Surgery for merely neck pain?--Dr Hoogland

[KL Aguilar]

Hi Lee,

I do not know enough about nucelotomy to answer your question, but I believe there is a detailed description on the Alphaklinik's website. A discectomy is when part, or all, of the disc is removed. In a cervical endoscopic discectomy (CED), approximately 10% is removed.

Prior to the three-level CED, I had constant shoulder blade pain, pain at the base of my neck, pain that radiated down my left arm, occasional "electrical shock pains" down my left arm, frequent numbness and tingling in my left hand, and occasional numbness and tingling in the right hand. Eight weeks or so post-op, almost all of my pre-op symptoms were relieved, except for some numbness in my fingertips and occasional bouts of muscle spasm pain in my shoulder blades.

I cannot say for sure that the compression was relieved as shown in a new MRI since I did not have one for more than six years--my insurance refused to pay for a new MRI as I had no ongoing symtoms.

I do not believe that discs will become healthy post-op. Black discs indicate that the discs are becoming dessicated and are degenerating. I have no idea what operation would fix that--nothing that is currently being done unless it's brand new. The purpose of endoscopic or percutaneous surgery is to remove the part of the disc that is compressing nerves or the spinal cord, not to repair the disc itself.

As for the space for the spinal cord (6.3 mm at C6-7 and 9.4 mm at C5-6), do you know what is reducing the space? Do you have a herniated or bulging disc that is pushing against the spinal cord or do you have bony growths that are reducing the space?

[Lee]

Hi KL Aguilar

I believe it is my herniated discs causing the compression as no doctor has yet mentioned bony growth though my MRI report did mention "spondylosis". Can you tell if there is bony growth just from the MRI pictures?

Can i ask what kind of pain you were experiencing in yr neck and shoulders? I would classify mine as more of "nagging discomfort,tight,stiff,sore,very tired" although my chinese massage therapist has told me from her experience that I have considerably high threshold of pain. Did your pain go away slowly after the op or you experienced immediate relief after surgery? Were you under general or local anaes? How often were your occasional bouts of spasms after that?

You mentioned you underwent surgery for "prevention of spinal chord damage". Since your symptoms do not sound compelling, dont you think it is kind of a pre-emptive action? This is something i think of a lot. Now my symptoms though nagging and frustrating are still bearable. But I am thinking long term, to prevent any irreversible damage since my chord is badly compressed though Dr Hoogland has advised otherwise 6 mths ago. That surgery should only be done if i really cannot take the pain.. I hv sent Alpha my latest MRI and still waiting for their diagnosis.

What led to your new injury?

[KL Aguilar]

"I believe it is my herniated discs causing the compression as no doctor has yet mentioned bony growth though my MRI report did mention "spondylosis". Can you tell if there is bony growth just from the MRI pictures?"

I personally cannot tell if there is bony growth, but any doctor or radiologist can. The medical term for bone spurs is osteophytes. Spondylosis is not bone spurs.

"Can i ask what kind of pain you were experiencing in yr neck and shoulders? I would classify mine as more of "nagging discomfort,tight,stiff,sore,very tired" although my chinese massage therapist has told me from her experience that I have considerably high threshold of pain. Did your pain go away slowly after the op or you experienced immediate relief after surgery? Were you under general or local anaes? How often were your occasional bouts of spasms after that?"

The pain was usually the way you describe: nagging discomfort. Sometimes others could feel a knot. Sometimes the pain felt as if something was forcibly pushing into the blade, almost knife like.

All the pre-op pain disappeared immediately following surgery although I suffered discomfort after the surgery, mainly a feeling of a sore throat, as if I were getting a cold. I was under various amounts of local anaesthesia: sometimes I was more or less asleep and then they would call my name and ask me questions. The occasional bouts of spasms happened between 2-6 times per year and sometimes seemed to be related to things I had done (long car rides, more exertion than normal, stepping off a curb wrong and suffering a severe jolt.

"You mentioned you underwent surgery for "prevention of spinal chord damage". Since your symptoms do not sound compelling, dont you think it is kind of a pre-emptive action? This is something i think of a lot. Now my symptoms though nagging and frustrating are still bearable. But I am thinking long term, to prevent any irreversible damage since my chord is badly compressed though Dr Hoogland has advised otherwise 6 mths ago. That surgery should only be done if i really cannot take the pain.. I hv sent Alpha my latest MRI and still waiting for their diagnosis."

I did not undergo my first surgery for prevention of spinal cord compression although that was part of the reason. I had surgery the first time mainly because I was unable to live a normal life. At times I was in too much pain to function well at work and at home. I was the sole support of four people: myself plus three children. I could not hold it together at work and do a good job. I came home and basically just tried to pull myself together for the next day. This time I will be undergoing surgery because 1) I am at too much risk for a spinal cord injury, 2) because the doctors will not release me to go back to work (again because I am at too much risk for a spine injury), and 3) because my left hand does not function normally. I was very lucky to have my "claw hand" resolve on its own; two surgeons told me it wouldn't. If anything else happens, the claw hand is likely to return and may not resolve.

"What led to your new injury?"

I had several heavy boxes of teacher editions in the back seat of my car. The one I needed was in the middle. I lifted the box over another one and turned to place it in a cart. As I bent down, I felt a searing pull from my neck to my shoulder blade. At the time, I did not realize how badly hurt I was, but within a week I was in excruciating pain, and about two to three weeks later, I woke up with my hand in a claw.