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Looking for advice regarding cervical surgery

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:22 AM in Neck Pain: Cervical
First a brief history

I had an posterior lumbar fusion done in 05 at L5-S1. The way the surgery was done going in through my back unfortunately seemed to destroy the musculature in my lower back leaving it very weak. Over time the pain again continued to build down my right leg and radiated up into my mid back. My legs began to feel week and I would get tremors in them as well as to a lesser degree my right arm.

January of this year I was finally limited to a wheelchair as a way to get around. I was sent to the Sheppard Spinal Clinic here in Atlanta where I was recommended to see one of the top Neurologists in the country. This gentleman did allot of testing and noticed that I had some very unusual responses in the reflex testing he did. In 5 different areas my reflexes were considered hyperactive leading him to believe I had some cervical issues that in no way had anything to do with my lower back pain.

He ordered a CT and Myelogram be done instead of an MRI because I have a spinal cord stimulator implanted in my mid spine making an MRI impossible.

The films showed the following:

Findings: The sagittal images show the vertebrae are intact and aligned, without fracture, dislocation, or lytic or sclerotic lesion. The patient has a normal appearance to the posterior elements, good alignment, but reversal of the normal cervical lordosis at the C4-through-C7 levels, with endplate osteophyte formation and near-obliteration of the disc spaces at the C4-C5, C5-C6, and the C6-C7. The patient showws prominent disc osteophyte complexes in these areas, with attenuation of the AP diameter of the spinal canal, which appears to have a congenitally reduced AP diameter, to approximately 6 mm at C5-C6, 7mm at C4-C5, and 7mm at C6-C7. Thye patient shows small uncovertebral hypertrophy of these levels; this appears to be more significant on the right than left.

Axial images confirm the above, showing abnormal appearance of the craniocervical junction and neural foamina. The mastoids and middle ears are aerated and normal, and the imaged posterior fossa shows a normal appearance.

C4-C5: Spinal canal stenosis, as described, with flattening of the ventral cord, and a somewhat triangular shape of the cervical cord. Moderate to severe right neural foraminal and moderate left neural foraminal stenosis secondary to uncovertebral hypertrophy and disc osteophyte complex.

C5-C6: Again, flattened ventral cervical cord, this finding fairly symmetric. Severe bilateral neural foraminal stenosis secondary to uncovertebral hypertrophy, and disc osteophyte complex.

C6-C7: Lesser degree of spinal canal stenosis, greater on the right than the left, bilateral mild neural foraminal stenosis.

IMPRESSION: Congenitally Short AP Diameter of the Cervical bony spinal canal, with Severe spinal canal stenosis to 6 MM, C5-C6 and lesser degrees at C4-C5 and C6-C7 of approximately 7mm. Ventral flattening of the cervical cord at these levels, and severe uncovertebral hypertrophy with neural foraminal stenosis.

This Neurologist said that in his opinion the neck problems were directly responsible for the weakness and trembling in my legs and arms. He felt that it was severe enough that without surgery to repair damage that I would lose control of both my bowels and bladder in the near future. Most likely within 12-18 months as well as the trembling and weakness reaching the point that I would effectively lose control of the lower half of my body.

I had a second opinion done despite the notoriety and acclaim of the neurologist who originally ordered the testing. The results were the same. Surgery was my only option.

The neurologist felt strongly enough about my situation that he referred me to the Professor of Neurosurgery at Emory University who I will see this week with the plan being to setup a surgery quickly.

Of course I don't yet know whether it will be anterior or posterior surgery until I meet with him or any other details. I was wondering what those of you who've had similar surgeries or conditions have to say regarding the surgery, the hospital stay, the recovery and level of success you incurred.

Sorry for any typos but the spasms make it hard to type.

Thanks for any help.
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Comments

  • I have been having twitching in my arms and legs, pain in my neck and into my left shoulder and arm, I also feel pressure in my head at times (like a balloon is blowing up inside) this is not painful. I just had surgery in april on C7-T1 and I am still in the soft collar. I was wondering if anyone else has had this or if I possibly have another disc problem. They are treating me with flector patches and tramadol now for 2 wks, but so far they don't seem to be doing anything. I had surgery 2 yrs ago on C5-C7 also
  • Welcome to spine-health. I am 5 months post op from a 2 level ACDF and a 3 level posterior cervical laminectomy, and 9 months from a 2 level ACDF. I would have to say that my ACDF surgery has been much easier to recover from than the laminectomy. Perhaps this link will help explain some things better for you as far as the symptoms of myelopathy.

    http://www.spine-health.com/conditions/back-pain/cervical-stenosis-myelopathy

    The first ACDF I had in Nov 2007 went rather well as it was done as a emregency. I had surgery Friday and sent home Sunday, was off pain meds by Wednesday, and only needed a few muscle relaxers after that. That recovery went well, was able to drive after 5 weeks, started PT around 8 weeks after surgery. The second surgery was done to prevent my myelopathy from getting worse, it has done that so far. I spent 4 days in the hospital, with one of them being in the ICU due to the length of surgery. This recovery has been much harder due to the laminectomy. I have started to regain some of my balance, it never will be perfect, my reflexes are still wacky, but with PT I am getting stronger, just way to slow for me, but what can one do. Overall I am pleased to be where I am at this time, heck things could be much worse. Feel free to ask questions, lots of good answers can be found here. Hope that this was of some help to you.

    mark
  • Hi and welcome to spine health. Sorry to hear all the things you have going on. It seems as though you have done some research and of course have a understanding after going through the lumbar surgery. The major thing i would do if i was you is to have the biggest list of questions ready to ask. Find out the names of the procedure they are doing what type of bone they will be putting in. Usually for multi-level fusion the risk of non-fusion goes up. So that would be a huge discussion that i would have cause you don't want to have to do it over if it does not fuse. I would also found out what type of expectations to have after the surgery. How much of the damage is already permement and is not reversible if any. The other obvious is how long will you need to be in the hospital. You will also want to know if you will be in a hard collar or soft and for how long after surgery.
    As far as would i have the surgery or not the answers is if my outcome was going to be what they are telling you then i would do sooner rather than latter and would not take the wait and see approach. Surgery is a very personnel decision and each individual has to weight the risk. As for me i have had the surgery and even with some troubles i have had and happy that i did it. Before the surgery i was almost bed ridden from the pain and not functioning at all. Even with some complications still happy that i made the decision. Let us know what happens after you talk to the surgeon and what they decide to do. Once again welcome to spine-health.
  • Good point about making a list of questions. Unfortunately my wife won't be there as she's usually the question person. I guess I'll have to come out of my shell and ask them myself.

    I hate to sound completely ignorant, I'm more familiar with lower back problems, what is the collar that many of you have mentioned?

    Again, thanks for all your help.
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