a pain medication. Please be aware that if patients don't specifically tell their doctors that something isn't working, the doctor may not ask; they will assume that everything is ok/working, so speak up and be specific. There are many many medications in each of these classes, and while extreme care must be taken when using them, if one or more don't work, there are others that may be tried. It can take time and trials to find the right pain management formula (whether medication, other, or combined therapies) for each individual. Moral: Hang in there. ;)

Doc

Hi C-
 

I am glad Doc. Smith came into the dicussion. He is so right about the medications. Please tell the doctor that what you are using isn't doing much good. There really are alot of meds to choose from. I hope he or she has compassion for you in dealing with your pain.
Because of the over all condition of your spine, just be real careful in making your decisions. Surgery isn't always the answer. That one test isn't going to give all the critical information he needs on the spine. Please continue to look into it, and read all the information. I sure do wish you all the best on this in what ever your decisions are. ginnie:hug:

i have been trying to research this and am having a hard time.. so what is this test suppose to do or is it just so he could make money. I will def speak up about my medicine problems..and thank you for the advice

Hi Cboncal
 

From what I read, this test involving needles is suppose to tell him something about the condition of your spine. However this test isn't done alot as the results don't really come out well. Also more than one area in your spine would have to have a needle applied to it. I would seek another opinion before I had needles in my spine, just personal opinion. If he can't see on the MRI what is wrong, I don't think this test will do much good. It can be a ploy to receive money, and sometimes the test is NOT covered in insurances. That way you would indeed owe the doctor and the hospital. Check into insurances. I wish I had the ability to send the sites to you that I found. I may be able to do that with your home e-mail, if you would care to share that with me. You can Private message your information, and I can attempt to send the web pages to you. I am not that great on the PC, but I sure would give it the good old college try. I am finding alot of information on this, you just have to go down the list of sites and look at each one. No one site gives you all the information on this test. It was maybe 6 different sites I went to. ginnie

Hi Doc
 

I am talking to this good woman with the back issues again. I have found alot of information on this test she wants to know about, but she is unable to find the same information. I am lousy on the transfering of information from the Web. to someones home e-mail. What is the best way to do this so I can send her some of the pages with all the information on the test?. this is where my lack of ablilty gets in the way. thanks ginnie