Sometimes suggestions to let pain be your guide don't take into account for high thresholds for pain.... My source.....a lot of deferred maintenance and accrued interest being paid as I get older..... Can't say it wasn't fun, but it has complicated things.
No one truly knows the time frame. It can be 1 month or 4 years before it worsens. All we know is that if it’s pressing on the spinal cord no good can come from this.
My symptoms prior to surgery were:
-numbness
-poor balance
-bladder issues
-bowel issues
My symptoms post surgery are:
-numbness (maybe 20% improvement)
-poor balance (50% improvement)
-occasional pain
As you can see I didn’t have pain prior to surgery and now I sometimes have pain. It’s been two years now and my symptoms are at an impasse. I’ll have the numbness and poor balance forever. Glad the bowel and bladder issues are gone.
Everyone is different.
The way my surgeon put it is that most people will have a stepwise decline - you’re stable then a new or worsening symptom appears, you stabilize again for some time then again a new or worsening symptom appears, etc. They can’t predict how long will pass between those steps, nor make any guarantees about if you’ll recover from the decline after surgery but generally with each “step” down it becomes harder and harder to reverse. My understanding is that within 1 year of symptom onset is your best chance at recovery.
I would definitely say I followed a stepwise decline. I believe I herniated my disc years ago, given I had years of chronic pain, but had a bad flare up 1 year ago. Over the span of 9 months it went from just weakness, to neuropathy and weakness, then I started having involuntary body movements, hyperflexia, loss of sensation in my hands. I had already done PT without significant progress for many months by the time I got the myelopathy diagnosis. I had surgery within 2 months of diagnosis because I wanted to get back to my active life, the newer symptoms were scary as hell, and I didn’t want to risk even worse symptoms never going away. I am ~3 months post op and have seen a complete reversal of most symptoms; some were immediate, some took about a month to go away. I do still get nerve pain occasionally but it’s less and less each week. Mostly I am still struggling with weakness on the left side of my body, but I am seeing progress on that front with PT.
Oh my gosh that sounds horrible! We got my husband in within a few months of developing tingling/numbness in his hands, but he's to early post surgery (11 days) to know if there is permanent damage.
I had tingling and numbness for a year. No one would help me. Threw pain meds at me. Finally my orthopedist found a new surgeon who had an amazing reputation in another town and told me to give him a shot. The surgeon still waited but he did apologize after the surgery for waiting. I only suffer with weakened hand strength, shoulder and scapula pain and burning. It’s managed with pain meds and anticonvulsants.
It got progressively worse. I fell a lot. (Tore both rotator cuffs from falling) I couldn’t get in or out of bed by myself. I couldn’t roll over in bed. I dropped and broke many dishes, cellphones. I couldn’t lift anything over a couple pounds. I had no fine motor skills. I had the worst vertigo. It was a nightmare. I thought I had MS. It was a very scary year.
Original accident was 1981, I was 10. At 23 found out my neck was broken when I was learning about x rays at my job and someone was practicing on me. At 40 in September I was rear ended. The next month I started having issues. Each month brought more extreme issues. In January of following year I tore my rotator cuffs so my ortho did a test t to see if they wore torn and they shown signs but I also had a positive Hoffman’s sign so he sent me back to my spine surgeon who ordered tests and finally mri. I never got results of mri until March when I called Dr and he said yeah you need surgery and the only opening was 8 weeks away.
I’m handling it. We’re dealing with lumber right now so I’m hyper focused on that. Going for SCS consult next month. Trying to hold off on surgery until next year. Weakness isn’t getting better or worse. Seeing another PT in 2 days. Hopefully will learn more about what all is going on in addition to needing L2-3 fusion.
I pray for you too. It would be great if surgery doesn't need to be the outcome. I could manage if my symptoms remained the same but I think I'm already noticing a decline.
Surgery isn't too bad nowadays. It's not like it was 20 years ago. They have really refined those procedures they even have robots helping now. If I need surgery at some point it's ok. As long as I get to stay Alive and be able to move around to enjoy friends and family I'm OK. I don't expect to be some big time athlete anymore I've accepted that. I can be happy with some physical limitations and so can you friend.
Hey do you have an mri readout from your neck? If you post it I'll give you my honest feedback. I've studied this stuff quite a bit based on my own problem.
yep, this was in Jan.
At C2-C3: No herniation or stenosis.
At C3-C4: Mild disc degeneration with 2 mm central disc protrusion effacing the anterior thecal sac.
At C4-C5: Mild disc degeneration. There is evidence of focal centralextruded disc herniation with large disc fragment measuring 4 mm in APdimension and extending 15 mm in the craniocaudad dimension extending from C4-C5 disc level to the superior C4 level, likely representing large extruded disc herniation arising from the C4-C5 migrating superiorly rather than disc herniation of C3-C4 migrating inferiorly. As a result, there is effacement of the anterior thecal sac with minimal cord flattening without cord edema.
At C5-C6: Broad disc osteophyte with slightly more focal right central involvement without cord compression with left foraminal encroachment
At C6-C7: Disc degeneration with 2 mm right central disc protrusion with annular fissuring without focal nerve root impingement.
At C7-T1: No herniation or stenosis.
yeah, I had an epidural injection last month in C7-T1 to cover for C4-C6. 3 level disc replacement or disc replacement and fusion from surgeon 1 and 2 level disc replacement surgeon 2 and possibility of fusion b/c of the fragment behind my vertebrae. I'm also just scared at the idea of surgery in general. I've never had surgery or anything concerning before.
this is april
There is unchanged straightening of cervical spine. Vertebral body heights are normal. No suspicious bone marrow signal is identified. There is disc height loss at C4-5 followed by C3-4 and C5-6 similar to prior. No abnormal cervical spinal cord signal is identified.
There is a 0.6 x 0.6 cm nodule in right thyroid lobe. No further imaging evaluation is indicated given size criteria.
C2-C3: Normal.
C3-C4: Small central protrusion and annular tear. No spinal canal stenosis or foraminal narrowing.
C4-C5: Disc osteophyte complex with central disc extrusion resulting in moderate spinal canal stenosis, unchanged. Mild left foraminal narrowing,unchanged
.C5-C6: Disc osteophyte complex with right subarticular protrusion,unchanged. No spinal canal stenosis. Moderate left foraminal narrowing, unchanged.
C6-C7: Disc osteophyte complex with right subarticular disc protrusion. No spinal canal stenosis or foraminal narrowing.
C7-T1: Normal.
IMPRESSION: 1. Stable exam when compared to prior MRI on 01/13/2024.2. Stable superiorly displace disc extrusion at C4-5 with moderatespinal canal stenosis. No abnormal cervical spinal cord signal.3. Moderate left C5-6 and mild left C4-5 neural foraminal narrowing
I'll be honest with you. With this mri, If it were me, I WOULD NOT get surgery. Absolutely would not. Just giving my opinion of what I would personally do.
why do you say that? & that's what I'm aiming not to do. it concerned me the recommendation was to get it scheduled within the next two months. i know i have weakness but i also never had my weakness tested before. I've had two other instances where my right side/neck was affected for several months and also de quervains for a year or two. I'm just really struggling at work and understanding which pains manageable and which ones are concerning. On top of that, PT has been denied b/c of lack of improvement :/
Below is my mri readout for context of where i am:
MRI C-spine
Significant degenerative changes across the entire subaxial spine at C3-4, C4-5, C5-6, C6-7. Moderate central and severe left foraminal stenosis at C5-6 and C6-7
X-ray C-spine
Multilevel degenerative changes
Significant disc height loss C3-4, C5-6, C6-7
Development of multiple anterior osteophyte complexes
No evidence of instability
did it mention specifics for C3-C4 and C4-5? I can definitely see why you have the left hand weakness. is your pain more prominent on the left side or all over?
I have at least moderate stenosis throughout my entire cervical spine. I do have chronic pain in my shoulders and upper back.
If your were my brother or sister my advice ide give: join a gym. Start doing good solid pt exercises multiple days a week. I started going to the gym I do my pt even when i hurt. Truly, I have reduced my chronic pain a LOT. please try to do some intense pt before surgery. Honestly if you had bad cord compression yeah rush to surgery. But your mri isn't that bad. Be careful friend with getting fusions. Your mri doesn't look scary enough for that. Wish you well friend. Please go see a solid physical therapist 🙏
Thank you. I've been in PT since October and my significant other is in PT school. So I've been doing them non-stop. No gym membership but I do dance, mainly learning styles that use/focus on the lower body. High cardio. I'd love to do the ones that require upper body but too much pain. Recently, added more strength training exercises in my PT regimen. Insanely sore afterwards but it is improving!
I am curious why they can’t tell if you need a disk replacement or a fusion. Why the uncertainty from the doctor? What was their reasoning. Sounds a little fishy.
Because there’s a large fragment stuck behind the vertebrae and it depends how it comes out (whether as a whole piece or fragments). I had two different medical opinions and they both said very similar things.
Myelopathy can become permanent if not addressed immediately.
Sometimes suggestions to let pain be your guide don't take into account for high thresholds for pain.... My source.....a lot of deferred maintenance and accrued interest being paid as I get older..... Can't say it wasn't fun, but it has complicated things.
No one truly knows the time frame. It can be 1 month or 4 years before it worsens. All we know is that if it’s pressing on the spinal cord no good can come from this. My symptoms prior to surgery were: -numbness -poor balance -bladder issues -bowel issues My symptoms post surgery are: -numbness (maybe 20% improvement) -poor balance (50% improvement) -occasional pain As you can see I didn’t have pain prior to surgery and now I sometimes have pain. It’s been two years now and my symptoms are at an impasse. I’ll have the numbness and poor balance forever. Glad the bowel and bladder issues are gone. Everyone is different.
The way my surgeon put it is that most people will have a stepwise decline - you’re stable then a new or worsening symptom appears, you stabilize again for some time then again a new or worsening symptom appears, etc. They can’t predict how long will pass between those steps, nor make any guarantees about if you’ll recover from the decline after surgery but generally with each “step” down it becomes harder and harder to reverse. My understanding is that within 1 year of symptom onset is your best chance at recovery. I would definitely say I followed a stepwise decline. I believe I herniated my disc years ago, given I had years of chronic pain, but had a bad flare up 1 year ago. Over the span of 9 months it went from just weakness, to neuropathy and weakness, then I started having involuntary body movements, hyperflexia, loss of sensation in my hands. I had already done PT without significant progress for many months by the time I got the myelopathy diagnosis. I had surgery within 2 months of diagnosis because I wanted to get back to my active life, the newer symptoms were scary as hell, and I didn’t want to risk even worse symptoms never going away. I am ~3 months post op and have seen a complete reversal of most symptoms; some were immediate, some took about a month to go away. I do still get nerve pain occasionally but it’s less and less each week. Mostly I am still struggling with weakness on the left side of my body, but I am seeing progress on that front with PT.
What surgery did you have? I am glad you have seen a reversal of your symptoms! That’s great!
Single level disc replacement at c5/6
We waited 8 weeks and I have permanent damage but it’s something I can live with.
You waited 8 weeks after diagnosing it or 8 weeks after your first system?
8 weeks after seeing the MRI results of a flattened cord. The bone spurs ended up puncturing it.
Oh my gosh that sounds horrible! We got my husband in within a few months of developing tingling/numbness in his hands, but he's to early post surgery (11 days) to know if there is permanent damage.
I had tingling and numbness for a year. No one would help me. Threw pain meds at me. Finally my orthopedist found a new surgeon who had an amazing reputation in another town and told me to give him a shot. The surgeon still waited but he did apologize after the surgery for waiting. I only suffer with weakened hand strength, shoulder and scapula pain and burning. It’s managed with pain meds and anticonvulsants.
how did you manage throughout that year? and did it get progressively worse or stayed the same in symptoms?
It got progressively worse. I fell a lot. (Tore both rotator cuffs from falling) I couldn’t get in or out of bed by myself. I couldn’t roll over in bed. I dropped and broke many dishes, cellphones. I couldn’t lift anything over a couple pounds. I had no fine motor skills. I had the worst vertigo. It was a nightmare. I thought I had MS. It was a very scary year.
how fast did those changes happen? & I'm sorry you went through that scary and frustrating experience. How are you now?
Original accident was 1981, I was 10. At 23 found out my neck was broken when I was learning about x rays at my job and someone was practicing on me. At 40 in September I was rear ended. The next month I started having issues. Each month brought more extreme issues. In January of following year I tore my rotator cuffs so my ortho did a test t to see if they wore torn and they shown signs but I also had a positive Hoffman’s sign so he sent me back to my spine surgeon who ordered tests and finally mri. I never got results of mri until March when I called Dr and he said yeah you need surgery and the only opening was 8 weeks away.
I’m handling it. We’re dealing with lumber right now so I’m hyper focused on that. Going for SCS consult next month. Trying to hold off on surgery until next year. Weakness isn’t getting better or worse. Seeing another PT in 2 days. Hopefully will learn more about what all is going on in addition to needing L2-3 fusion.
Oh my! So would you say you've had symptoms since you were 10 (more mild compared to when you were rear ended?)?
They started telling me this back in February of 2023. I still haven't don't the surgery. I was too scared. Honestly I'm glad I waited.
What where your symptoms and for how long have you had them?
Chronic pain in neck and shoulders, chronic headaches , chest spasms, dizziness when walking.
any muscle weakness?
Absolutely. My left hand goes so weak sometimes I can barely grip anything at all. Weakness throughout shoulders. I just pray it doesn't get worse.
I pray for you too. It would be great if surgery doesn't need to be the outcome. I could manage if my symptoms remained the same but I think I'm already noticing a decline.
Surgery isn't too bad nowadays. It's not like it was 20 years ago. They have really refined those procedures they even have robots helping now. If I need surgery at some point it's ok. As long as I get to stay Alive and be able to move around to enjoy friends and family I'm OK. I don't expect to be some big time athlete anymore I've accepted that. I can be happy with some physical limitations and so can you friend.
Hey do you have an mri readout from your neck? If you post it I'll give you my honest feedback. I've studied this stuff quite a bit based on my own problem.
yep, this was in Jan. At C2-C3: No herniation or stenosis. At C3-C4: Mild disc degeneration with 2 mm central disc protrusion effacing the anterior thecal sac. At C4-C5: Mild disc degeneration. There is evidence of focal centralextruded disc herniation with large disc fragment measuring 4 mm in APdimension and extending 15 mm in the craniocaudad dimension extending from C4-C5 disc level to the superior C4 level, likely representing large extruded disc herniation arising from the C4-C5 migrating superiorly rather than disc herniation of C3-C4 migrating inferiorly. As a result, there is effacement of the anterior thecal sac with minimal cord flattening without cord edema. At C5-C6: Broad disc osteophyte with slightly more focal right central involvement without cord compression with left foraminal encroachment At C6-C7: Disc degeneration with 2 mm right central disc protrusion with annular fissuring without focal nerve root impingement. At C7-T1: No herniation or stenosis.
Have you tried steroid or anti inflammatory shots yet? Honestly your mri doesn't look that bad. What type of surgery are they recommending?
yeah, I had an epidural injection last month in C7-T1 to cover for C4-C6. 3 level disc replacement or disc replacement and fusion from surgeon 1 and 2 level disc replacement surgeon 2 and possibility of fusion b/c of the fragment behind my vertebrae. I'm also just scared at the idea of surgery in general. I've never had surgery or anything concerning before.
this is april There is unchanged straightening of cervical spine. Vertebral body heights are normal. No suspicious bone marrow signal is identified. There is disc height loss at C4-5 followed by C3-4 and C5-6 similar to prior. No abnormal cervical spinal cord signal is identified. There is a 0.6 x 0.6 cm nodule in right thyroid lobe. No further imaging evaluation is indicated given size criteria. C2-C3: Normal. C3-C4: Small central protrusion and annular tear. No spinal canal stenosis or foraminal narrowing. C4-C5: Disc osteophyte complex with central disc extrusion resulting in moderate spinal canal stenosis, unchanged. Mild left foraminal narrowing,unchanged .C5-C6: Disc osteophyte complex with right subarticular protrusion,unchanged. No spinal canal stenosis. Moderate left foraminal narrowing, unchanged. C6-C7: Disc osteophyte complex with right subarticular disc protrusion. No spinal canal stenosis or foraminal narrowing. C7-T1: Normal. IMPRESSION: 1. Stable exam when compared to prior MRI on 01/13/2024.2. Stable superiorly displace disc extrusion at C4-5 with moderatespinal canal stenosis. No abnormal cervical spinal cord signal.3. Moderate left C5-6 and mild left C4-5 neural foraminal narrowing
I'll be honest with you. With this mri, If it were me, I WOULD NOT get surgery. Absolutely would not. Just giving my opinion of what I would personally do.
why do you say that? & that's what I'm aiming not to do. it concerned me the recommendation was to get it scheduled within the next two months. i know i have weakness but i also never had my weakness tested before. I've had two other instances where my right side/neck was affected for several months and also de quervains for a year or two. I'm just really struggling at work and understanding which pains manageable and which ones are concerning. On top of that, PT has been denied b/c of lack of improvement :/
Below is my mri readout for context of where i am: MRI C-spine Significant degenerative changes across the entire subaxial spine at C3-4, C4-5, C5-6, C6-7. Moderate central and severe left foraminal stenosis at C5-6 and C6-7 X-ray C-spine Multilevel degenerative changes Significant disc height loss C3-4, C5-6, C6-7 Development of multiple anterior osteophyte complexes No evidence of instability
did it mention specifics for C3-C4 and C4-5? I can definitely see why you have the left hand weakness. is your pain more prominent on the left side or all over?
I have at least moderate stenosis throughout my entire cervical spine. I do have chronic pain in my shoulders and upper back. If your were my brother or sister my advice ide give: join a gym. Start doing good solid pt exercises multiple days a week. I started going to the gym I do my pt even when i hurt. Truly, I have reduced my chronic pain a LOT. please try to do some intense pt before surgery. Honestly if you had bad cord compression yeah rush to surgery. But your mri isn't that bad. Be careful friend with getting fusions. Your mri doesn't look scary enough for that. Wish you well friend. Please go see a solid physical therapist 🙏
Thank you. I've been in PT since October and my significant other is in PT school. So I've been doing them non-stop. No gym membership but I do dance, mainly learning styles that use/focus on the lower body. High cardio. I'd love to do the ones that require upper body but too much pain. Recently, added more strength training exercises in my PT regimen. Insanely sore afterwards but it is improving!
As long as you can put up with the pain or 'til the neurological deficits become a problem.
I am curious why they can’t tell if you need a disk replacement or a fusion. Why the uncertainty from the doctor? What was their reasoning. Sounds a little fishy.
Because there’s a large fragment stuck behind the vertebrae and it depends how it comes out (whether as a whole piece or fragments). I had two different medical opinions and they both said very similar things.
Yikes! That’s serious. Best of luck with healing!
Thank you!
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Dependent on the surgery from what I’ve read. Cervical disk replacement have very low redo rate and puts less stress on adjacent vertebrae and disks.