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Multilevel Cervical Diskectomy with Fusion & Instrumentation

From: 100000014553880... - on 06/04/2011 9:42am

I have OA, DJD, foraminal stenosis C2-C7. Natural curvature is lost and high risk for SC compression. Sx include neck pain, severe pain to right arm and hand with numbness and tingling 4th and 5th fingers, limited ROM. My Dr recommends anterior and posterior entry with diskectomy, fusion, and instrumentation C2-T1. It would be very helpful if anyone out there has had such a procedure and what their opinion is. Also what was your experience during recovery? This will be done in two sessions and I will remain intubated overnight. HELP!!!

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on 06/17/2011 9:59am

I have been watching this and it looks like no one (so far) has had this drastic surgery. I know you have to be desperate for pain relief but surely there is another way. Is your doctor a neuro guy? I would at least get a second opinion before considering it.

I'm sure this is no help but will keep watching, thinking of you, Nora.

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on 06/23/2011 1:13pm

Sorry for my delayed response. I had a similar fusion and I am far worse off now than pre-surgeries. First of all what does at risk of sc really? Everybody gets stenosis with age so ignore that. Same goes for OA. I have scc( spinal cord compression). I lived in constant pain but I did not have the numbness that you have.

The numbness is due to nerve root compression. Short answer is to get an opinion from a neurosurgeon who does not want to fuse everything. The net result of so many adjacent vertabrae being fused will be accelerated disc degeneration at lower levels and extensive painful arthritis.

I got 3 opinions. The first two wanted to fuse c1-c2. The third opinion, which I chose, fused from the occiput (AKA C0)-c5. The screws pulled out of the occiput (common). So now I am fused c1-c5. C6-t2 are now shot too. I now have scc at c5-c7.

Feel free to contact me, even offline, for more info. Biobot@gmail.com

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on 06/23/2011 1:33pm

One question, how old are you? I ask since OA and many of your problems come with age. However, the nerve compression is tricky to deal with. I am not an MD so I don't know how to deal with it. I am very leery of anyone who says that you are at "risk of" or "almost have" anything.

You clearly have severe disc degeneration and nerve damage. I also understand and can empathize with your pain. Mine is shear hell. Spinal cord compression sounds scarier than it often is. I was afraid that I might get paralyzed with all of my compression, which is why I accepted such radical surgery.

Just to be clear. It is extreme and it is pretty much guaranteed to have a low success rate. Most likely all that fusion will make you worse. Again feel free to email me. Maybe we can chat by phone and I can provide more advise. But with respect to the forum I just wanted to state that it is extreme and that you need other, confliicting, opinions. Most spine surgeons will not fuse to such an extreme anymore.

For clarity. I have rods fusing C3-C5. I had 2 other rods connecting C3- the occiput (rear base of skull) and they also fused C1-C2, which was necessary. When the screws in the occiput pulled out the fusion at C1 pulled away a little bit, just enough to hurt but not so much as to get a third surgery.

Finally, I had surgery from 2 top surgeons. So they did not do a poor job but the opinion to fuse to such an extreme is highly questionable. The screws may have pulled out due to my physical therapist having me do exercises that presumably loosened the screws. But they also pull out since the bone may have been soft.

As for medmal, nobody would touch it since screw pullout cannot be proven to be due to the PT or even failed surgery. So now I cannot work and I live in constant pain. My only reprieve is meditation and anything to reduce stress. In some cases accupuncture may help. And stay away from a chiropractor. You have too much damage in your upper cervical spine to risk more damage.

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on 06/23/2011 2:03pm

Oh my!! Reading all this really has me fearful. I have so much going on with my spine. And the thought of surgery really does scare the hell out of me. My neck has nerve compromise going on which affects my left arm, my balance and I have issues with gripping things. I have become a total clutz. Sighs! My left leg has become darn near useless due to problems in my lower back too. I now use canes and a walker to get around. I was told over 20 years ago I had degenerative joint and disc disease and tried to exercise and stay as active as possible but at 54 years old. This has all caught up to me and now I just feel so totally lost. The constant pain in my body day in and day out is unreal, Then the horrible headaches that I get are getting worse day by day and the sad part is, no one, even doctors don't seem to take you very seriously. It's soooooooo frustrating!!!

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on 07/14/2011 8:01pm

I had a very similar surgery 11 months ago. My stenosis was severe so they actually removed 2 vertebrae from my neck.They went in from the front and did that surgery first, adding a cage, and a metel plate. A week later they went in from the back and i ended up with C2 to T2 fused, 2 long rods, and 16 screws.The only major problem was when I got an infection in the recovering wound. I had to spend another 10 days in the hospital after the initial 2 wks, and then had to go to a rehab/nursing home for 6 more weeks! That is a whole 'nother story-one I'd rather forget, but I'll go into detail if somebody asks.
Because I also have severe problems in the rest of my back, and need a long fusion there too (T-10 to Sacrum) we couldnt be sure how many of my problems would be improved by the neck surgery. I didn't have much pain before in that area- just occasional acute episodes that might be severe for 4-6 wks.
I didn't have much post-op pain. My walking improved. I still walk with 2 canes, but I'm not nearly as wobbly as I was before. Ive regained strength in my right arm, and now it is my strong side again. I also have somewhat improved coordination with my hands and fingers. The first surgery was the easier one,and I was up and walking soon after. The second one was the more difficult. Most of my post-op pain came when I would ride in a car,and my neck would feel the pull of turns and brakes. That pain disappeared after 3 months. I discovered that a C-curve pillow for your neck helps a lot. I am still able to drive and have full mobility in my neck from side to side.
I would definitely have the surgery again, even with the complications of infection. It was much easier than the single level fusion I had at L4-5 a few yrs. earlier.
Being intubated sucks!!! I had problems with that after the posterior surgery, and don't want to have to go thru it again, but I just try not to think about it. (Worrying just doesn't do any good, and i already have probs w anxiety.)
Well, I hope something Ive said helps.Ask any questions u like. I couldn't find anybody online to talk to prior to mine. Finally I met a woman in the E.R. waiting room who had a surgery like mine, and I was able to pick her brain for a few minutes before she was taken back to see the Drs. Good info conquers fear.
Good luck to you, and better yet, God bless you!
P.S. Look out for signs of infection. I had to go to the E.R. immediately when my incision started leaking an enormous amount of pink fluid.There was no pus at all. But let me tell you - they don't play. I had to have strong, broad-spectrum antibiotics pumped to my heart thru an I.V. line. The meds are strong and they make you feel very nauseous.

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on 07/14/2011 11:47pm

I am happy that are not too damaged by the surgery and infection. Not to sound cynical but try asking your doctor or getting tested for arthritis in another 1-2 years. Your story will change for the worse. Our body is not designed to be fused from top to bottom. Arthritis is almost guaranteed in the c-spine. And if you fuse the rest of your spine expect the pain of arthritis for the rest of your life.

I have been told that by *eery* doctor and neurosurgeon except my surgeons. BTW, check out a recent AARP (last week). They list 4 surgeries to reconsider or not get due to lack of evidence that it helps.. Once of the 4 is multi-level fusion.

Granted AARP is not a scientific publication but a few Google searches of reputable medical sites will confirm that multi-level fusion is rarely helpful and usually harmful.

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on 07/15/2011 9:27pm

Wow!

I had C3-C7 done in one 11hour festival, anterior and posterior. It was amazing. I'd be happy to share the entire experience with you on here or offline.

The surgery was extremely successful, 2/2/09. I was able to drive again after about 3 months. (I'd been totally disabled since 1999, was only a surgical candidate after I developed spinal cord compression in the area which was fused, and it was big-time fusion front and back or be paralyzed).

Anyway, I thought *i* was a trooper. 2 sessions, intubated overnight!?!?! I hope your health is otherwise good. I'm a big girl, 5'5" 280 but with no other health problems (no heart disease or diabetes), and I had a weird reaction to being under for 11 hours - my heart rate wouldn't calm down and I had to stay in ICU for 4 days post-surgery, even though I otherwise recovered just fine. I think, despite them giving me Rx to bring my heart rate down, I was just in shock after being under for so long, and all the titanium introduced into my system. I hope you are otherwise healthy (and you pretty much MUST be, if they're suggesting this surgery to you).

My recovery was awesome. Unfortunately, I'm having a huge flare-up with symptoms in the fused area (saw my neurosurgeon yesterday, and he said the big 80% numbness in both arms and severe tremors in my left thumb and first 2 fingers is indicative of problems in the C3-4 area, which is the top of my fused area. So...2.5 years after such miraculous neurosurgery, i'm having either a new symptom, or a complication, or a flare of old symptoms. I did not expect this. Maybe changes below the fusion (which I also have...but they're not causing the new bad symptoms).

So...my recommendation is to do it. I had a lot less symptoms in both arms for most of the past 2.5 years, although I have never gotten rid of the numbness completely (even my best days are 10-20% numb in both arms, and i can easily flare up doing stupid stuff like cutting vegetables or cheese for a few minutes, or carrying groceries or laundry, or folding/hanging laundry. UGH!). I had to wear a hard cervical collar for 8 weeks after my big surgery, 24/7 except for showering. Gradually, I could eat without it. That was pretty hard, I hated that collar after about 2 weeks...but it worked. The bone growth stimulator didn't hurt at all, and apparently really worked well for me. (I'm 45 now, was 43 when I had the surgery). My doc says I healed "textbook."

Feel free to ask me any questions. I do have one for you - will you have to have a Halo post-surgically, and for how long?

---pam, hopeful for you

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on 07/15/2011 9:37pm

oops p.s. my big 4-level anterior and posterior c3-7 surgery was decided on due to cord compression there. both arms had been seriously numb for years, and got worse, dropping stuff, and actually then the pain level went down as the cord compression came on. my neurologist blanched when doing my EMG to see if i might've had carpal tunnel...he knew it was cord compression right then.

i don't think i'd be any better off if i hadn't had such drastic fusion...but i just re-read my pre-surgical MRIs and was amazed to realize that we had looked at the entire C and T spines back then, just for fun. even in late 2008, i was already herniated at varying degrees from c3-t8. c3-7 were fused front and back in 2009, and c5 removed. now i have nerve root compression in the fused areas (mild to moderate) and new bulging protrusions just under the fusion (c7-t2). so...am i worse just below the fusion area? yup. did i expect that? kinda.

then again, when disease is so severe at such a young age (aggravated/brought on early by a low-speed whiplash in my case)...what do we really expect? i am starting to think, with a 2.5 year mean time between failures from procedures...when will i have lower back involvement? what if i really become paralyzed, when my arms don't just feel stupid and slow but can't respond at all? any relief, surgical, medical, alternative-medical, holistic...any relief at all is helpful.

the first neurosurgeon i ever saw told me to never give up seeking relief. and he was right! but learn all you can, get multiple opinions, and don't deal with doctors who don't explain and don't listen to you.

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on 07/28/2011 2:00pm

I have extensive OA and stenosis. I had my ACDF in 2006 for C3 thru C-6...bone from hip removed ...titanium plate.
I thought it was successful but I just had a Posterior Laminectomy C3 thru C7 again with graft and plate since after 4 years I didn't properly fuse and was having the same neck and shoulder pain that I had in '06.
My ACDF was severly painful for the first day or 2 but this post laminectomy has been brutal.
When they got me out of bed to try to stand up..forget the log roll technique! Once they got me onto my walker I stood there and violently shook from all the pain. It was horrible!
I never thought I'd be able to walk without assistance but I am now 4 weeks out and feel ok. Lots of muscle spasms but not stabbing pain.
My surgeon informed me that there is no guarantee of pain relief and it could be worse but I took that gamble because I'd eventually need it anyway. Mine is so bad that PT was not even an option since stenosis extensive and I refuse to have pain injections in my neck!
Many people have said that once you start having neck surgery the ACDF's only last for about 5-10 years. Who knows?
I hope your recovery goes smoothly and don't forget to take your time in healing. Don't rush it even if you feel better!
I just can't wait until I can finally lay in bed! I've been sleeping in my recliner and after awhile you just start praying to lie down!
Blessings!

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on 09/19/2011 4:47pm

Hi,
I have degenerative disc disease throughout my spine. Presently, I have L4,L5,L6 herniated. I had C4 C5 which I had a neck stretch, whereas the neurosurgeon replace the discs with bone, and covered with a titanium plate. It has taken almost a year for the pain in the hands has completely gone away.
My concern is my Lumbar discs, if I can go through the rest of my life with these like that. I manage the pain without painkillers. My body was on painkillers for the nerves and now my body is so sensitive from the long usuage. Anyone have such a surgury that was sucessful?

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