Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
147 Doctors are Online

Have numbness in hand, neck and head after surgery. Had cervical disc herniation. Help?

User rating for this question
Very Good
Answered by

Spine Surgeon
Practicing since : 2002
Answered : 322 Questions
Question
The numbness of my right hand has came back after 2 months since surgery on this March this year at Wooridul Spine Hospital in Korea, so I need the correct treatment as soon as possible.
If I need the second surgery for my cervical spine, I have to treat completely all the problems occur, namely I have to avoid another surgery after the second surgery.
Currently I have the numbness of my right hand and also dull pain from my neck and back head, I think this is coming from cervical disc herniation, so my neck will be tired and uncomfortable soon from the dull pain.
I feel my slipped discs - C3-4-5-6 are out of control and have to replace the artificial discs by Total Disc Replacement.
I have to avoid to remain the numbness and the dull pain after second surgery and I want to start sports, walking, gardening and house renovation without the corset of the neck.
Currently I have to wear the collar all the time, because my neck is very unstable now.

I would like to ask you the following question.

1. I have a full consultation from Korean another hospital as a second opinion as follow.

The spinal disease is C3-4-5-6 disk herniation and C5-6 foramina nervosa stenosis.
Especially C3-4 you had a surgery at Wooridul Spine Hospital has recurred and I have confirmed the disk herniation by the burst of disk XXXXXXX nucleus pulposus, also C5-6 has disk herniation and a foramina nervosa stenosis as following pictures.
You need a surgery treatment as following selections with C5-6 foramina nervosa stenosis.
a. Artificial Disc Replacement - C3-4-5-6, 3 parts
b. Artificial Disc Replacement - C3-4-5, 2 parts and ACDF - C5-6, 1 part

But ACDF surgery make integrate by one artificial bone with 2 real upper and lower bones, so after surgery, it has limited movement and the bigger problem will be possible to happen the disk herniation again or regressive change of disks, as the upper and lower of integrated bone by ACDF surgery become more movement than before.
Artificial Disc Replacement perform completely the same role with normal disk, so after surgery, the upper and lower bones of the treatment part can perform without excess, therefore the other problems don't occur by this surgery and the artificial disk can work 60 to 70 years, so there is no necessary of the second surgery.
Namely I strongly recommend you take ADR treatment of 3 parts for complete treatment.

But when I have a full consultation in Australia, the specialist advise me the following "b" is best solution and he says C5-6 should not treat with ADR.
b. Artificial Disc Replacement - C3-4-5, 2 parts and ACDF - C5-6, 1 part

Which is the best solution "a" or "b" for my condition?
If "b" is better, why don't you recommend TDR at C5-6?

Also, regarding C5-6, don't I have a intervertebral foramina stenosis and need a surgery as attached information?

I hope you can advise and answer me by email.
Posted Fri, 2 Aug 2013 in Back Pain
 
 
Answered by Dr. Rahul D Chaudhari 1 hour later
Thanks for the writing to us.
You have very valid questions. You have stenosis at C3-6 levels. Ideal indication for disc replacement is soft disc herniation where you removal minimal bone to prepare the end plates for the implant. If you have foramainal stenosis which is due to bony spurs and in such situation to decompress the nerves you need to remove more bone and it may compromise the implant stability.
Another thing I want to clear that if you do disc replacement it does not guarantee that you will preserve the motion at those levels for more than 10 years. Although the disc replacement is good option but that does not mean that it will totally prevent the disc degeneration at upper and lower levels. If you read the literature it does not prove the assumption that it prevents the adjacent
level problems.
In your situation I would not consider doing disc replacement at C5-6 level as it showing significant disc height reduction with foraminal stenosis. Option B is better. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Have numbness in hand, neck and head after surgery. Had cervical disc herniation. Help? 26 minutes later
Dear Dr Chaudhari

Thank you for your advise in deitails.
I would like to proceed the second surgery carefully and decide the best solution, so I hope other surgeons give me your opinion.
Follow-up: Have numbness in hand, neck and head after surgery. Had cervical disc herniation. Help? 1 hour later
>Another thing I want to clear that if you do disc replacement it does not guarantee that you will preserve the motion at those levels for more than 10 years. Although the disc replacement is good option but that does not mean that it will totally prevent the disc degeneration at upper and lower levels.

According to the above advise, I worry to fulfill the artificial disk replacement, as this surgery is good option, but not perfect and no guarantee that I preserve the motion the level for more than 10 years.
I am still 44 years and want a bright future and would like to go back to a normal life including playing sports.
If I decide the surgery as "b", I need your advice how long does it work normally?
I understand it is very important the care of the post surgery, but I want your opinion, because I don't want to make the surgery anymore.
Also in Australia, the specialist has recommended "C" option is good as well.
Which is the best solution in the following selection for my condition?
And if I decide "a" option, what may happen after surgery?

a. Artificial Disc Replacement - C3-4-5-6, 3 parts
b. Artificial Disc Replacement - C3-4-5, 2 parts and ACDF - C5-6, 1 part
c. Artificial Disc Replacement - C3-4, 1 part and ACDF - C4-5-6, 2 part
 
 
Answered by Dr. Rahul D Chaudhari 2 hours later
Hi,

Thanks for writing back.

I understand your point.

I would still consider ADR option. B or c option can be considered.

Leave it to operating surgeon. Sometimes we make intraop decisions.

Thanks.
Above answer was peer-reviewed by
 
Follow-up: Have numbness in hand, neck and head after surgery. Had cervical disc herniation. Help? 13 hours later
Dear Dr Chaudhari

Thank you for your reply.

If I make operated by "a" option, what may be happened after that?
I want a neck movement as normal as possible without the problem.
 
 
Answered by Dr. Rahul D Chaudhari 5 hours later
Three level disc replacement results are highly debatable and very few patient being studied who underwent such procedure. Again you need to think about implant stability to minimise possible complications related to ADR. Few patients with ADR may need revision for implant related problems. Its not full proof that if you do 3 level ADR and you will not need revision surgery.
In the end you need to discuss with your operating surgeon about it. Every surgeon has comfort level with particular procedure. Thanks.
Above answer was peer-reviewed by
 
Follow-up: Have numbness in hand, neck and head after surgery. Had cervical disc herniation. Help? 2 hours later
Dear Dr Chaudhari

Thank you for your prompt advice.
As I say, this is my second surgery and I am afflicted with Australian surgeon - 2 ADR + 1 ACDF or Korean surgeon - 3 ADR and the both has a good and bad point.
Australian surgeon
Good point
1. I live in Gold Coast, Australia, so it is easy to have a contact with the surgeon in a pre and post surgery.
2. Surgery expense is half than the Korean one.
3. I believe 2 ADR+1ACDF is best solution for my condition.
Bad point
1. It takes a long time to proceed all and I still have to wait to do a nerve conducting study at a private hospital for 1 month, then have to make an appointment with the specialist, then have to decide what is the best solution, then have to wait at least 6 weeks after that for a surgery.
In Australia, this is the negative point.
2. It is difficult to make an appointment with the specialist soon even if there is urgent problem like the strong and sharp pain and numbness.
3. I have a bad experience of my knee arthroscopy surgery that it takes 2 years to relief a pain and settle after surgery since August 2010.
I feel the surgery to take in Australia is risky.
I understand this depends on a surgeon, but I had a lot of amazing experience in hospital.

Korean Surgeon
Good point
1. Everything speedy and provide details report - the remote consultation reply and the surgery date etc.
I have contact with Korean medical consultant and he can speak a fluent Japanese, so it is easy to communicate with him and he will organize that the president of the Nanoori hospital will make a surgery for me. The surgeon has a lot of experience of the spine surgery. He can promise me I can take a surgery end of this month.
As you know, I have a lot of discomfort from my intervertebral disks problem, so I would like to relief from such a stress, therefore I appreciate the surgery fulfill as soon as possible.
2. Good and kind support
If I have a questions, he can reply me as soon as possible.
In Australia, it is very slow.
The consultant organize I can speak with a patients who took a ADR surgery in Korea to relief a worry.
I will speak with patient who took 3 ADR surgery in Korea soon.
3. The "b" option can make in Korea, but they recommend me "a" option.

Bad point
1. Very expensive - the expense is double than Australian one.
2. Far from my living place which means it is not easy to go there and chat with a surgeon.
3. The care of the post surgery

I can't decide yet which is Australia or Korea.
The expense is important, but the best surgery for my condition is the most important.
So I need you and other surgeons opinion.
Thank you.
 
 
Answered by Dr. Rahul D Chaudhari 17 minutes later
I understand your situation. I think you will have to make those decisions. Even I can provide you the best quality treatment at a very cheaper rate. May be less than 15k. I am us trained surgeon and will do the best job. Thanks.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics

The user accepted the expert's answer

Ask an Orthopaedic Surgeon

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor