Brief Answer:
Surgery for the neck- is this really the LAST RESORT? Really? Are you SURE?

Detailed Answer:
It's a bit out of the ordinary for a young man of 28 years to have such a neck condition as yours that would necessitate surgery because everything else has failed.

However, I can tell you something a very wise attending once told me regarding surgeries of the neck and back. Dr. XXXXXXX Daroff, Emeritus Professor in the Neurology Dept. at University Hospitals of XXXXXXX once told us (neurologists)....he said that we should never advocate SURGERY to any patient who has some type of radiculopathy or other painful peripheral nerve condition UNLESS there is measurable and ongoing MUSCLE WEAKNESS corresponding exactly to the level of the neck where the problem is being identified. He said that if our patients have gotten through all the paces of conservative physical therapy and medication and nothing seems to be helping then, we must order "the patient to bed...tell him to go to bed since this is likely the most definitive way for the patient to get any meaningful relief from his pain." Then, from that point forward it will be the patient will come to you and tell you that they are absolutely incapable of tolerating another day in the bed and that they absolutely want or need to get back to work or school....or whatever.

Then, it is time to discuss surgery.....Again, unless there is also muscle or dermatomal weakness that can be demonstrated and shown which if surgerized could have a positive impact. However, if it is just the expected mechanical or sensory pain symptoms that remain static for the most part...and there is no muscle weakness that can be measured then, surgery is not recommended.....UNLESS THE PATIENT SAYS, "Uncle."

Remember, you can't take back surgery once it's been performed....and in spinal column surgery the result is USUALLY A LESS STABLE bony skeleton to support the head and brain....than before the surgery. No matter how much pain relief is obtained through the surgery the outcome is almost always going to be something less stable over the long run than what you would have without the surgery...even though some degree of pain may be resolved through the surgery.....

You are the best judge to decide the answer to the question whether it is the right time....You are 28 and will likely live to a ripe old age of 90 or better if all goes well.....do you really think you've exhausted all avenues of pain management to the point where surgery is the only thing left to try and are you ready to take on the responsibility of additional surgeries (not uncommon) if this one or any subsequent fails....and be aware that there are a large number of cervical surgeries for pain management that either fail within the first few days or first few months due to columnar instability.

Please write to me at: www.bit.ly/drdariushsaghafi for more information or questions regarding this or any other medical topic on this network.

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