Follow up Neurosurgery visit

J&G, interesting a CT was done. Sorry I can not remember what your MRI showed. What I am reading you have mild bulging disc, mild stenosis which means narrowing & two spurs. I would not worry about the resident. The main thing is the neurosurgeon sat & listened & talked. It is worth giving PT a good effort to see how you respond. By the way, the mild bulging disc are ok, people have bulging disc & do not even know it until they have diagnostics done. Bulges & herniations can heal on their own. When do you see the dr again? Please keep us posted.

Jaken:
It is wise to adopt a course of conservative treatment and symptom management as a first - line approach.

Any surgery has the risk of unexpected consequences and a less than ideal outcome.

I hear you and acknowledge your troubling upper extremity pain and motor weakness. That the resident failed to acknowledge your symptoms is obviously upsetting to you. That alone leaves you subjectively feeling that the appointment was inadequate and impersonal.

Almost everyone has disc bulges - that is, small extrusions of diac material. Thoracic and lumbar protrusions are a common incidental finding when individuals have imaging studies. A bulging or protruding disc is not addressed with surgery as a first line treatment option.

The truth is that most disc protrusions will retract on their own with time and patience. The disc material receeds on its own. Disc material is a thick and viscous consistency and morphs easily.

Physical therapy will likely include manual traction that applies long-axis traction, to ease protective and reactive muscle co-contraction. The long-axis traction provides a posterior directing moment, enabling the disc material to recede. Physical therapy will also provide postural alignment - again, with an intent to provide an energy to direct the disc material to flow posteriorly back into the body of the disc space.

Posture is key. The human head weighs about 10-12 pounds. It is analogous to a bowling ball suspended on a thin pole (which is the next). A forward oriented posture - shoulders rounded forward and head forward ) is typical in upright humans. This places an inherent stress on the cervical vertebrae, translating top down. A frequent root cause of recurrent headaches and disc protrusions is owing to the forward posture of the head and shoulder girdle.

Find a physical therapist that is a good "fit" for you. A congruence of personality and work style. A good relationship is a collaborative relationship where you, the client, are involved in the plan of care. A good therapist will constantly evaluate and treat during the physical therapy session - modifying and tweaking exercises, modalities, postural re-education as the session is in progress. Use your voice to communicate to the therapist with regards to pain, stiffness and range of motion, what is working/aiding you, and what is not working/hinderence to you.

The body has amazing abilities to heal itself. I would give your body ample time to resolve and heal your cervical disc protrusions.

Best wishes for healing,
Karen

Yes absolutely, was pleased with the overall appointment. Just the choice of words. We all have to learn and would not have any problems seeing either of them again. Both very professional. It just strike me funny, my thought was, wait a minute I have been miserable with all this pain and it's nothing?!? That was my only concern.

Thank you Sarah for your response. I have not gone back to my neurosurgeon yet. I have PT this week and then two weeks later I go back to him. Hoping he doesn't say anything bad but worried that maybe my problem isn't just my disc but the bone spurs. What do they normally do for bone spurs? Anyone know???

Sarah, gave you a very good explanation about the bone spurs. The spurs can irritate things causing a lot of inflammation, this is where steroids can help get the inflammation down. Conservative care is the first line of treatment for this condition. Surgery is also a last resort, any reputable dr will recommend conservative care before going the surgery route. You certainly do not want some knife happy cat taking care of you. Here is another thought too, the dr may consider a short course of oral steroids for five days or so, something like a Medrol Dosepak. If I remember correctly my son did that prior to having an ESI.

If it comes down to you having injections you do want a dr that is trained to do them & the injections should be done by guided imaging to insure the correct area is being injected. I recently had a Ct of my neck, I have implanted metal & cannot have MRI's. I have had neck problems for years but as I have gotten older & have a lot of narrowing at multiple levels, spurring & disc issues, lots of nasty things going on. My PM dr started me on Gabapentin because of the nerve pain. I have a lot of burning pain in my shoulder & upper arm. Narcotics will not touch nerve pain, this is why he rx'd the Gabapentin.

If you want to read about your neck problems, go to SpineUniverse.com., its an excellent site to read about spine issues. The more informed you are about your condition the better for you. Drs. tend to not always go into a lot of detail with us patients.

Hang in there.

JakenGess, please look at your thread on the front page called cervical myelopathy I believe is the title. I have addressed some surgical issues there.