Urgent surgery: C4-5 right herniated disc with severe right C5 motor weakness
Desperately seeking procedure type advice and surgeon recs in NYC.
I've (49 Female) had 3-4/10 pain on the back and right side of my neck since early July, almost like a stiff neck. I did urgent care twice, first visit helped and I was pain free for 2 weeks. The pain came back July end after carrying weight on my left side. I did physiotherapy 1 session and acupuncture 1 session, both made the pain worse. Since August 1, I started weakness in my right upper arm that progressed to not being able to lift my right arm; forearm & hand/ grip are not affected.
MRI level by level says:
C4/C5: There is minimal retrolisthesis with disc bulge and superimposed large right subarticular to foraminal disc extrusion with caudal migration in the right lateral recess behind the C5 vertebral body to the superior aspect of the right neural foramen at C5/C6. There is effacement of the right lateral recess and severe right neural foraminal narrowing with compression of the right C5 nerve. There is effacement of the ventral subarachnoid space and abutment of the ventral surface of the cord though the canal remains adequate in caliber. The left neural foramen is adequate in caliber.
Had a video consultation with a spine surgeon last week. His findings are: C4-5 right HNP with severe right C5 motor weakness and moderate right C5 radicular pain. Because I am roughly 1-2/5 deltoid, he strongly advises prompt surgery; he recommends a Total Disc Replacement (TDR) C4-5.
EMG study done yesterday shows: Interdistal latency difference between second DI-lumbrical is normal on left, and prolonged on right. Needle EMG of selected muscles in right arm shows mild fibrillations/PSWs in deltoid, biceps, infraspinatus muscles, with increased MUP amplitudes; recruitment patterns are full/reduced on maximal/submaximal effort. There is no evidence of active denervation in right cervical paraspinal region at the levels examined, though there is CRDs at right C5-C6 paraspinal region.
QUESTIONS: I am wondering if less invasive surgery might be an option - what type? TDR seems like a big leap and obviously something I can't undo.
I barely have any pain. The weakness is the main symptom. It's been 10 days since onset, I now have numbness through the entire arm (not pins and needles, it feels like deadweight to touch). Am I delaying matters by waiting for a second opinion?
Where do people go to get second opinions? I haven't even met my surgeon in person, looks like they need me to commit to surgery before I can get an in person visit. Please share DM's for surgeons in NYC. I have Aetna through employer, it'd been pretty decent so far.
Appreciate any help please. Feeling so pressured and still reeling, it's only been a week since I walked in to meet a Spine Specialist!
