Dear Lee,
Ahtough you sent me a PM, I am going to try and answer your questions here because the information might be helpful to others.
First, I am going to suggest that you post more specific info from your MRI so that others with similar issues can share their stories or compare their symptoms with yours.
Dr. Hoogland is very well respected in the world of percutaneous or endoscopic discectomy.
Although he stated that the cord compression shouldn't be a concern to you, perhaps he meant that yours was not so severe as to be a major concern although 50% sounds very severe--that is another reason to post specifics from your MRI. My MRIs state the diameter for the spinal cord space and my worst level is compressing the spinal cord to 7.9 mm, while the minimum space needed is 10 mm.
As for whether or not you should have surgery, only you can decide that. However, in my personal opinion, pain should not be the only determinant for surgery; prevention of spinal cord damage is more of a reason.
In regard to which surgery you should be looking at, my belief is that one should have the least invasive surgery that is effective for the situation.
I had a three-level cervical endoscopic discectomy (basically the same surgery as Dr. Hoogland described to you) in 2000. It resolved most of my symptoms most of the time; a few times each year, I had bouts of muscle spasms that were relieved with a few days of prescription muscle relaxants. However, I had a bone spur at one level that was left in place and that bone spur has continued to grow. I was able to work and live a relatively normal life with few restrictions.
Six years and seven months later, I suffered a new injury, re-injuring the same three levels plus one more. I was in excruciating pain, to the point that simply walking a few steps made the shoulder pain much, much worse; the slight movement of my arm felt like a knife being dug in. My left hand suffered wrist drop and claw hand. I could not raise my wrist or use my fingers at all. The wrist drop and claw hand slowly resolved, but more than one year later, my left hand still does not function normally.
If I were in your exact situation, I would do the following things:
1) find out exactly how severe the spinal cord compression is and how much you are at risk for cord injury (some of this can be determined from the MRI
2) get a second opinion from someone who does alternatives to fusions and fusions (most spinal surgeons only do fusions)
3) continue to do research on your own and learn as much as possible about your specific problem
4) research all your surgical and non-surgical options
5) assuming that your symptoms don't dramatically progress, allow yourself the time to make a truly informed decision prior to surgery.
Disclaimer: I am not a medical professional and what I have advised is based on my personal experience as a cervical patient.
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