Just a pain in the neck

[Mike Smith]

Well, sort of. I have been having numbness and tingling in my left arm and hand for @ 4 months. It finally got bad enough for me to go to the doctor. MRI and EMG/NCV were done. NCV showed minimal medial nerve delay, no biggie. However, the MRI was another matter. Degenerative disc disease with mild stenosis c5-c6 with no cord compression, moderate stenosis c6-c7 with no cord compression. One round of oral corticosteroids, one CESI and 3 sessions of cervical traction haven't helped. So today I saw the surgeon, and of course he has a hammer and I look like a nail. He is recommending ACDF C6-C7. So to my questions. First and for most is, what is my long term prognosis if I have this surgery? Do I want autograft or allograft? Hardware? Have I exhausted non surgical remedies, or do I continue with PT a while longer? Chiropractor? And far in the rear, what does it mean for a class III? Thanks in advance for any insight.

ETA. I know jack nothing about medical stuff, I wrote this from memory it may be all jacked up.

 

[BrianR]

Mike, I'm in the medical field, but this is not my area of expertise. However, I do have some personal experience here. I had similar symptoms a few years ago. First, I'd be loathe to let a surgeon near my spine until I'd exhausted all other options. And if I did, it would be a neurosurgeon, not an orthopedist. You are correct, if you seek an opinion from a surgeon in this situation, it will likely be to operate. And this may end up being your best option.

But be sure you carefully review the alternatives. For my situation, I went to physical therapy for, I think, 4 or 6 weeks, at the conclusion of which, my symptoms had resolved. My cervical spine still looks like a 70 year old's, but I've had only one recurrence of the discomfort, which promptly resolved with the exercises the PT had recommended.

Dr. C may be along to comment further on the effects on your third class, but I don't think it's a big issue, as long as you have the ability to safely conduct pilot operations. He doesn't give medical advice here, only certification advice. But that being said, he used to practice pain management, and knows this stuff upside down and backwards, so he could no doubt cite the statistics for long-term outcomes for surgical vs conservative approaches.

 

[gkainz]

Did the oral steroids last fall with very limited relief for sciatic pain. I'm now doing traction (spinal decompression) for L4 L5 stenosis, bulging disk and nerve impingement (sciatic) and, according to the chiropractor I use, 20 visits for traction is his recommendation.
With over 100 patients treated who were recommended surgery, he says only 2 went with surgery after this treatment.

 

[bbchien]

That's probably a good summary, Mike.

The real trouble with surgery is this: Imagine a bicycle chain with a frozen link. We've all seen one. The linke before and the link after "klunk" coming off ot he sprocket. When you fuse a link in your neck, the two joints, one above and one below pick up the slack for motion, extension, flexion etc. So those joints are under greater stress.

IF you continue to use your neck as if it has had no fusion, you hasten the same preocess to the one above or the one below. So a lot "depends".

Most wait until there is no option but to proceed- it gets unbearable. But also do not wait until you have weakness. Weakness Never recovers fully, andit recovers slowly.

FAA doesn't care so long as you don't need meds afterwards. They care equally about use of meds with NO surgery, and use of meds AFTER the post op surgical period.

 

[Mike Smith]

Thank you all for the responses. I have decided to maintain the wait and see approach, continue PT and naproxen for a while.

 

[Mike Smith]

One more question, I guess this would be for Doc. My medical will expire 6/1, should I just let it expire and renew after all this is over? I'm not flying right now anyway. Thanks again to everyone for the advice.

 

[bbchien]

I'd just let it go and re-up when all is said and done....

 

[douglas393]

PM sent.

Doug