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New Here - Recent MRI Done and Shocked at The Results

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philm45
philm45

Hi guys,

Just new here and wanted to try and get some patient info rather than all the medical feedback that I quite frankly don't understand or trust.

Male age 49, started with pain in my right hand 4 years ago. Graduallt transferred to left hand and now is what I would describe generally as a combination of burning, aching tingling and numbness in both hands, wrists and forearms. No other issues, aside from that in good healtha nd do lots of regular physical activity.

Lived with the pain which has gradually got worse and probably is something like a 5/10 on the pain scale now.

Recent stressfull domestic issues seemed to agrivate the pains so finally decided to see a Spine Doctor (I am a Brit but live in the Philippines where medical care is excellent, especially when they see a foreign face with bulging pockets !)

The Dr did all the usual physical tests and none of them replicated the symptoms and her diagnised me with Carpal Tunnel Syndrome in both hands, to which I said "Sorry Sherlock, it ain't CTS).

Ok, he said, go do an MRI, which I just did and have the results (results pasted at the end of this post)

Went back to see the Dr and he said that I need surgery (Fusion of C5 and C6).

So, my quandry now is should I believe him or should I try a different approach.

The first paste below is the original MRI findings and the second paste is a second opinion that I got from an independant on line service.

Many thanks indeed Guys.

IMPRESSION: -BILATERAL NEURAL FORAMINAL STENOSIS AT C5-C6 SECONDARY TO RIGHT FORAMINAL DISC EXTRUSION ON THE RIGHT, BILATERAL UNCOVERTEBRAL JOINT HYPERTROPHY WITH PROMINENT SPUR ON THE LEFT. -CORD EDEMA, C5 AND C6.

Second Opinion

OPINION:

There is a moderate sized, posterior disc protrusion/osteophyte complex at C5/C6 causing moderate spinal canal stenosis, moderate compression of the cervical cord and cord edema. The segment of cord edema extends from the level of the C4/C5 disc to C6/C7 disc and affects the left hemicord more than the right hemicord. Significant bilateral foramen stenosis at C5/C6 with compression of both exiting C6 nerves (right more than left) seen.

 

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  • philm45
    philm45

    Posted

    H Brevis, many thanks for this update. To answer your last question, I am a Brit but I live in the Philippines, 49 year old active offshorre worker.

    So, on my side I have reached what I think is a viable conclusion and controlled gamble. I am booked for surgery for Saturday 16th May for C5/C6 discectomy and the insertion of a Prestige LP (the one without any screws or plates) I have a team of 4 lined up to do the job - Neurosurgeon, Spinal Surgeon. Orthapedic Surgeon and a wonderful general surgeon who happens to be a life long frind of mine. The cost is anticpated to be around 16K pounds and is being covered totally by my insurers. I am with Bupa and once I made my initial treatment authorisation request, went straight to the BUPA second opinion service and had them engage two spine experts, one from London and one from Switzerland. They came back with an excellent report and were unanymous in their diagnosis and treatment plan, so the insurance diddn't really have a gerat argument at hand. They did say that in my case the severity has been caused by a trauma, but nobosy knows better than myself, I jave not suffered any kind of accident in the last decade or so. Anyhow, its all systems go and fingers crossed for a favourable outocome smile

  • amanda_17683
    amanda_17683 philm45

    Posted

    I had mine done by a Neurosurgeon he was lovely, my second op they put the cage with plates and screws as they had to take out 2 vertebrea, and was allowed home the next day.  Good luck for Saturday, keep us posted.
  • philm45
    philm45

    Posted

    Thansjk once again Brevis. I may be wrong, but I feel I have really done my homework on this one and definitely don't want to go the fusion route. I have studied all the stats and pros/cons between both and the only shorcoming on the part of the artificial disc without fusion is that it hasn't been around long enough to get a true representation of its longevity. The great benefit of course, is that fusion is always an option at a later date if we do TDR initially, whereas doing fusion first, pretty much preculdes the optuion for future TDR.
  • philm45
    philm45

    Posted

    Thanks once again.............to be honest, I have never in my life had and type of surgery, let alone anesthesia and am totally ***tting myself !
    • Brevis
      Brevis philm45

      Posted

      You sound as though you are very fit, which will certainly benefit you with regards recovery. The chap who had the same operation as me the same day was up, walking and out of the hospital the next day! I stayed in 2 nights. It's not nearly as bad as the same operation in the lumbar region because they don't have to go through muscle. I have a tiny scar in the front of my neck which is barely visible (I am 3 months post op). Be prepared for muscle pain across the base of your neck - this is because of the position you will be in during the operation. I had a look on You Tube and saw some useful video diaries of people who had been through the same thing. I'm in touch with two people who had the same operation as me and it's very useful to keep in touch. I do hope all goes well for you.

  • philm45
    philm45

    Posted

    Sincere thanks Brevis, admittedly I have also looked a lot of YouTube videos, but more towards the surgery itself. I really don't like what I see but I am hoping that these wretched pains will go away, even if the ease by 50% I'll be a happy customer. Perhaps I mentioned earlen in my post, the pain is not ths issue, I can handle that and am well used to it now -  it seems to me (maybe psychological) but the pain is the root cause or many other symptoms such as being easily irritated, unable to concentrate, not doing daily tasks that I know I am capable of and many more....... The first thing I wlll do when I wake up on Saturday is check thet the toes ane still working smile that is my greatest concern, being proactive and in doing so, causing more harm thn good.
  • tracey64776
    tracey64776 philm45

    Posted

    hi there, unfortunately im not able to answer your question, but would like you to know you are not alone, my dr unfortunately hasnt been much help, so im looking for answers myself, hope you find the answer you are looking for, and i wish you every success with whatever you do end up doing, i will say this if in doubt check it out, get a second opinion if you arent happy, after all its youre spine yopu talking, again all the very best , tracey
  • Frances_1964
    Frances_1964 philm45

    Posted

    my goodness go for it i have suffered for four i got the injections only worked for a short time, i live in northern ireland and have totally been  refused surgery saying there is to big of a risk i m willing, but down to the usual with the nhs MONEY. i've worked all my life and asked for nothing when i need help,(well) i got paid off work because of the severe pain.
    • Gerry_the_neck
      Gerry_the_neck Frances_1964

      Posted

      Hi Frances

      It's not always just about the NHS funding.  Sometimes,  with C/S,  they won't recommend surgery if they can't determine the possible outcomes.  Different consultants will have different opinions on that....so it tends to be a lottery who you get.  There's always the option of asking for a second opinion from a different consultant,  and they might suggest surgery.  Behind all that,  there lies the fact that they know that surgery is risky,  and even if all goes well,  it doesn't necessarily fix as expected.  I'm pretty sure that if any of us saw 10 different consultants,  we'd still have to decide between 5 different options.  That's a reflection of the current science on C/S.  Sometimes 'benign neglect'  is a good way forward because the surgical options will still be available in the future.  There's every likelyhood that, in 10 or 15 years from now,  the surgical techniques will have improved significantly,  and any hold-off now might be a good thing,  despite the frustrations it causes.  The current surgical techniques are fairly recent,  and I think they are overused when other less invasive options should be explored first.

  • philm45
    philm45

    Posted

    Hi again all,

    Just to update you, I wemnt in to hospital last Thursday 14th, had surgery on Saturday 16th. Surgery took 6 hours. Has C5/C6 disc removed and had a Prestige LP replacement inserted. This is the type without ant screwsm plates or fusion. The worst part was that this was my first ever hospital stay in my 49 years worth of life so to be honest the hospital and anesthesia was my biggest issue to deal with. Was pumped with steroids, antibiotics, the whole lot during Saturday evening until being discharged yesterday (Monday) afternoon. A bit sore from all of the knocking and hammering that they must do but delighted to say that the spinal cord is freed and offending disk and associated bone spurs gone. Too early to tell if my initial symptoms have gone completely but will update later. Attached are two x-rays taken during the surgery showing the implant and its positioning. 

  • Robert_Jones
    Robert_Jones philm45

    Posted

    Hope all goes well for you - much my worst problem at the moment is the lower back and hip area: not a happy combination with CS, and I doubt that an operation would be of much help.  It's amazing what you can used to if you have to, but being more or less retired probably helps - I certainly couldn't do a full-time job with this condition, and feel sorry for those people of working age who are pushed to get a job by the Dept of Work and Pensions.
    • Gerry_the_neck
      Gerry_the_neck Robert_Jones

      Posted

      I feel exactly the same way about the new generation of C/S'ers.  Makes it look like we had it easy....which we didn't !.   I can't imagine what it would have been like,  or how depressing it would have been,   if current DWP regulations had been in place 20- years ago.  Only way is to keep making a noise on behalf of the younger ones.

      Philm....can't help but admire the technology.  Hope it works out.  Let us know when it settles down.

    • philm45
      philm45 Gerry_the_neck

      Posted

      Thanks Gerry, I will keep regular updates and will let everyone know the pros and cons as they come along. Nothing to report yet except that I can still walk and there are no new symptoms apart from feeling like I did 12 rounds with Tyson before they knocked me out last Saturday ! They really must be heavy handed on us when we are under anesthesia I guess.
  • philm45
    philm45

    Posted

    Hi all, 2 weeks post op now and glad to report that all is well. No new symptoms, no reduction in range of motion, scars healed and bandages off. Interestingly enough, the pre-op MRI did not show (or pehaps was poorly interpreted) bone spurs from C6 compressing nerve roots. Anyway job done, new Prestge LP fitted, bone spurs grinded down, possibly a 10% in reduction of symptoms (pain and tingling in both hands), nut the expectation of the surgery was to eliminate the potential problem as I had severe compression from a C/5/ C6 Herniated disc. The disc is gone, the implant is there now so lets see if the nerves ever heal, although I understand it may take a fair while.To be fair, despite having severe compression, my symptome were never so bad and I presume that the milder the symptoms, the milder the post surgery improvements. In summary happy happy for now. 
  • Robert_Jones
    Robert_Jones philm45

    Posted

    Sounds promising - looks like you had a good surgeon.   Hope all continues to go well, and the improvements you're hoping for come about in due course - patience would seem to be required here!  I presume you've got physio too, to help with a useful range of exercises: just don't go mad with that, it wouldn't be hard to undo a lot of the good work if you strain muscles which you need to support the deeper structures.  
    • philm45
      philm45 Robert_Jones

      Posted

      Thanks Robert, yes indeed, I plan to take things really easy for a few months and see how things go. Due to the type of implant that I had and the nature of the compression, the surgeon says that physio is not necessary as I never lost any muscle tone or strength prior to the operation. It is rather unbeleiveable when I look at the level of compression on the MRI but suppose that I was just one of the luckier ones maybe. I just wish I had done it sooner before the possible long term or even permanent nerve damage occured. Problem is that we all face, not one of us decides to go for a consultation or MRI at the first sign of any mild discomfort, we all seem to "wait and see". It is a impossible scenarion to do the right thing at the right time I suppose,
    • Gerry_the_neck
      Gerry_the_neck philm45

      Posted

      Glad to hear it went well.  You took the plunge and you deserve a good result.  I guess it will take some time for the neck to fully adjust to the new setup,  and hopefully there will be added improvements developing over time.  It's all good info for those of us who haven't yet made a decision.  I'd probably normally have something different to say about 'wait and see' and 'predictive' issues,  but I'll go with the flow on this.  Primary concern has to be re-hab of the surgical after-effects until you feel it's back to normal functioning.
    • philm45
      philm45 Gerry_the_neck

      Posted

      Thanks Gerry, too true on waiting and seeing. The biggest and most expected issue is having a 49 year old set of disc spaces, only one of which is brand new. I have no medical knowledge but a fair bit of engineering knowledge and appreciate only too well that the new implant will certainly do a great job but will place additional stresses on the adjacent and alerady weathered discs etc. Time will tell guys but I will definitely update periodically.
    • philm45
      philm45

      Posted

      Hi all, well 2 years on, medication free, but the dreaded pains are creeping back...... Same pain type but now more around the neck and left shoulder area. I've adequate experience now (I hope) so am going to bypass all of the preliminaries and get an MRI done as soon as I can to see what's occurring now. Don't want to pre-guess but I won't be surprised if C7/C7 has taken offence of big brother one level above and has gone into flat line, dried out sleep mode....... Updates soon after the next scan lads and lasses smile

    • RRobison76
      RRobison76 philm45

      Posted

      I hope it gets better for you.

      I had total disk replacement at two levels C4/C5 C5/C6. The implant is called Mobi-C. I hade the surgery in July of 2016, was pain free for 8 months and now all the pain is back, like I never had surgery.  Sucks. I see a pain Dr. and we  looked at all my MRIs back to 2010 and recently I had a CT scan with Mylogram (Post) and I’m still showing pinched nerves in the same location that I had the disk replaced the problem is I thought the surgery was supposed to  fix the pinched nerves and that’s what I was told by the surgeon. So I’m wondering did the surgeon do the wrong surgery on me? He has no answer for me why the pain is back. He now says I need a fusion. I said no. I don’t know what to do. 

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