MRI For Spine Done. No Relief From Gabapentin And Naproxin. Should I Go For Decompression Surgery?

Posted on Thu, 25 Apr 2013

Question: Hi. I am a female professional fighter/instructor. 30yrs. MRI report: reversal of cervical lordosis, hinged on c5/6. Large lateral disc osteophyte complex, resulting in severe narrowing of neural foramen, with associated indentation of thecal sac. I am currently on gabapentin/naproxin, which isn't working. I am on a waiting list to see a spine surgeon, and was refered by a consultant rhumatologist. unfortunatly, i didn't get to ask as much as i'd have liked. The consultant mentioned the next step as a possible decompression surgery, but didn't mention what that might involve. I would like to know if it comes to surgery, which of the decompression options do you think would be most appropriate. If I can have a choice, then I would want the one that would let me remain sporting for as long as possible. Thank you.

Answered by Dr. Shivakumar S. Kupanur (17 hours later)

Hello.

Thanks for posting your query.

Cervical decompression is releasing the pressure on the cord which are causing the symptoms. There are few options available. Decompression with fusion, decompression and artificial disc, or simple decompression.

In your case, considering your age, your profession and the findings you have provided, artificial disc will be more acceptable. But, I need to see your radiological report (MRI) and also clinically to comment whether you are ideal candidate for artificial disc (whether it will fit you).

So, I will suggest you to discuss all these things with your spine surgeon, as he/she has the opportunity to examine you clinically. Decision can be taken only after that.

I hope, I have answered your query. I will be available for follow up queries if any.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shivakumar S. Kupanur (30 hours later)

Thanks for your answer.
I do have my MRI on disc, but there are 180 photos, and I have no idea which ones are the most useful.

Assuming I am a suitable candidate for the disc replacement, can you explain to me why that might be better than a simple decompression?

My concerns for the 3 surgeries are:
ACDF: the potential for stress on the immediate discs above and below. (I am the least interested in this option, unless it proves the only option.)
Simple decompression: potential to leave me with instability in the spine.
ADR: the replacement joint may be hyper mobile compared to the other disc? (I read this in a clinical trial, but cannot find supporting evidence.)

Also, could you explain if a disc replacement would also correct the curvature of the neck?

Thank you.

Answered by Dr. Shivakumar S. Kupanur (2 days later)

Hello.

Sorry for delay in answering your query.

Considering your age, pathology and your interest in continuing sport profession, artificial disc replacement will be more reliable. It will leave your spine mobile, not hypermobile. It can also correct the spine curvature.

Assessment is required before surgery which any trained spine surgeon can do it. You can contact spine surgeon in your locality with your MRI report so that correct decision can be taken.

I hope, this answers your query. I wish you speedy recovery.

Regards.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar