Donald Corenman, MD, DC
Moderator
Post count: 8368

I assume the nerve root compression is at the same level as the original compression. It is very good that you have no neck pain as your options are expanded. The symptoms that radiate into your thumb and index finger most likely indicate the C6 root (at C5-6). If you had a herniation at that level before, you probably have a combination of herniation and spur now.

Cervical surgery has four indications; Myelopathy (compression of the spinal cord), weakness of important motor groups (a C6 nerve would go to the biceps and wrist extensors), instability and pain that is not tolerable. Surgery for weakness is more of a value judgment but recovery of motor strength after surgery is not guaranteed. It is therefore probably better to not wait if weakness is a major factor.

Pain is the major surgical variable. If pain, numbness and paresthesias (pins and needles) are the only complaints, a program of physical therapy and nerve injections (SNRB- see web site)can be effective to control and manage the symptoms.

If the symptoms are intolerable, then surgery is warranted. Your choices are an ACDF (decompression and fusion) or an artificial disc. There are benefits and drawbacks with each (again- see website for descriptions of these).

Hope this helps.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.