Hello. I have vascular/neurological Thoracic Outlet Syndrom and now it appears I also need a discectomy and my symptoms can be compared to a multiple-crush type issue where I have symptoms from both the bad disk and TOS affecting the same areas.

I have read and read about TOS but the disk thing is a new variable I am clueless about. If I hadn't TOLD my orthopedic that my vascular surgeon wants a cervical mri, I'd still be clueless. At my first visit with the neurosurgeon for my TOS, he blew off my disk issue and said "everyone has bad disks". I had my second visit today and asked him to re-consider my MRI/disk and now that he actually LOOKED at my MRI, he has changed his recommendation from treat TOS first to treat Disk first.

At my C5-6, the MRI results reads:

• moderate degenerative changes at c5-6 with loss of disk height and degenerative spurring
• Moderate sized broad-based central and right sided disk protrusion and spurring.
• Spurring is extending into the right neural foramen causing moderate right foraminal compromise.
• Mild impression noted on the thecal sack but no definite cord compression seen

Other cervical disks:

• mild anterior bulging and bone spurring on c4-5 and 6-7

Is this something that they would immediatly recommend surgery as the only/best treatment option? This surgeon didn't really talk nonsurgical treatment since I've had this pain for a year and it has been progressively increasing during that time. My neck pain is pretty severe. I look like the pictures in the surgery brochure the dr gave me where I walk around/sit holding my neck. I work on a computer all day and by the time I get off work it hurts to hold my head up and bumps in the road hurt. Hurts to hold a phone to my ear... basically to move my neck in any manner. I've been on flexeril & NSAIDs for my TOS for about 2 months now. My muscle tension in neck/shoulders is a little less now, but the bones in my neck seem to hurt more.

I asked about epidural steroid injections and he said those are not without their own risks and pretty much dismissed that and recommended the ACDF.

Is this normal for this type of disk problem? Is finding a good surgeon (i assume neurosurgeon??) to do this difficult? I'd say that finding a TOS doctor is like a trip to hell, but atm I think I'd rather take a trip through hell than deal with TOS doctors anymore.

Hi Colleen,
Sometimes the way the report is written doesn't really give enough specifics.
I've seen a few where there is specific measurements listed , those are nice, tells how much something is compressing or protruding.

Did you get to look at the MRI films with the Dr?
did he show you where his concerns were on the films?

If not I would go back for these details and to see it for yourself before agreeing to any surgery - and take films to another dr for second opinion.
If you do agree to go with surgery -
Find the best rated surgeon for it so less chance of any complications or additional TOS aggravations.
Make sure they are aware of the TOS and cautious of your positions during surgery...

MRI-
i got a copy of mine - just because I wanted to have it. it did cost 10 dollars a page {5 pages of mine- C & T spine}

I have a CD of my MRI. I wont go back to the doctor I saw today. This was my 2nd visit... basically a lets see if my initial opinion was right, and it was.

My 1st visit he didn't even bother to look at my mri. Now he is ready to go cut.

I need to find a doctor who is willing to sit and talk to me about my options rather than someone who just wants to jump into the operating room.

I have an EXCELLENT recommendation for a neurosurgeon in the Carolinas, if this helps. Dr. Dennis Bullard. Let me know if you need his information. He did a very successful Trans-sacral fusion on my back last year AND was a partner of the surgeon in London, (Crockard) who fused my neck in '04. Crockard is widely known to be the top cervical neurosurgeon in the industry.
Bullard is also revising my neck next month to add two levels!?!?
How are you feeling?
D

Colleen I am right there with you.

I have TOS and have a c5/c6 complication that will eventually need an ACDF.

I am putting off surgery as long as possible.

Surgeons will always want to cut, they are surgeons its how they know how to fix things.

I do think and nerve root epidural might give you some relief for a while. It might help calm down those nerve roots.

Maybe a rhizotomy which could get you some longer term relief.

I sure hope you get some answers don't give up