Cervical Percutaneous Nucleotomy-Dr Hoogland
 

Hi all, I belong to the "ticking bomb" category which Mark has mentioned in the thread "Rebound Myelopathy". I have cervical cord compression (30-50%) from 2 herniations in C5/6, C6/7 after an automobile accident 6mths ago, with manageable symptoms (stiffness,discomfort in neck,shoulders,head),mild weakness & numbness in left arm & fingers.

Surgeons in Singapore are split in their opinions.Some advised I should get surgery (ADR recommended) done so as to prevent the risk of paralysis should I fall down or possibility of slow irreversible paralysis over time (especially since Im only 27). The conservative ones think I should just wait as long as I could deal with the pain or change in lifestyle. Surgery to me is a very last resort especially since I seem to be coping,but after a high-regarded doc told me I have significant cord compression which should not be ignored,i feel my life has been stalled at a cross road junction until I make a decision. Pertinent question is: Should I address a "sleeping" problem? What if my current manageable symptoms worsen after surgery, especially since I heard that open surgery can lead to internal scarring and the pain lasts for life. Has anyone come across cases where ignored cord compression later led to paralysis?

To add to my frustration,after intensive physiotherapy for 4mths, not only did my first herniation at C6/7 did not improve, I had another herniation at C5/6 after a 2nd MRI. I wonder if my entire structure is now already unstable and I should do something about it before it worsens. Docs say "anything could have caused the 2nd slipped disc, nobody knows."

After much research,it seems that minimally invasive procedure might be the answer for me. Minimal tissue damage & risk but pressure off the cord can be relieved. The question that remains is, my discs seem to be degenerated (black on MRI). If only the herniated portion is removed, does it mean that my pain (asssuming its discogenic) will still be there? This is a question I will ask Alpha.I am also curious on whether abrasion can really help to regenerate disc and whether I will need to do it, and if abrasion is only practised at alpha? Is anyone familiar with the difference between Dr Hoogland & Dr Dekkers departments in Alpha? I've made an appoinment with Dr Hoogland as I've been recommended to him. Appreciate any feedback/ discussion regarding percutaneous nucleotomy (prescribed to me via online consultation) and Dr Hoogland. Chance of re-herniation is 5-8% and so far no major complication from surgery. Laser Spine Institue recommended that I do foraminotomy but i think any prosterior approach is risky. Im flying down to Munich in 10 days.

Cheers
Lee
PS: Upkeeping the optimism...

Hoogland and Dekkers' spine centers are completely separate businesses that operate out of the same building.

I don't know anyone with permanent paralysis, but I do know a couple of people with such rapid onset of very severe neuro deficit, that it's not difficult to imagine. I have had several clients with substantial cord compression, but without pain or substial symptoms. They understand the risks in waiting and some are proceeding prophylactally, while others are waiting. The client I wrote about on the 'rebound' thread has such a severely altered gait, but as I said, he waited more than a year in the presence of such severe symptoms. These are tough questions that you'll get conflicting answers to. I won't presume to know what you should do. Let me know if you want to talk,

All the best,

Mark

Lee,

I can't comment on your situation, but I've got symptoms throughout my body, particularly the legs, that started several weeks after injuring my neck.

They have slowly but surely gotten worse over time. My only advice would be that you know best what is going on in your body - make sure you are dealing with a surgeon that is listening to what you're saying and not just waiting until they seem some damage on your MRI scan (possibly irreversible).

My experience has been that you can be in a pretty bad way from the inside even though you look pretty normal from the outside (I'm sure everyone with a spine condition, lumbar or cervical understands this situation).

And a lot of surgeons seem to be very conservative about recommending surgery. You need to find someone that is both a respected/skilled surgeon, and that is also listening to you the patient.

Rob.

Anyone familiar with Dr Hoogland-Minimally Invasive?
 

Thanks Rob & Mark for your replies!

Appreciate feedback from anyone familiar with Dr Hoogland (also from Alpha Klinik) as I am flying down for consultation and possibly surgery next weekend or anyone who has done Percutaneous Nucleotomy or any kind of minimally invasive surgery for cervical region. Thanks!

Regards
Lee