I'm a 35-year-old male trying to decide whether to undergo cervical spine surgery now or continue monitoring. I've seen a spine surgeon and have had multiple discussions with him, but I'd really appreciate hearing from people who've been through something similar.

MRI Impression

• Congenital block vertebrae at C3–C4.
• Multilevel degenerative disc disease with spinal cord and nerve root compression.
• Severe cervical spinal canal stenosis, which becomes even more pronounced when my neck is extended.
• My surgeon told me that there is virtually no cerebrospinal fluid (CSF) left around my spinal cord at the most compressed level, meaning the cord is almost completely surrounded by bone/disc rather than its normal protective fluid.
• T2 hyperintensity within the spinal cord at C5/C5–6, consistent with compressive myelopathy.

My symptoms

• Most of my hand symptoms have been present for around 4 years.
• Constant numbness/tingling in my ring and little fingers on both hands.
• Clawing of my right hand with muscle wasting in the palm below my little finger (my doctors think this may also be related to a separate ulnar nerve issue).
• My left triceps muscle twitches/fasciculates if I bend my elbow to a certain angle and hold it there.
• Occasional knee buckling, which I've only noticed relatively recently, although I'm not sure exactly when it started.
• Leg stifness, feel rigid at times. Numbess if i stand in the same place for 5 minutes
• subtle balance changes on one leg that I'm not even sure are related. impossible to wear shoes using just 1 leg
• No major weakness.
• I can still work full-time, drive, go to the gym, and play badminton.
• I occasionally wake up from sleep because an entire hand (and sometimes the area below my wrist) becomes extremely numb. It usually improves after changing position or moving my arm.

Neurological examination

• Positive Hoffmann's sign.
• Positive Babinski response, more pronounced on the left.
• Other neurological examination findings were also more abnormal on the left side.

What my surgeon said

• This is not an emergency.
• I'll likely need surgery at some point in my life.
• I could choose surgery now or continue monitoring with follow-up every 6 months.
• Waiting carries the risk of further spinal cord damage, and any neurological deterioration may not be completely reversible.
• Surgery is intended to prevent further neurological decline, not necessarily reverse existing spinal cord damage.

He has left the decision to me because my symptoms are still relatively mild and I'm functioning well day to day.

My dilemma

This is one of the hardest decisions I've ever had to make.

On one hand, I'm only 35 and I'm still active. If surgery can preserve my current neurological function before things worsen, it seems like a good opportunity.

On the other hand, surgery has its own risks, and once a fusion is done there's no going back. Since this isn't considered an emergency, I wonder if I'm operating too early.

I feel caught between:

• having surgery before it's absolutely necessary, or
• waiting too long and missing the chance to prevent permanent spinal cord damage.

My questions

1. Did anyone here have surgery while their symptoms were still considered mild?
2. Looking back, are you glad you had surgery early?
3. Did anyone decide to wait? If so, how did that work out?
4. If your MRI looked much worse than your symptoms, what ultimately influenced your decision?
5. Has anyone regretted either having surgery too early or waiting too long?

I'm not looking for medical advice instead of my surgeon's opinion. I'm simply hoping to hear real experiences from people who've faced a similar decision, because it's been mentally exhausting trying to figure out the right path.

Thank you for taking the time to read this.

I'm a 35-year-old male trying to decide whether to undergo cervical spine surgery now or continue monitoring. I've seen a spine surgeon and have had multiple discussions with him, but I'd really appreciate hearing from people who've been through something similar.

MRI Impression

• Congenital block vertebrae at C3–C4.
• Multilevel degenerative disc disease with spinal cord and nerve root compression.
• Severe cervical spinal canal stenosis, which becomes even more pronounced when my neck is extended.
• My surgeon told me that there is virtually no cerebrospinal fluid (CSF) left around my spinal cord at the most compressed level, meaning the cord is almost completely surrounded by bone/disc rather than its normal protective fluid.
• T2 hyperintensity within the spinal cord at C5/C5–6, consistent with compressive myelopathy.

My symptoms

• Most of my hand symptoms have been present for around 4 years.
• Constant numbness/tingling in my ring and little fingers on both hands.
• Clawing of my right hand with muscle wasting in the palm below my little finger (my doctors think this may also be related to a separate ulnar nerve issue).
• My left triceps muscle twitches/fasciculates if I bend my elbow to a certain angle and hold it there.
• Occasional knee buckling, which I've only noticed relatively recently, although I'm not sure exactly when it started.
• Leg stifness, feel rigid at times. Numbess if i stand in the same place for 5 minutes
• subtle balance changes on one leg that I'm not even sure are related. impossible to wear shoes using just 1 leg
• No major weakness.
• I can still work full-time, drive, go to the gym, and play badminton.
• I occasionally wake up from sleep because an entire hand (and sometimes the area below my wrist) becomes extremely numb. It usually improves after changing position or moving my arm.

Neurological examination

• Positive Hoffmann's sign.
• Positive Babinski response, more pronounced on the left.
• Other neurological examination findings were also more abnormal on the left side.

What my surgeon said

• This is not an emergency.
• I'll likely need surgery at some point in my life.
• I could choose surgery now or continue monitoring with follow-up every 6 months.
• Waiting carries the risk of further spinal cord damage, and any neurological deterioration may not be completely reversible.
• Surgery is intended to prevent further neurological decline, not necessarily reverse existing spinal cord damage.

He has left the decision to me because my symptoms are still relatively mild and I'm functioning well day to day.

My dilemma

This is one of the hardest decisions I've ever had to make.

On one hand, I'm only 35 and I'm still active. If surgery can preserve my current neurological function before things worsen, it seems like a good opportunity.

On the other hand, surgery has its own risks, and once a fusion is done there's no going back. Since this isn't considered an emergency, I wonder if I'm operating too early.

I feel caught between:

• having surgery before it's absolutely necessary, or
• waiting too long and missing the chance to prevent permanent spinal cord damage.

My questions

1. Did anyone here have surgery while their symptoms were still considered mild?
2. Looking back, are you glad you had surgery early?
3. Did anyone decide to wait? If so, how did that work out?
4. If your MRI looked much worse than your symptoms, what ultimately influenced your decision?
5. Has anyone regretted either having surgery too early or waiting too long?

I'm not looking for medical advice instead of my surgeon's opinion. I'm simply hoping to hear real experiences from people who've faced a similar decision, because it's been mentally exhausting trying to figure out the right path.

Thank you for taking the time to read this.

I'm a 35-year-old male trying to decide whether to undergo cervical spine surgery now or continue monitoring. I've seen a spine surgeon and have had multiple discussions with him, but I'd really appreciate hearing from people who've been through something similar.

MRI Impression

• Congenital block vertebrae at C3–C4.
• Multilevel degenerative disc disease with spinal cord and nerve root compression.
• Severe cervical spinal canal stenosis, which becomes even more pronounced when my neck is extended.
• My surgeon told me that there is virtually no cerebrospinal fluid (CSF) left around my spinal cord at the most compressed level, meaning the cord is almost completely surrounded by bone/disc rather than its normal protective fluid.
• T2 hyperintensity within the spinal cord at C5/C5–6, consistent with compressive myelopathy.

My symptoms

• Most of my hand symptoms have been present for around 4 years.
• Constant numbness/tingling in my ring and little fingers on both hands.
• Clawing of my right hand with muscle wasting in the palm below my little finger (my doctors think this may also be related to a separate ulnar nerve issue).
• My left triceps muscle twitches/fasciculates if I bend my elbow to a certain angle and hold it there.
• Occasional knee buckling, which I've only noticed relatively recently, although I'm not sure exactly when it started.
• Leg stifness, feel rigid at times. Numbess if i stand in the same place for 5 minutes
• subtle balance changes on one leg that I'm not even sure are related. impossible to wear shoes using just 1 leg
• No major weakness.
• I can still work full-time, drive, go to the gym, and play badminton.
• I occasionally wake up from sleep because an entire hand (and sometimes the area below my wrist) becomes extremely numb. It usually improves after changing position or moving my arm.

Neurological examination

• Positive Hoffmann's sign.
• Positive Babinski response, more pronounced on the left.
• Other neurological examination findings were also more abnormal on the left side.

What my surgeon said

• This is not an emergency.
• I'll likely need surgery at some point in my life.
• I could choose surgery now or continue monitoring with follow-up every 6 months.
• Waiting carries the risk of further spinal cord damage, and any neurological deterioration may not be completely reversible.
• Surgery is intended to prevent further neurological decline, not necessarily reverse existing spinal cord damage.

He has left the decision to me because my symptoms are still relatively mild and I'm functioning well day to day.

My dilemma

This is one of the hardest decisions I've ever had to make.

On one hand, I'm only 35 and I'm still active. If surgery can preserve my current neurological function before things worsen, it seems like a good opportunity.

On the other hand, surgery has its own risks, and once a fusion is done there's no going back. Since this isn't considered an emergency, I wonder if I'm operating too early.

I feel caught between:

• having surgery before it's absolutely necessary, or
• waiting too long and missing the chance to prevent permanent spinal cord damage.

My questions

1. Did anyone here have surgery while their symptoms were still considered mild?
2. Looking back, are you glad you had surgery early?
3. Did anyone decide to wait? If so, how did that work out?
4. If your MRI looked much worse than your symptoms, what ultimately influenced your decision?
5. Has anyone regretted either having surgery too early or waiting too long?

I'm not looking for medical advice instead of my surgeon's opinion. I'm simply hoping to hear real experiences from people who've faced a similar decision, because it's been mentally exhausting trying to figure out the right path.

Thank you for taking the time to read this.