C3-T1 ACDF & posterior fixation

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newmanmaple
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Date Joined Feb 2017
Total Posts : 11
   Posted 2/25/2017 1:17 AM (GMT -6)   
I am scheduled for surgery March 23rd. On March 7th (after a CT scan), my surgeon gives me the dirty details, but in my initial consult, he said I need a C3-T1 ACDF & posterior fixation (7-8 hours on the table). He said this is a HUGE surgery and not normally done. He pointed out issues starting at C2-C3 and my major issue at C7-T1 and said this is a HUGE surgery, but was necessary. He added that he would offer an easier solution if possible. He did not go into any detail since he wants to talk after seeing the CT scan. I have had previous C6-C7 ACDF in 2000 with donor bone and C5-C6 ACDF in 2010 with plate & cage. The first surgery was a great success with no pain medications needed after I went home. The second one was rougher. I did have some pain and medicated a couple weeks, but a few months after surgery, I developed vocal fold paralysis and did a year of voice therapy. I am a teacher, but was doing a technology related non-classroom job that year so I managed. When back in the classroom the following year, I used a sound system. I have not needed it for the past four years.

A five level ACDF is huge and don’t know yet If the posterior part includes fusion. I studied the MRI film for months and with my chiropractor’s assistance, speculated he would want this fusion, but we did not expect the five level ACDF as well.

I am taking the last eight weeks of this school year off for this and will have 20 weeks to recover for the next school year. I know this will be a rough recovery and I am very concerned about my voice.
Has anyone had anything similar to this surgery? There is very little information about five level ACDF’s and I am very concerned. I see a benefit of ACDF vs. posterior laminectomy, but there is just no information out there I can relate to. My T1-T2 & T2-T3 discs are also herniated and will discuss that with him in 10 days.

Any advice is appreciated. I am a 50 year old male.

straydog
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Date Joined Feb 2003
Total Posts : 14955
   Posted 2/25/2017 8:23 PM (GMT -6)   
Hello newmanmaple & welcome to Healing Well. I honestly cannot remember anyone coming through here that has had a 5 level done. You are right, this is a huge surgery. What type of surgeon will be doing the surgery, neurosurgeon or orthopedic? Since you have had some prior surgery you have a really good idea what to expect.

At the very top of this page you will see a locked thread called CP101. I suggest that you go there & read up on some tips provided by members here that have had cervical fusions. The very first post there are tips from a member that had a 4 level done. He had a bad motorcycle accident if I remember correctly. Everyone of those folks all agreed sleeping in a good recliner was a must. It was just too painful & hard trying to get up & down out of bed right after surgery.

One of our mods here named WhiteBeard had posterior work done, hopefully he will come along & comment here to your post.

Please keep us posted on how you are doing. Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

newmanmaple
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Date Joined Feb 2017
Total Posts : 11
   Posted 2/25/2017 8:51 PM (GMT -6)   
Thank you for the reply. I appreciate you taking time to give me some advice. My surgery will be at Christ Hospital in Cincinnati by a Neurosurgeon. I have researched everything that has been on my CT scans, MRI’s, and X-ray reports for several years now and fully expected a C3-T1 or C3-T3 posterior fusion. Knowing the 5-level ACDF is proposed, I have researched it at length. There just is not information out there for 5-level ACDF or a combo 5-level. I know every case is different and every surgery is unique; I just hope to gain some personal or medical insight to what I am in for.

Before my last ACDF, I bought a good recliner. Two months ago, I bought a lift recliner. This time around, I think I will need it.

I will look at the items you mention and give an update after my CT scan 3/7. Thanks!

Abilene
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Date Joined Apr 2014
Total Posts : 942
   Posted 2/25/2017 11:39 PM (GMT -6)   
Welcome!

I'm sorry you are facing surgery again. Is it the same doctor you have used before. I hope you will take the time to consider a second opinion, especially if everything is not clear to you. You do have the benefit of understanding this and even expecting something needed to be done. Did you have any loss of range of motion from your previous surgeries?

Whitebeard had 3 separate surgeries, I think, so he will be better able to discuss the different possibilities. I've had one neck surgery and it was a big one I thought, but not what you are facing. Mine was all posterior C3-C7. My own story title is the same as in the note below. It's been just over 3 years for me, I'm very glad I had it done for the pain relief, but it did leave me with a decreased range of motion. I am glad to hear you already have the lift chair. That will be used a lot! I'll be looking forward to your updates.
Posterior C3 - C7 laminectomy and fusion 2 rods and 10 screws, local bone graft from surgery site-lamina and other bony tissue 12/17/2013; Hyperthyroidism; Sleep Apnea;
Thankful for my husband of over 40 years

newmanmaple
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Date Joined Feb 2017
Total Posts : 11
   Posted 2/26/2017 1:21 AM (GMT -6)   
Hi Abilene! Thank you for the reply. My first ACDF was done in Columbus, OH and he had retired before my second so I saw a neurosurgeon in Cincinnati I was referred to from my chiro. I liked him and thought about seeing him this time, but I was able to get into the VA system in 2011 and wanted to give them a chance. Using the Veterans Choice program, I won’t have to worry about the out of pocket expenses. I was prepared to get additional opinions, but I am close friends with my chiro and we discussed all possible ways to deal with this. He was surprised at 5 anterior levels, but said he understands why he wants this. In his opinion, the ACDF fusions are easier to recover from than a laminectomy at that many levels and fusion rates are higher. I am not certain yet if he is doing just a fixation or a fusion with the posterior portion. I am satisfied I am in good hands. I would not consider this otherwise. My surgeon is young (34), but has an impressive resume. I have researched him and he is an excellent surgeon. I know a different surgeon may offer a different solution, but that would certainly be some ACDF and posterior laminectomy. A couple people have posted comments about this surgeon stating he took their case when others would not. The VA referred my case to 8 neurosurgeons and he took my case. I do not know if that is an indication of him being willing to do this surgery or if others would not.

I have some loss of range of motion from the two previous surgeries, but not a great deal. The surgeon told me with this surgery, I would have 50% left and right, but limited up and down motion. I had major voice issues after the second surgery that appeared several months post op. I saw a voice specialist who diagnosed vocal fold paralysis and I had do voice exercises several times each day for a few months. I was lucky to have taken a technology coaching job for two years that let me recover without having to stress my voice teaching every day. When I did return to the classroom a year later, I used a sound system my Superintendent insisted they purchase for me. I still have it and use it occasionally. My voice is weaker than it used to be and I stutter from time to time. The voice part has me worried. Before my second ACDF, the surgeon said that an ACDF to T1 (which was already slightly herniated) had some risk of voice loss.

The Nurse Practitioner who we talked to for a long time was very surprised I do not have other symptoms. She said my MRI and reports indicate I should be in pain, but she seemed to think I should have leg pain or other debilitating symptoms. Maybe I have been lucky getting this far.

I am trying to do all the right things in preparation and I am not going into this with blind eyes. I have researched this endlessly and know I have a very long road ahead. It is frustrating knowing I am having a surgery that is so uncommon, there is zero information I can refer to for 5 level anterior/posterior fusions.

Sorry for the long reply. It is good receiving feedback and having dialogue about all of this.
Age 50 - USAF Veteran - 80% VA Disability rating
Psoriasis, psoriatic arthritis, DDD, moderate to severe cervical stenosis, several heriations. Chronic pain
C5-C6 ACDF w/plate and cage. C6-C7 ACDF w/ bone plug.

Abilene
Veteran Member


Date Joined Apr 2014
Total Posts : 942
   Posted 2/26/2017 2:30 PM (GMT -6)   
Long replies are just fine. We understand needing to talk about this. We're interested too in what you are dealing with. You must have lots of questions ready for that next appointment.

Be sure to read the notes in Chronic Pain 101 written by and for us neck patients. Those comments start on 9/14. There's lots of helpful information.

Thank you for your service!

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 2/26/2017 10:20 PM (GMT -6)   
My wife tells me to not be so worked up about this and just let things happen as they are meant to. I have no interest in changing what is suggested, but in anything I do, I research and study things until I am confident I know everything I need to know.

Abilene, I have a working document I add things to when I think of a new question for the surgeon. I am sure some of it will be answered before I need to ask, but I do not want any surprises. I have read through many of the Chronic Pain ACDF threads. I do learn things and can relate to many. I see so many people not able to work or function normally for months after 1-3 level ACDF's. After both of mine, I was up and active quick. I had my last one in November 2010 and was making maple syrup (requiring heavy lifting) four months later.

My arthritis is worse and I am older than ever (duh) so I know this is different. From what I have read, adding a level of fusion makes a big difference in recovery time.

I might add that as long as my C5-C6 & C6-C7 fusions are sound and the nerves have space, he will leave those alone so technically, the ACDF will be three additional levels to create a 5 level fusion.
Age 50 - USAF Veteran - 80% VA Disability rating
Psoriasis, psoriatic arthritis, DDD, moderate to severe cervical stenosis, several heriations. Chronic pain
C5-C6 ACDF w/plate and cage. C6-C7 ACDF w/ bone plug.

Post Edited (newmanmaple) : 2/27/2017 6:45:53 AM (GMT-7)


Abilene
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Date Joined Apr 2014
Total Posts : 942
   Posted 2/27/2017 9:11 AM (GMT -6)   
I appreciate your attitude, research, and preparation. There are just bound to be some surprises along the way with such a surgery, but keeping the unknown to a minimum is a worthy goal. Do you have questions listed about time in a neck brace, bone stimulators, physical therapy?

I wonder have you read the 2nd post on our page called Chronic Pain 101? It's just a bunch of advise we all put together after one man started it. Our comments start on 9/2014. I think you would find some of the research done by therabidweasel interesting.

So glad you mentioned that if the previous fusions are sound they will not be redone. That's a good thought to hold to.

Like you, I did not have pain, other than in my neck, that so many other people have before this surgery. My doctor questioned me about that too. Maybe that just means it has been caught before causing so many other problems. Riding on a bumpy road was most difficult for me. Even walking jarred my neck some and hurt, but I could control that better than the road. Do you have that?
Posterior C3 - C7 laminectomy and fusion 2 rods and 10 screws, local bone graft from surgery site-lamina and other bony tissue 12/17/2013; Hyperthyroidism; Sleep Apnea;
Thankful for my husband of over 40 years

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14955
   Posted 2/27/2017 9:17 AM (GMT -6)   
I think Abilene just said it all in her post above. Being prepared as best as possible is the key & you have time to get it done. I personally think the way Abilene does, the ones with lots of issues have a bit of a more difficult time turning the corner after surgery.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 2/27/2017 6:00 PM (GMT -6)   
I put my bone growth stimulator (from the last fusion) in my car so I would have it next week when I see the surgeon. I have questions about it, PT, and brace time and if I will have a shower brace or extra pads on my list with plenty of other stuff. The brace I used 17 years ago was much different than the new ones.

Assuming I will be in a brace and assuming it will be for a significant length of time, I did some shopping at The Salvation Army Store to pick up long and short sleeve button up shirts, some elastic waist shorts, and some sweat pants. I already bought slip on shoes and have been breaking them in.
I have been reading the posts on CP 101. I am not sure if I have read the one you are referring to.

I have arthritis pain in some joints, but I always refer to what hurts as “the pain of the day” because when something hurts acutely, the other pain isn’t noticed. For the last few months or longer, my neck pain overwhelms everything else.

Rough roads do not bother me too bad luckily since I live back a rough county road. When I get out of the car or truck after a long drive, I am hurting.

White Beard
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Date Joined Feb 2009
Total Posts : 3667
   Posted 2/27/2017 11:36 PM (GMT -6)   
Hi Newmanmaple I've been reading your post wow sounds like your whole neck will be fuse when they're done with You! I can definitely relate to allot of the problems you've had and continue to have! I had voice problems to after my first ACDF at C6/7 back in 1985. On that one I totally lost my voice for around 3 months, they took bone out of my right front pelvis for the graft and that hurt worse than the ACDF! Took longer to heal and was in a cervical collar for over 4 months as at that time they didn't use any screws and bracket to stablelize the fusion while it healed! Anyways my voice did finally come back but is bit gravelly, and nearly 25 years later in September 2009 when I had to have my second ACDF, this time at C5/6 I found out my vocal cords on the right side was still partially paralyzed from my first fusion! Anyway with that second one they used cadaver donor bone and screws and bracket and it was allot Easier! Then in November of 2010 I had a posterior fusion at C3/4 they fused the articular joint and put in rods and pins on both sides. That surgery although easy to do according to my neurosurgeon was a real bear pain and healing Wise! I had 47 staples down the middle of the back of my neck from the base of my skull to just about the beginning of my shoulders. It was worth it in the end but it did take a long time to heal and for the pain to go away and I also had to have some PT after too! Personally I thought the posterior surgery was allot worse than the ACDF! I also can empathize with you on joint Pain! I've had surgery on both my knees and finally had a total right replacement Don in December of 2014. I've had lower back surgery done in Jan of 2013 too, but my herniated thoracic disc they won't touch !

Anyway if I can be of any help to you just let me know. Best advice I can give you right now, is be gentle with yourself and after your surgery don't over due It! Follow your surgeon's post-op orders to the Tee and just take it easy and let your body Heal!

I do wish you all the Best! Oh and Welcome to the Forum!! I think you've really came to the right place!!


White Beard
Moderator Chronic Pain
USAF retired in Sept.1991. I went back to school and became a licensed RN in 1994, I worked on Oncology and Med Surg, Disabled in late 1999, was approved SSD in early 2002! Diagnosed with: DDD and Multiple herniated Disks; Foraminotomy L3/4/5 Jan 2013; Posterior Articular Joint fusion Nov 2010; C5/6 ACDF Sep 2009; C6/7 ACDF 1985; Implanted pain Pump Jun 2014.

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 2/28/2017 3:31 PM (GMT -6)   
It is great to hear from you White Beard! I have been reading your posts. It is very helpful to read the experiences others have had and to have dialogue with others “like us.” I can talk to my colleagues, friends, and family all day about this stuff, but they really cannot relate.

My voice has me more concerned than the pain when the school year starts in August. I will still have limitations at that time, but can manage. Not having a teaching voice is a deal breaker. I have everything I need to succeed if I can talk. I can adjust the sensitivity of my microphone and sound system to the point I can speak with a soft voice, but I am not a monotone teacher. I like to project and have fun in my classroom so this does me concerned. At the first sign of trouble, I will get a voice specialist to look at me and we can go from there. I still have my CD for voice therapy so I might begin using it once I am able. My vocal cord problem was diagnosed as Laryngeal Myasthenia which is vocal fold paralysis. I struggled to catch my breath at times and could not project my voice at all. She said I likely have partial permanent loss.

I am anxious to find out what his posterior plan is. He did not explain at the initial appointment if it would be a fusion or not. I assumed that, but my wife Maria said she thought he meant he was just putting in rods and screws to keep the ACDF from failing. A fixation only would be easier to recover from for sure. I will know next Tuesday.

You can certainly relate to what I will be dealing with more than anyone I have talked to. I have not had my lower levels checked so I do not know how messed up I am below the T3 level. I do have lower back pain, but that is not my concern for now.

If there is such a thing, I am over-preparing for this surgery. I have accepted that I will not be doing my normal summer activities like having a huge garden and cutting wood, etc.. I replaced my old zero turn mower with a new one for my wife and two teenagers at home to use. My oldest is now in the Air Force so he won’t be around to help. I have had many friends tell me they will help out anytime I need them.

I agree that I have come to the right place. I have gotten more from this forum than any other.

Post Edited (newmanmaple) : 3/2/2017 10:20:32 PM (GMT-7)


White Beard
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Date Joined Feb 2009
Total Posts : 3667
   Posted 3/1/2017 12:38 AM (GMT -6)   
Hi newmanmaple just out of curiosity along with your voice problems do you have any problems with swallowing or laryngeal Spasms? Like in abnormal gag Reflex? The reason I'm asking besides having partial paralysis of my right vocal cords from my first ACDF I also have some swallowing problems problems and problems with gagging caused by laryngeal spasms. Over the years as I've gotten older it has become less of problem , but on occasion if I've put to much strain on my neck (cervical spine) it will come back and haunt me! Being the fact that you have the same ACDF'S that I've had, and had voice problems, I was just wondering if you have experience some of these other problems Too?

I do wish you well on your up coming Surgery! And no I don't think you can over prepare for it! I will tell you I was really surprised how rough the posterior surgery was as in comparison to the ACDF! My surgeon tried to warn me that this would be a very uncomfortable experience, but would be all worth it in the end. Well uncomfortable was an understatement but in the end he was Right! It was worth it! One thing that one of my later neurosurgeons told me that non of the other surgeons mentioned, is: That in allot of patients that have fusions (ACDF's) usually within ten years the disc above or below that fusion will go bad! Knock on wood! I got close to 25 years out of mine before the one above went bad!

Anyway Good Luck to You!

White Beard
Moderator Chronic Pain
USAF retired in Sept.1991. I went back to school and became a licensed RN in 1994, I worked on Oncology and Med Surg, Disabled in late 1999, was approved SSD in early 2002! Diagnosed with: DDD and Multiple herniated Disks; Foraminotomy L3/4/5 Jan 2013; Posterior Articular Joint fusion Nov 2010; C5/6 ACDF Sep 2009; C6/7 ACDF 1985; Implanted pain Pump Jun 2014.

Post Edited (White Beard) : 2/28/2017 11:43:18 PM (GMT-7)


newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 3/1/2017 3:43 PM (GMT -6)   
White Beard, I had frequent swallowing problems for a few years, but swallowing is not an issue now. I do occasionally have laryngeal spasms. If I strain my neck, I sometimes get spasms. I am sure I will have them again in a few weeks and likely linger for years.

I know a huge ACDF will be rough and the posterior will be rough too. Once I know what posterior procedure he is doing, I will have a better idea about what I am looking at recovery wise. I am sure you are right about levels above and below an ACDF going bad quicker, but I had no real choice either time. I asked both surgeons about it and they did say it can make a difference. With T1-T2 & T2-T3 already herniated, I suspect they will go quickly after surgery.

It believe it will be worth the pain and recovery, but it will be easy. I look forward to a continued dialogue in the future.

Post Edited (newmanmaple) : 3/2/2017 10:22:48 PM (GMT-7)


newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 3/5/2017 6:03 PM (GMT -6)   
I thought I would add my MRI findings. It is a lot to read, but you can see what I have been studying for 6 months now. I have the CT scan Tuesday and will get the surgical details.

9/16/16
COMPARISON: Cervical MRI exam dated 10/20/2010
FINDINGS: There is no evidence of abnormal marrow signal. The craniocervical junction is unremarkable and the intrinsic cord signal is normal in appearance.
C1-C2: Unremarkable
C2-C3: Left-sided degenerative hypertrophic facet arthropathy produces moderate to severe foraminal stenosis. This finding represents interval change.
C3-C4: Disc dehydration is accompanied by shallow broad-based disc displacement effacing the thecal sac without evidence of neurocompression. Degenerative facet arthropathy produces mild to moderate biforaminal stenosis.
C4-C5: Shallow broad posterior disc displacement effaces the thecal sac, noncompressive in character. Left-sided degenerative hypertrophic facet arthropathy produces moderate foraminal stenosis.
C5-C6: Anterior surgical fusion has been performed, representing interval change. Right-sided degenerative facet arthropathy produces moderate foraminal stenosis.
C6-C7: Anterior interbody fusion has been performed. Prominent right paracentral posterior vertebral body flattens the thecal sac without evidence of neurocompression.
C7-T1: Disc dehydration is accompanied by moderate loss of disc height and anterior vertebral body spondylosis. Broad-based disc displacement effaces the thecal sac and encroaches on the neural foramina effacing the left C8 nerve root. This finding was not demonstrated on the prior study.
T1-T2: Disc dehydration is accompanied by loss of disc height and anterior vertebral body spondylosis. Broad-based disc protrusion encroaches on the right neural foramen, closely approximating the right T1 exiting nerve root. Degenerative facet arthropathy produces mild biforaminal stenosis.
T2-T3: Disc dehydration is accompanied by loss of disc height and anterior vertebral body spondylosis. Broad-based disc displacement encroaches on the right neural foramen without evidence of neurocompression. Degenerative facet arthropathy is noted.

CONCLUSION:
1. C7-T1 broad disc protrusion with biforaminal encroachment, effacing the left C8 exiting nerve root. Coexisting discogenic spondylosis accompanied by degenerative facet arthropathy, contributing to biforaminal stenosis.
2. Broad disc protrusion at T1-T2 and T2-T3 encroaching on the right neural foramen at the T1-T2 level, closely approximating the right T1 exiting nerve root. Coexisting discogenic spondylosis.
3. Shallow noncompressive disc displacement at C3-C4 and C4-C5, accompanied by left-sided degenerative hypertrophic facet arthropathy, resulting in moderate to severe and moderate foraminal stenosis respectively. Coexisting left-sided foraminal of moderate severity.
4. Status post anterior surgical fusion at C5-C6 and C6C7, accompanied by posterior vertebral body prominence at the C5-C6 level, flattening the thecal sac without evidence of cord compression.
Age 50 - USAF Veteran - 80% VA Disability rating
Psoriasis, psoriatic arthritis, DDD, moderate to severe cervical stenosis, several heriations. Chronic pain
C5-C6 ACDF w/plate and cage, C6-C7 ACDF w/ bone plug, R elbow reconstruction.

Abilene
Veteran Member


Date Joined Apr 2014
Total Posts : 942
   Posted 3/6/2017 8:41 PM (GMT -6)   
Rest well tonight and have a good visit with that doctor tomorrow and get lots of questions answered. We are eager to hear what you are told.
Posterior C3 - C7 laminectomy and fusion 2 rods and 10 screws, local bone graft from surgery site-lamina and other bony tissue 12/17/2013; Hyperthyroidism; Sleep Apnea;
Thankful for my husband of over 40 years

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 3/7/2017 2:22 PM (GMT -6)   
Well my CT scan was uneventful, but my consult was a surprise. My neurosurgeon said ever since we spoke last, my case has been wearing on him and he has studied things very closely. He told me I have major spurring at the T1-T2 & T2-T3 and he pointed them out on film. He said he believes some of my pain is from that level and a fusion would have to include them.

His conclusion was that I should not have any fusion. He said he understands that I am in pain and suffering, but a fusion at any level in my severely compromised spine would quickly lead to more surgery which would eventually leave me with an occipital fusion. He said this would be “a miserable existence.” He went on to tell me he does expect to see me again, but that should not be until my symptoms are too severe to live with.

I texted my chiropractor who said he wants me to see a pain management anesthesiologist to look into nerve ablation.

So that is all I know for now.
Age 50 - USAF Veteran - 80% VA Disability rating
Psoriasis, psoriatic arthritis, DDD, moderate to severe cervical stenosis, several heriations. Chronic pain
C5-C6 ACDF w/plate and cage, C6-C7 ACDF w/ bone plug, R elbow reconstruction.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14955
   Posted 3/8/2017 8:37 AM (GMT -6)   
Well, this is a complete surprise but at the same time I have a deep respect for your surgeon's honesty. It has to be reassuring to know that he cares enough about you as his patient.

Let us know if you are a candidate for the ablation procedure. Several members have had this done. It is like anything else we try to get our pain level down. It is something to consider trying at least.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 660
   Posted 3/8/2017 9:44 AM (GMT -6)   
Newmanmaple:
I did not post a reply to this thread earlier, as I did not want to inject an opinion when none was being sought.

But I will admit now that I did have concerns seeing the benefits of such an invasive cervical procedure. Believe me, as a physical therapist I have worked with individuals who struggled with less than ideal post-surgical results. Many of these individuals were worse for the surgery than if they had stayed the status quo (and the status quo was less than ideal with pain, numbness, and limited fine motor control).

I applaud your surgeon with being upfront and honest with you in expressing his reservations about the proposed procedure.

I have a substantial pituitary tumor/adenoma. It has been recommended to me, on several occasions, to have it surgically excised. The technique is a trans-shenoid approach, up the nose to the brainstem. I have also been on corticosteroids for 25+ years. The risk of a cerebral vascular accident during surgery or post surgery is a real risk. I have declined the surgery and manage the day-to-day reality of living with a pituitary tumor. The deciding factor for me? I could not agree to a surgery where there was substantial risk that I could be worse in health (cerebral vascular stroke).

All to say . . . I think your surgeon was wise in taking a pause to the proposed surgery. There is every real reason to believe that you could be worse for the surgery.

Not to say that your situation is ideal. I am sure that it is not, what with cervical spurring and foraminal narrowing. But every surgery has consequences. Personally, I think you will do better staying the course.

I already live with fairly compromised health. I was not willing to compromise my health further with the proposed transphenoid surgery. Once you lose your health, it can be very difficult to reclaim.

The cervical spine is a delicate area. It should always be treated with the upmost of respect. I appreciate your surgeon's honesty in assessing your situation and possibly saving you from additional disability and hardship.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 3/8/2017 11:48 AM (GMT -6)   
All of this was very surprising and frustrating. It leaves me less optimistic as I would like. I will move forward and hopefully have nerve ablation. The person who does the insurance authorization and schedules specialty appointments for my chiro is out of the office until next week so it will be awhile before I know anything.

I agree that the surgeon was looking out for my best interest. I do appreciate his honesty. He seemed very sincere and said he wished there was another way.

I will have a copy of the CT scan and report in a few days. I am sure it will have similar information to the MRI report.

So I will get back to teaching Friday and try to manage the grading and such. I do rely heavily on my teaching team and 3-4 students who do much of the paperwork I have to do. My team knows I cannot handle grading everything so they are supportive. Dealing with 8th graders when pain is high can be a problem. The higher the pain, the greater the stress and higher the stress, the greater the pain. It can be hard not to take pain out on students. At least my students will be pleased to know I am not leaving for the last quarter.
Age 50 - USAF Veteran - 80% VA Disability rating
Psoriasis, psoriatic arthritis, DDD, moderate to severe cervical stenosis, several heriations. Chronic pain
C5-C6 ACDF w/plate and cage, C6-C7 ACDF w/ bone plug, R elbow reconstruction.

Post Edited (newmanmaple) : 3/8/2017 12:17:33 PM (GMT-7)


Abilene
Veteran Member


Date Joined Apr 2014
Total Posts : 942
   Posted 3/9/2017 12:15 PM (GMT -6)   
We do wish you the very best....whatever that may be. Please stay in touch. We care.
Posterior C3 - C7 laminectomy and fusion 2 rods and 10 screws, local bone graft from surgery site-lamina and other bony tissue 12/17/2013; Hyperthyroidism; Sleep Apnea;
Thankful for my husband of over 40 years

StormyAutumn
New Member


Date Joined Mar 2017
Total Posts : 1
   Posted 3/18/2017 2:32 PM (GMT -6)   
I had anterior ACDF C3-C7 on 11/2015. One year later, after a speedy recovery, I learned I had not had a complete fusion and had a broken screw in that area. I just had Posterior C3-T1 Decompression and Fusion on 2/22/17. Thus far recovery is going well. Still a lot of issues with what I call "zingers". Those bee stings that begin at one end of the body and end at the other after feeling the full length of the "zing". I have no reference to know what to anticipate other than trying to keep a positive attitude and pray some of the symptoms I'm still experiencing will continue to heal. I wish you the best.

newmanmaple
New Member


Date Joined Feb 2017
Total Posts : 11
   Posted 3/18/2017 2:34 PM (GMT -6)   
I am seeing a pain management anesthesiologist next Wednesday. I will report back after that visit.
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