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Old 06-06-2012, 10:21 AM #1
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Default 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.
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Old 06-06-2012, 11:03 AM #2
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Default 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
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Old 06-06-2012, 11:17 AM #3
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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
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.
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Old 06-06-2012, 01:18 PM #4
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Default 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
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Old 06-06-2012, 03:32 PM #5
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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
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Old 06-06-2012, 06:41 PM #6
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Default 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
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Old 06-06-2012, 07:17 PM #7
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Default 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
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Old 06-06-2012, 07:40 PM #8
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Originally Posted by ginnie View Post
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
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
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Old 06-07-2012, 12:35 AM #9
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the doc has not mentioned anything about degenerative joint disease or disk disease.
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! ) 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

Quote:
you are definitly not scaring me.. the more you know the better you could help me and i truly appreciate that.
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.

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Old 06-07-2012, 01:14 AM #10
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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
While chiropractors go over the line at times, you should know that quackwatch is run by a psychiatrist who is not at all likely trained in physical medicine so it is not exactly an unbiased source to cite. Some of what he says may be true; while other information is junk science and represents his own bias against the profession. For example, he alludes that stroke and manipulation run hand in hand while the literature points out that the incidence is 1 in 1 to 3 million manipulations; not even enough really, to list it on informed consent. You have a higher chance of dying from a bee sting or being struck by lightening (this is not an endorsement of chiropractic, just my opinion of a mis-statement). Another perspective, roughly 1 in 1000 die from disc surgery and prescription anti-inflammatory medication. There are many more scientific studies that prove the limited value of manipulation. In fact there is one study out there from a couple years ago that states that you are more likely to have a stroke shortly after seeing your GP than your chiropractor (is that one on his site?). And besides, I know several orthopedists and neurosurgeons as well as neurologists and GP's who refer to chiropractors. They can't be all bad as there are good and bad of everything! Oh...BTW, manipulation under anesthesia is a procedure developed by osteopaths some 50 years ago that actually has very favorable outcomes in the literature. Some chiropractors are trained and certified in this procedure and do quite well with it.
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