2nd and 3rd opinions are confusing - Help! Foraminotomy Versus Fusion
 

Hi
I have C-spine issues at C3-4 and C5-6. Symptoms are burning pain down my left arm (C5-6 distribution) and neck stiffness, tightness and pain. Sleeping is a problem. I've had 2 MRIs and a myelogram. Done the PT, epidurals, etc. Still no better.

So now I'm scheduled with 2 surgeons for surgery and have to decide which way to go. Both are neurosurgeons.

Surgeon #1: Young, only 6 years experience. She wants to do a posterior foraminotomy to "clean up the disc." I like her, trust her, but still not so sure if you know what I mean. (I'm currently trying to get an appt with another doctor in her same clinic with much more experience to see me - this seems to be hard to do)!!

Surgeon #2 (different office and hospital than above doc) - Neurosurgeon with 27 years experience. He is ultra-conservative and would not even talk surgery with me until now, almost a year after seeing him the first time. He says I would do better with a one level fusion at C5-6 as this has more promise to help the neck pain and not just the arm pain.

I'm hoping for a visit with a more senior neurosurgeon in the office of doctor #1 to give me a tie-breaker decision. Hope I can get in to see him.

Another physician (not a surgeon) says I could always do the foraminotomy first, see what kind of relief I get and then go back later and get a fusion if it doesn't work. I hate the idea of 2 surgeries tho!

I have read the horror stories on this site about fusions and am really scared to go that route, yet I really want to get rid of this awful pain that has been pestering me for over a year now.

I hope some of you can give me some advise ASAP as I need to settle on which way to go this week.

Thanks so much for helping me!!

Diane

Hi Diane, sorry to hear about all your issues, i have had neck pain for the past 7 month, with numbness in my fingers, and pain. since 5 month I have done "treat your own neck " by robin mc kensies and egoscue techniques, and I am doing much better, pain come and goes, but I am not in awful pain all the time. i have also back issues.
I am not going to do surgery in my neck, as I believe that therapy will eventually work, the worse is my patience is very thin, and I like to be out of the pain, right now. But I did not get there in pain in 5 minutes, It took years of bad posture to get this neck to be unhappy.
I had the same neck pain for a year 10 years ago, and got out of it with therapy, I know I am older, (50 ) but I just don't think screw and plates are going to feel better. and doctors are like mechanics, they love to work on you !! if i would consider surgery I would go for minimally invasive surgery, very small incision, tiny work down, out of it in 2 hours. and search for the top of the top. like a good mechanic, you have the good one, then you have the others... How long, you had neck pain ? and what therapy have you done ?
for sleeping you may tried a neck roll from mc kensies, you can buy it on amazon. I sleep with one, I made it smaller though.
cheers virginie

Hi ~ The doctors should have told you that PAIN IS NEVER a reason to have surgery!!! Surgery ONLY corrects mechanical problems. It does NOT correct pain. If you should happen to get pain relief after surgery, it's just a fluke. Usually you end up with the same pain or worse after surgery. That's just the way it is. I'm sorry to have to tell you this.

The American Medical Society said last year that people that had fusions got the same results that people who had physical therapy did!!! In other words, there were thousands of NEEDLESS SURGERIES. This included the fusions & regular surgeries (spinal). That's kind of scary if you ask me.

Also, once you have fusion (or regular spinal surgery) the level above/below will FAIL because it has to take on more of the load. That means that you will probably need more surgery within about a year or two. It's called the "domino" effect and it happens all the time. Surgery just begets more surgery. The only time surgery should be seriously considered is when the spinal cord is being impinged or when you are in danger of permanent nerve damage. Usually the nerves can be "undone" by physical therapy, which should be the FIRST road taken. Physical therapy ALWAYS should be tried before surgery.

Stay conservative as much as you can. Surgery will just make you worse than you are now. God bless and take care. Hugs, Lee

Thanks for your advice. I have tried PT on two separate occasions, with relief for a little while but then the pain is right back at me. It has not helped the right hand weakness. I have also had 3 epidural steroid injections. The last one gave me relief for 3 weeks, so the doc feels they found the pain generator. I do have a level of stenosis where you can see the nerve "rubbing" but doc feels it is not constant which would make sense since my pain is not constant. The burning electrical pain is what is getting me the most. I am used to being active, playing tennis, etc., and can't do any of that any more. I am a young 57, not overweight, not depressed and want to get on with life.

I may start with the foraminotomy with the hope that it will give me just enough relief. I work in the medical field and never realized that this back/neck pain is such a huge problem.

Now I really have to think about this....

I need help finding the right neurosurgeon!
 

How do you go about choosing your neurosurgeon?