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My cervical foraminotomy operation

TurtleTTurtle Posts: 161
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
I know I had many questions before my C7 root nerve decompression via the Jho's Procedure. I still have questions about post-op symptoms. I am writing this for others-maybe I can help them-maybe you can help me.

I saw a local neurosurgeon after a severe flare up of left arm and hand pain, weakness and numbness. An MRI was taken and I was told I had a herniated disk at C7 and needed to have it removed and a fusion preformed. I wasn't ready to have something so permanent, so I got a second opinion at a teaching hospital.

I had an anterior cervial foraminotomy which removed bone spurs and part of the offending herniated disk which were causing the pain and spasms in my left arm and hand. No fusion was preformed-this is called Jho's Procedure. Research has shown that fusion may not be necessary for all cervical patients, especially those without neck pain.

I had the operation 6 days ago. During the 1st day in the hospital I only took Tylenol for a headache and heat packs for muscle pain in the rigth shoulder. I asked why I was having right shoulder pain and the surgeon said it was likely from the way I was placed on the operation table for the operation. It still hurts-you'd think they could have used a soft pillow.

Once home I had to take Vicodin and Hydrocodone for pain in my back and both shoulders and for left arm tingling. I think I felt better in the hospital because of residule anesthetics.

I woke up from the operation with numbness on the tip of my tonuge. Nurse said it was likely from the stuff they put in your mouth during the operation, but I now know that isn't likely. If it does't go away after a few more days I'll be calling the neurosurgeon. I think it's an surgery effect.

I was warned I may have hard time swallowing and that was an understatment. The incision was done on the right side of my neck even though the compressed nerve was/is on the left. Apparently my surgeon prefers not to deal with the lymph stuctures that are present on the right, but that means the esophogus must be moved over more for access to the spine. My throat feel like it's out of place but the surgeon said most patients get over the discomfort-he's only had to refer a few to an ENT. Isn't that comforting to know?

I have probably been doing more than I should because it is a relief to have less pain, but I have read here and on other forums where patients have done too much, too fast, so I am going to slow down. I have a soft neck brace, but was not told I had to restrict movement of my neck. I will try not to bend over to pick things up or put pressure on my neck for at least 2 weeks. I think it takes that long for the skin to heal. It's just patched with steri-strips and not sutures.

One other concern I have is heartburn. It's pretty bad and was wondering if anyone else with neck surgery has had it.

The best thing I can recommend is to get an experienced surgeon. I had to go to three before I found the one I thought was the best one for me. For those going for their own operation-best of luck! To the others who have had one-please share with me your recovery stories. I will keep this updated until I see my doctor in 5 weeks.
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Comments

  • my back issues are L5 S1 so I can't really help. I wanted to welcome you to SH though! >:D<

    There are several people on here who have had cervical surgeries, and I'm sure they will be chiming in soon. :D

    Caity
  • Anyone who had cervical surgery get a numb tongue? The tip of my tongue is numb and feels somewhat like I stuck it in hot coffee or something. I called the surgeon's office and the staff there said she'd never heard of that happening before but will ask the doctor. Anyone else had this happen to them and did it go away? It feels weird-not painful-but definetly bothersome.
  • Today is post-op day number 13 and I feel more energy-even ON the pain med and muscle relaxants! I tried to get off the valium after 10 days (well, really that was all the hospital sent me home with) but had muscle spasms, especially during the night and morning and I had to call the surgeon and ask for more-he even gave me something for seizures! Not sure I will take them because I know I didn't give them any impression I felt I was having them :) They even made an appointment for me to see them next Moday without me even asking! Great doctor-but I cancelled it because my husband can't take me and if you have read some of my other posts you know I live 2 hours away-plus I was reminded by DH that nothing is different from this go around than last time and it's time I just sucked it up. He thinks I try to do too much and I should just rest for the next few days to another week. I'll try that.

    My tongue is getting better, i.e. smaller section is numb so maybe even that is healing. I still wear a soft neck brace and would suggest that to everyone-even the ones whos doctors didn'tsuggest them. It has saved me from several accidental head jerks while stumbling in the dark, or accidently thinking I had lots of pillows behind me only to find I didn't and falling flat on the couch!

    DH gladly massages my shoulders when they are in pain and though his patience with me is wearing thin-he still tries to make me laugh and I appreciate him.

    But this is a critical time for us from the many messages I have read here-many people have a set back around this time-2 to 4 weeks post-op. Maybe we do too much, or a healing process really kicks in, but I intend to take it easy until Christmas Day-after that all bets are off. I'll tell you what happens again after that day.
  • to hear things are getting better for you! You sound real good at 4 weeks post op. But like you said, take it easy. Don't do too much. You don't want a set back. :D

    Caity

    PS A water park sounds like so much fun!!! I miss those days. What I wouldn't give to go on a roller coaster either! :))( =))
  • This on-going (basic monologue) discussion is for others who may have the same type of operation and would like to hear one person's experience of recovery.

    Four days ago I fell down a step on my deck and sprained my right ankle bad enough where I could not stand on it and had to lay on the deck in the cold until my husband started wondering where I was, lol! He took me to PromptCare where they did x-rays and said I had a bad strain and should wear an Air Cast for 4 to 6 weeks. But more scary than the fall was "what did I do to my neck"?! I did not fall on the bad left side, but I have had more pain in the left arm and shoulder since the fall. I can't tell if it was from me actually damaging my neck (no, I wasn't wearing my neck brace-for shame!) or from me just jarring my whole body. I fell like a tree in slow motion and had time to tense up, so I hope my increase in pain is caused from the overall body ache and soon will go away.

    The incision site is still ugly looking-I had to cover it with a bandaid when I had my young great neice and nephews over for New Years so they won't stare at it-just my luck that is what they will remember when I'm dead and gone-"oh yeah, the great aunt with the hiddeous neck" :& But the large lump beneath it is going down-now I have a lady-like Adam's Apple, lol.

    I am on no, or less pain meds and muscle relaxants during the day, but still take them at night as I am a flopper in bed and don't want to do something to my neck, plus by the end of the day now, my arm and shoulder hurt and burns-sometimes I feel a pinching sensation. Is this the feeling of healing? Or am I over doing it? I probably do to much, there is no doubt about that-I am a terrible patient, no patience at all. I can go a whole year without dusting but as soon as I shouldn't dust-I want to dust! Go figure.

    I will know more when I see the surgeon next week and will give an update then.

    But I think I am doing well and wish we all could say the same, however I know there are many people on SSD and into their 3rd-4th-5th or more operations! I wish you all well and a lessening of your pain.

  • My numb, tingling tonuge is getting better but still dead feeling at the tip, but at least it doesn't feel burned anymore. Some people here have had the same thing and said it will get better.

    I am not taking the one of the meds the doctor recommeded because the side events sounds worse then the symptoms-which are muscle spasms (not too painful anymore) and numbness in fingers. I rather have that then the bloated fingers and toes plus double vision!

    The shoulders are still being helped by the heating pad and massage (thank you DH!). The pain level had gone down a lot. I have to say after 4 weeks of EXTRA SPECIAL lounge lizard like behavior I have healed nicely from Anterior C7 root decomppression from herniated disk and bone spur removal. I went to a teaching hospital and recommend checking them out too for the latest advances-but rememeber residents may be working on you! They did on me and I was not told beforehand!

    Neck is still weak-as I have to literally move neck by hand or I feel pain in area of C7. Still on 1 Valium and 1 Hydrocodone at night- but only 2 Tylenol 2 X day to half a hydrocone during the day because I need to drive.

    Scar looks Frankensteinish but people have assured me it will get better, too.

    I have no complaints at this time-only must remember I am still just 4 weeks post-op and anything can happen if I over do it-which I did yesterday with a trip to a small water park with neice and great neice. I stayed in hot tub and the lazy river but did a lot of neck movement and slept in hotel bed without my heating pad. I paid for it today, but at least I know I caused it. I will accept my pain as justifiable punishment :P

    I go back to college as a 55yo on the 13th and that will be the real test. I rushed this operation because I didn't want to postpone my classes. We'll soon see if I made the right choice. And I will update this again after my first day of classes and after I see the surgeon the next day :)

    Word to others who might be considering the Jho's Procedure (it uses no fusion), it is only for those patients without actual neck pain or gait disfunction. I only had shoulder, arm and hand pain. Lots of it, but very localized. Not all doctors trust it, but I've had it twice now and the 1st one held up almost 9 years. I hope this last as long. It protects the disks above and below the herniate disk, whereas a fusion can sometime speed up decay in those areas.

    Good luck to all surgery patients!
  • I am happy to say the surgeon who did my cervical foraminotomy and herniated disk removal was pleased with my recovery. I mentioned the continued morning time muscle spasms and twitching and evening time muscle soreness which sometime borders on pain. He says he think most of the pain will go away and ordered 6 weeks of PT, and another round of muscle relaxant. The scar may take a year to dissapear :)

    Thanks everyone for your time and help during my recovery. If I can help anyone with the same type of surgery-please PM me!
  • I'm still waiting on full recovery. It has been slower then the first time I had work done on this nerve (C7). Last time it was the bone spurs were removed posteriorly, this time it was from the front and there was disk herniation as well as bone spurs. I am not unhappy, there are people my age who are dying, afterall! But it is a sad daily routine for me to decide what I can and cannot do, which meds to take and which I can forgo for the day. But such is life and I do the best I can and with the help of my husband, who recent told me he can't recall a day I was irritable, unless I was coming off my steriods (for asthma) or really sick :) That was nice of him to say because I know it's not true, but it did cheer me up to know he doesn't hold my bad days against me.

    Hope everyone is progessing well! I'll be back with an update, but for now I must admit to still weak left arm muscles, mild pain and twitching of the bicept and tricept, tight shoulder muscles and pointer and index finger numbness-but thank goodness, no flare up of the severe muscle spasms that used to send me to the ER or keep me in beds for days :)

    Tess
  • I'm back to give you an update on my procedure-it only involved removal of the bone spurs and herniated disc, not the whole disk and fixation with plate and screws/pins.

    So far the operation seems to be a success-I cannot say it has been a total cure as I still get muscle spasms-but it is not like the types that put me in the ER. It is like what I got for a year before the final straw-more like twitching and soreness. I hope all symtoms will go away in time, but that is unlikely, after all, this my second operation in the same area.

    Every once in awhile I will get a very sickening feeling when I move my head and the nerve or something is rubbed together. I don't know what it is and it rarely happens, but when it does my whole body flushes. It is scary, but there is nothing I can do about it-I can't even recall what I did to cause it. I look in a direct and bam!, it happens. I can make the same movement and get nothing.

    I have decided to get the degree I walked away from almost 30 years ago :) I'm in classes with 20 and 21 years old. There are a few older students, but so far no one as old as me, lol! I quit the job that had me at a computer all day long, but I can't say college is much better with the research and papers I have to write.

    I hope all I have met here are doing well. I'll be back in a few months.
    Tess

  • Hi Tess,

    This subject caught my attention because I haven't seen much discussion about this surgery. I had cervical foraminotomy 6 weeks ago. Mine was done posteriorly, however, and I didn't have bone spurs and the surgeon also did not remove any of the disc material, he just removed some bone to give the trapped nerve some space.

    My post-op recovery was much smoother than yours, but I also never had previous surgery in the area which no doubt makes a huge difference. It was a same day surgery and I could tell before leaving the hospital that it had been successful because I could move without nerve pain. The only strange thing I've experienced is burning muscle pain and spasms on the opposite side to my surgery, which didn't make sense to me. My physical therapist says that you can't sort the neck into "left" and "right" because the neck functions as a unit. I still get some burning and spasms if I work with my head tipped forward for more than a few minutes, like when preparing food, but that's getting much better. I'm experiencing occasional nerve pain but it is in a new location and infrequent. I'm faithfully doing my exercises and plan to do them for the rest of my life so I hopefully won't need more surgery. Most all of my cervical discs are bulging but hopefully I can avoid further herniations.

    Best wishes to you. :)
    P.S. I have a friend named Tess who also has gone back to college. Hope your studies are going well.
    Linda

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • Just wanted to chime in here, havent had a chance to read all yet (at work). I too had a numb tongue. It lasted almost a month. I found out it was from them getting my tongue between my teeth and the taped down breathing tube. Its like the circulation was cut off for 3 hours.
  • It's been 8 weeks since the Cervical Foraminotomy in C5-6 & C6-7. That's when they cut in the back of your neck, move the muscles to the side, & with a tiny drill they grind down the 2 discs that were impending on the nerves, which had caused the pain & numbness in my left arm (which is all gone now). I had no idea recovery would be taking this long. The docs just say "several weeks for recovery" "& everyone is different". If I had to do all over again, I surely would. Just lucky they had a way to get rid of the moderate DDD. Life is good.
  • >:D< I dont know if you still come to this forum, but wanted to agree with you that if not comfortable with your first advise from surgeon, see another one. I went to 3 myself before making decision to have posterior cervical foraminotomy. Seemed like so many people never heard of a foraminotomy. It is less procedure than bone implant. What is good for one, might not be good for another. This is your body & your life. It is very important to shop around. Find a reputable doc that you feel comfortable with, and take his advise on what to do & what not to do. After surgery, I liked coming to the forum to discuss recovery. Made it somewhat easier because everyone in here is dealing with similiar issues.
    GOD SPEED & hugs to all ----
  • im 23 years old and have 2 disc herniations. my c5 c6 and my c6 c7. i have a large protusion on my c6 c7 and ive been on 8 different meds and 3 high doses of anti imflammatories in the past month and nothing seems to be helping. ive been on everything from pain meds to steriods ive done physical therapy which killed me and so on. the dr. told me today i had a choice to get a Cervical foraminotomy. though he said he would do it but said he really didnt want to because i was so young. what would you do? i just need to go back to work and im tired of feeling this pain and pressure in my neck. im left handed as it is and i do everything with my left hand and that's what side its on. i dont know what to do?
  • I had a posterior cervical foraminotomy at the C6-C7 level in April and I would do it again if it was called for. It took about 6 weeks before I didn't need pain meds but since this was my only cervical spine surgery to date I have nothing to compare the experience to. I don't know what your age has to do with this particular type of surgery. They don't remove the disc (or may remove a portion of it) and there's no fusion, etc, so his response is a bit mystifying. If this surgery somehow weakens the spine or predisposes a person to future trouble, I wasn't told about that. I do notice a mild depression directly over the spot where bone was removed and my physical therapist said I may have had some loss of muscle in that spot but I don't have any adverse effects from the surgery, not yet anyway.

    Maybe someone else will chip in with a different perspective. :)
    Linda

    2009 Foraminotomy C6-72010 PLIF L4-S1Multi RFA's, cervical inj, lumbar injLaminectomy L3-4 and fusion w/internal fixation T10-L4 July 17Fusion C2-C5 yet to be scheduled
  • Today is friday & Im sitting hered bored at work & thought I'd stop in here & read a little. I agree with inch, "what's age got to do with it" Pain is pain no matter your age. A Cerv. Foramin. is like a finger nail clip compared to some of the other types of surgeries for neck & back pain. The only part that hurts is the muscles afterwards, big deal.
    >:D< a BIG hug
  • Hell-o Im new and was searching my daughter had surgery and saids her tongue is numb. Just like user turtle, so let me ask you turtle you said it was getting better and did you ever reach a full recovery and how long before feeling came back. we are worried about this it all sounds the same as my daughter has mention and doctors never heard of that before.
  • I will be graduating on Thursday 8} University classes were a lot of work, but taking them didn't allow me time to worry about the little things that are still not right after my anterior cervical foraminotomy operation on C5/C6. Often the same tingling sensations and some muscle twitching will occur, especially if I overuse my left arm and shoulders. However, the excruciating pain and spasms that would contract my muscles into hard balls has not returned and that is GOOD. My tongue numbness went away in about 2 months. The scar is flattening and looks fine to my husband and who else counts?

    This is my second neck operation. The first was a posterior cervical foraminotomy on the same discs, plus one other level. Therefore, I am not convinced I will never need another operation, but hopefully this one will last at least 10 years like the first one did.

    I have accepted my body and that includes my bones, too. Of course we each have different levels of pain, disability and risks we are willing to accept as we go through life, but for me, the risks of a unsuccessful operation was more acceptable than the levels of pain and disability I would have to live with without an operation.

    I hope everyone will find help and relief for their spine issues. Thanks Spine-Health and SH members for helping me out when I needed it.
    Tess

  • I've not seen any of your posts before, but it is so good to hear that, in the main, your surgery has been successful. I don't think we expect a complete return to our perfect spine, but just to get rid of the really bad pain, is such a relief.

    Congratulations on graduating on Thursday. :-) Hope it is a very special day for you, and that you will feel especially proud of yourself, as it will mark a stepping stone in on the way to your new 'improved' life.

    Thanks so much for taking the time to come back here and post how your recovery is going, even after 19 months. It is so encouraging for others who are just about to have surgery, or who are still in the early days after surgery.

    Take care, and really enjoy Thursday! :D
  • SpineAZSpineAZ WiscPosts: 1,084
    I had an ACDF C5-C7 in 2006 and then in 2008 had a posterior cervical foraminotomy for stenosis and bone spurs. The posterior approach is definitely more painful than the anterior approach. My muscles in my neck have never been the same and occasionally need heating pads, massage, etc.

    I now have some C4 problems so if he recommends surgery I'm not sure if he'll re-do my ACDF or go in from the posterior side.

    I did not have any tongue issues but it makes sense given the cervical nerves. And those nerves take time to heal. After my foraminotomy I had an epidural injection about a month after since I had one cervical nerve that was fired up and would not calm down. One ESI helped.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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