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Cervical fusion..degenerative disc disease

From: cervfus4lev - on 03/02/2011 1:08pm

I've had neck,shoulder, hand and arm pain and various symptoms since 2002. Went from a bulging disc C4-5 to herniated discs C4-5, 5-6 and 6-7. Had cervical spine surgery with fusion of C4-7 with bone grafts from pelvis and titanium screws/pins on March 18, 2010.
I have pretty good range of motion considering the fusion but still have lot of the same symptoms. Can't do much without 'flaring', then pain in neck region, hands, top back muscles. I've gone through physical therapy which actually made me have more pain because their focus was range of motion and strengthening and no pain management.
I am in need of a good specialist to further treat this condition, possibly diagnos the arthritis, help with pain managemnent, see if the bones have fused well, see how the adjoining discs are holding up (top and bottom of fusion were alreaky bulging before surgery).
I would appreciate suggestions regarding type of specialist I should see. My surgeon let me go as soon as the brace came off. Currently seeing a phy med and rehab Dr. who is good for nothing!

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on 03/05/2011 2:17am

Dear CervFus4lev,
I'm writing this not as a physician per se but as a Degenerative Disc Disease fighter personally - having suffered and dealt with a similar situation - had a fusion 10 years after the first major Cervical Disc herniation, between C4-C5 , & C5-6. The neck relief lasted quite a while but I did have a flare of symptoms after returning to an over ambitious work schedule involing 3 hours of commuting & use of my neck in its full range of motion repetitively - Of course I had changes in the disc level above the fusion, then I had to adjust my activities again...
Anyway - a few points to consider from my experience:
Once there is some established problem structurally & pathologically with the spine discs, the joints - the spaces between the spine bones, (which contain the discs) are forever changed - the functional dynamics of the series of joint spaces adjoining the levels operated are now the major mobile sections of a more restricted spine. The forces that normally would have spread out along all levels in a healthy spine have been shifted - first in the "sick" presurgical spine due to muscle spasm induced restriction of motion, and alterred mechanical operation, and then after surgery the mobile joint/disc spaces above & below the fusion become the functioning points for flexion forward & back, & side bending. They are from the same biochemically structured person you still have a propensity for degenerative/weak cartilage, ligaments etc & for arthritic changes etc to form. So the disease tends to propagate itself. The fusion initially frees the nerves which were being pinched, but then down the road the nerves coming out a level above or below may become compressed as the same syndrome repeats itself at those levels. - Also different processes eg arthritis in the facet joints (the articulating stabalizer bone projections from the main block of spine bone(the vertebral body,) can occur.) These can cause similar pain syndromes but may require different treatment. It's a bit like dominos, surgery temporarily stops the cascade of effects in one spot...
Have you tried acupuncture for pain Management? Have you seen a skilled pain Management physician, eg. one coming from an anesthesia or neurology background who can administer injection treatments of all kinds? Have you been treated by a neurosurgeon who can do disc replacement? Disc replacement my help maintain a functional use of the disc segment, preventing the "propagation" of the disease up & down.
Have you been using warm moist heat applications, cervical pillow to sleep, support for neck eg. soft collar for driving long distances, TENS Unit application for pain Management? Lidocaine patch ? Adjusted your posture while sitting, standing - changing position frequently, taking breaks ? Supporting your Lumbar spine with a small pillow? (Be careful of reading or watching TV in bed as the neck will be in a very bad position.) Are you wearing cushioned (sport or work grade) insoles to absorb impact from the floor being transmitted all the way up the spine?
Avoiding drafts to your neck & shoulders? Have you adopted a" pain free" diet? Anti-inflammatory diet? (Low animal fat & low cholesterol, high in Omega 3 fatty acids & free radical scavenging nutrients (from certain spice & herb groups) Avoid all neurotoxins eg. Alcohol, Tobacco smoke, household chemicals & fumes from paints glues , pesticides, Aspartame & other artificial sweetners, Soda pop etc...) Are you supplementing nutrients which your diet may lack? Calcium, copper, magnesium, VitaminD may need attention. Have you tried Glucosamine sulfate for 6-12 weeks, MSM, SAMe? A medical doctor, nutritional consultant may be able to advise you. Youo can use many of the "alternative therapies" along with traditional treatments getting a measure of relief from each that can add up to substantial benefit altogether. I would recommend that you get adequate pain relief from a combination of many of the above modalities only per your own physician's advice so that ongoing pain does not affect your central nervous system on a more long term & ongoing basis leading to a sort of chronic pain syndrome - & maintaining your functional state in life as much as possible. Pain on a nearly continuous basis can cause depressed mood & depression in many pain sufferers - 3/4 chronic pain patiens are depressed - which can further slow recovery or cause other problems.
I tried to condense what I've learned in 13 plus years of spinal degenerative disease to provide suggested venues to explore - remember Medicine is a "Complaint" driven professional practice - the doctor must hear your complaint of a specific problem recurring, or starting & not being relieved in order to act to help. You most certainly can go back (by referral of your family doctor if needed,) to the surgeon who did your surgery. Seek & ye shall find.... Keep fighting the good fight....... I wish for you results & relief - all the best, Suzanne.

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on 03/10/2011 8:43pm

Hi cervfus4lev! I hope you get to feeling better soon. I am so shocked at how we are are so similar. I have not had surgery...yet. doc only gives me 50-50. I think that was some Great advice from Suzanne. I have been doing ok but I know I can do better with the management of a more healthy lifestyle. I have cervical stenosis, DDD, spondylosis, radiculopathy, foraminal narrowing, chronic pain. im seeing a certified pain managment doctor for possible CSI. Im worried about the potential for weight gain and lack of positive results. ive been managing ok on MS contin.

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