Need some advice, herniated disk at C8

[driftwood]

I was just diagnosed with a herniated disk at C8 affecting the ulnar nerve in my left arm. The neurologist said that no amount of faith healing (chiropractors) or physical terrorism (therapy) or drug dealers (steriods) will help me. That leaves the blood letters (surgeons). My question is what type of surgry will have the highest rate of success while allowing me to continue diving after the recovery period?

[Kevrumbo]

EMG/Nerve conduction studies showing neuro muscular damage along my right arm --I can't extend my index finger anymore. Latest MRI shows significant nerve root canal/foramen narrowing and compression in the C5-C7 region, with disc herniation and osteophyte (bone spur) formation. Spinal Cord appears normal.

Looking at undergoing (or procrastinating!) a Cervical laminotomy/foraminotomy, anterior cervical discectomy and fusion. Hoping to recover in time for dive trips to Singapore/South China Sea in May and Cocos Island Costa Rica July next year. . . (If QB Peyton Manning can come back and play after this surgery, so can I!).
Pinched Nerve (Cervical Radiculopathy). . .).-.-.

Kerlan-Jobe Orthopaedic Clinic

[Thiad]

I am post instrumented ACDF C5-6 done in late 2009 for disc disease with posterior osteophyte.

The abbreviated version of my experience.. My surgery went fantastic so much so that within about a week, I did a lovely 3 mile hike (neck brace and all). I was back to work within 3 weeks and back to full activities within 2 to 3 months. It was uncomfortable at first, but I sought pain management through acupuncture throughout the first two weeks. The hospital stay was quick - overnight, and I was walking within a few hours of waking up.

It was interesting that within a few hours of the surgery, I immediately felt relief.

Since then, I have had minor complications. For the first 3 or 4 months, I had issues with sensation on my right side. I couldn't differentiate hot from cold. I had an EMG (which felt like I was wearing a shock collar), which indicated nerve damage most likely caused by the compression. It's taken almost the full two years for most feeling to return and I'd say I'm about 90 to 95% - which I can happily live with. I also found out that neck injury was masking a compressed disk in my lower back. Didn't feel it until after the surgery and now, they want to fix it (no).

I think that my turnaround time - when I started to feel "really" normal again (less the numbness), was about 5 or 6 months. I was pretty freaked out about whiplash or flipping my neck around too quickly. The only activity I probably wouldn't do at this point is ride a roller coaster. Today, I have a full range of motion and zero limitations.

The only caution I have is to fully research what you're going to do before it's done. Surgery is never easy and everyone's going to have a different experience. I read some real horror stories about the same surgery and then made the mistake of watching the surgery on youtube. Kind of freaked me out. But I also think pre-surgery conditioning has a lot to do with my success. I did my best to make sure I was in good physical shape before I was cut open and prepped myself physically for what I knew I'd go through.

Good luck with whatever you decide. I really do feel your pain.

[Dsix36]

I went through an anterior cervical discectomy with fusion. My surgery began at 8:03am on July 22, 2011 and by 10:31am I was awake in recovery. By 12:17am, I was cleared for release by the physical therapist and surgeon.

I had instant releif of any and all symptoms. I have been following the doctors orders following the surgey and made my first post surgery dives on Thankgiving Day. I have been progressing slowly and have now been below 200' and had over an hour of deco. I have experienced absolutely no issues with the surgery.

There is a lot to be said for your physical condition prior to the surgery. I did pre surgery exercises to get ready, as well as all the other reguired steps. Your surgeon should walk you through the entire process. I had to go to a special pre surgery consultation where we learned all about the recovery steps and possible side effects/issues.

Now on another note. My neighbor has had the same surgery and is experiencing a lot of problems. He is actually scheduled to have another surgery to try and find the source of the problems.

[Malpaso]

Have you considered acupuncture? I know some may consider it voodoo, but it's the only thing that has allowed me to be fully active with a blown L5/S1.

[driftwood]

I appreciate the thought but it has been made very clear to me that if the disk is not removed further nerve damage will continue to the point I will lose the use of my left arm and hand.

[Malpaso]

I appreciate the thought but it has been made very clear to me that if the disk is not removed further nerve damage will continue to the point I will lose the use of my left arm and hand.

Is this because the disk is damaged, or just bulging? Acupuncture (in my case at least) "shrunk" the disks so that they are not impinging on the nerves, at least not as much as when I could barley walk.

Also, have you gotten concurring opinions? I saw no less than 6 doctors about my situation, including the head of the spine clinic at Mass General. There was very little they agreed on.

I'm in no way downplaying your situation, just trying to offer some hope.

[Underdoc]

It's a truism that "If you are a nail, the solution to every problem is a hammer". "If you are surgeon..." So right off the bat let me state that I am a chiropractor. Before you repeat back my quote, I was taught that there is a progression of approaches you should take starting with the least intrusive and finishing with the most intrusive(surgery). Remember that when you cut, you have to go through healthy tissue to get to the damage. That means creating some more damage on your way to fixing the problem. That damage may always remain and cause new issues. Talk to your surgeon about the possible down sides of the surgery. Ask what is the success ratio of the surgery. You need to be able to balance the up side against the down side. Are you willing to live with the down side and is the down side worse perhaps than your present situation. I was also taught that having exhausted all your possibilities(chiropractic, physio, acupuncture) are you willing to take a chance on restoring your old lifestyle versus the possibility of the down side of surgery. If the success rate of the this surgeon or the surgery in general is 50/50 or even 80/20, you have some serious decisions to make.
Having said all this, you need to know what kind of disk damage you have. As you have seen from all the responses you've gotten so far, everyone has had different results. That's every person is different and will respond differently to different therapies. Am I saying that chiropractic isnotthe right answer for everyone? You bet! Is surgery not right for everyone? Same answer. So, do you have a disk protrusion,where the bulge will probably resolve on it's own without therapy, or do you have disk herniation where there is more damage but with conservative care it will eventually heal? The worst case scenarios the sequestered disk, where the protrusion has been "pinched" off and is now floating in the spinal canal waiting for an opportunity to do some real damage?
You need to have a clear idea of the seriousness of the situation and how it can best be resolved. Ask questions. If you don't like the answer, ask another expert. Keep asking until you have consensus of opinion that you can live with. Base your decision on how you want to live the rest of your life, not on whether you can go diving next year.

[driftwood]

The I was told by the neurologist that the MRI clearly indicated surgery was my only option. No drugs, physical therapy, chiropractic care, acupuncture or the healing effects of time was going to do any good.

In my first post I said C8, that was a mistake. The disk that had the blow out was at C7-T1. Paired the list of surgeons by consulting with my PCP and then called a personal injury attorney to get his opinion. They both came up with the same three surgeons. Between Larry, Moe and Curly only one was in network with my insurance.

Had the surgery in late January and was discharged the same day before rush hour. No complications and strength is returning at a nice clip.

[DocVikingo]

In my first post I said C8, that was a mistake. The disk that had the blow out was at C7-T1. Had the surgery in late January and was discharged the same day before rush hour. No complications and strength is returning at a nice clip.

Hey Driftwood,

The C7-T1 intravertebral disc sits in between the C7 and T1 vertebral bones. The C8 nerve root is the one typically involved in herniations or other injury of this disc.

Glad to hear your surgery appears to have been succesful.

Regards,

DocVikingo