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C3 to T1 decompression with instrumented posterior fusion

AnonymousUserAAnonymousUser Posts: 51,489
edited 06/11/2012 - 8:29 AM in Degenerative Disc Disease
I have multilevel cervical stenosis (congenital) with myelopathy and am due to have posterior instrumented fusion in the Summer.
The surgery is for C3 to T1 decompression with instrumented posterior fusion.
I would be really grateful to hear from anyone who has been through a similar procedure and who can give me some advice on what to expect during recovery.
I am particularly worried about how my neck will feel mobility wise and whether I will be able to move it at all afterwards.
I am 39 and have had nexk and arm symptoms for several years, my legs are now affected and I guess surgery is the only option?

Thanks and best wishes
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Comments

  • Greetings from Australia

    I had the same surgery in 2007 - for symptoms in arms & hands. There was severe degeneration in all cervical discs and had been for years but I was asymptomatic - until I was in my early 50s. Various osteopaths and doctors over the years - when they looked at my neck X-rays - couldn't understand why I didn't get headaches nor why I had such degeneration in my cervical spine when I'd never been involved in any type of accident that could have caused this.

    Finally, the symptoms started. Nerve pain radiated to shoulder blade/rhomboid area & was incredibly difficult to deal with as it was constant and I could get no relief except for temporary relief after massage. I had to stop my daily swimming as it became too painful. Arms and hands were tingling, fingers were numb, and nerve conduction studies showed signal changes in the left arm. I started dropping things. The spinal cord was becoming affected, so surgery was warranted before any permanent spinal cord damage occured. Although they did try steroid injections under X-ray before surgery, but they didn't help. Just cost me more money.

    I've recovered extremely well. People can't believe I've had so many levels fused when they see me. Most neck movement is from C1-C2 so I can bend forward, chin to chest, but I can't really bend my head backward (looking up to sky). I can turn my head right & left fairly well, though it is limited compared to a 'normal' person. I don't have much movement bending ear to shoulder, though. I don't drive, but I would think that the movement limitations I do have would affect my ability to drive, so that's something to consider - you may not be able to drive after this surgery. Although cars these days are coming with built-in camera systems for backing up, etc that you may be ok for driving. I still do Pilates, Yoga, weights, aqua aerobics.

    However, immediately post-op the pain was pretty intense. Worse than my two lumbar fusions by far! When they first got me up the weight of my arms hanging down was worse - I had to walk with my arms folded across my chest to prevent their weight pulling on my neck. I had to wear a neck brace for 2-3 months (can't quite remember, but it was at least 2 months). This had to be on constantly, shower and all. I had to learn how to change the foam pads after showering so that the brace was dry (it came with extra pads). I had to do this lying flat, so I'd shower with the brace, dry off, then lay down in bed to change the foam pads. I was measured for the brace while in hospital, but I don't remember the guy coming in to do it. I also had to go straight into intensive care after surgery for the first 24 hours. I didn't have to do this for the lumbar fusion.

    They used a nasal breathing tube for surgery, instead of one down my throat. This was painful when it was removed, and I had a bit of bleeding from that nostril for a while after surgery. Also, your face is quite 'puffy' after surgery because you're on your stomach throughout the surgery - my surgery was just over 7 hours!

    They took a bone graft from my hip, but this didn't cause any problems. What was painful was removing the drain near the op site. Pulling this tube out was very painful, but it was quick.

    I learned how heavy the head is - especially when the brace started to come off. You take it for granted, but after this surgery, suddenly you're aware of just how heavy the head actually is.

    The best thing I did was go into a rehab hospital after being discharged from the hospital where the surgery was done. I live alone, and if you live alone, you need assistance. At rehab, I got my meals, help with the neck brace, clean sheets & towels, daily physio sessions in the physio 'gym' and in the hydrotherapy pool. I spent almost 3 weeks in rehab and strongly recommend this option. Not sure how the American system works, but all hospitalisation costs were covered by my private health insurance. I was out-of-pocket for the surgeon, anesthetist, & surgeon's assistant as these types of specialists charge more than the standard 'fee' so the patient has to pay the 'gap' in spite of having private health insurance and government Medicare coverage.

    On an end note, you will definitely be able to move your neck again. But be disciplined with the physio - daily exercises - and above all, remember - one step at a time. I thought I'd never get past the 'head & arms feel so heavy stage' but I did. And all symptoms have gone and none have returned (not like my lumbar fusions). By far, the cervical decompression & fusion with bone graft & instrumentation was a SUCCESS.
  • Hi Zirgle,

    Hope your surgery went well as for me I am still suffering. I had c3-4 fusion then got in a car accident and had C5-6 fusion which failed. 12/08 c3-7 decompression. I suffer from spasms down my right arm- neck pain- tingling in my right hand and fingers. I take pain meds and get periodic pain injections and I am now waiting a EMG test of my nerves. I dont think fusion or decompression is a cure it just stabilizes the spine. How did your surgery go? wishing you well. Also I am frustrated that the doctors act like there is nothing wrong when you complain, its like they want you to go away. Does anyone else get the feeling yo are a burden on the doctors??
  • I was just told I'm in need of a C4-T1 post fusion, decompression, etc. Putting it off right now long as I can. I've had a 2 level ACDF that's failing so not looking forward to promises about how good this ones going to be!
  • I had a decompression with multi-disc fusion 6 weeks ago C3-T1. I'm having alot of problems, pain, nerve damage, frozen right shoulder. they went into hte front and back of neck. I start physical therapy next week. goood luck
  • Oct 2009 I had a Cervical Anterior Corpectomy w/ fusion C4-T2 and a Posterior Laminectomy w/ instrumentation C3-T2 at the same time. I didn't want to have 2 separate surgeries. I have plates in front from C4- T2 and rods with w/screws in back C3-T2. At first the pain was very intense. Once I was home after 5 days in the hospital i did much better. Did take a lot of pain pills - Oxycodone and Valium among others. The NS was impressed with my recovery but I have a high tolerance to pain most of the time. I stopped taking the meds after 6 weeks because I wanted to drive again.

    Went to phyiscal therapy for 8 weeks which helped a lot with Range of Motion (ROM). I think it was 6 months after that I found I can look up farther than I thought. My ROM was better than I expected. I am not able to look over my shoulders all the way like I could before (my right side didn't have a lot of trouble before the surgery) but i can look down and up but not for long periods of time without pain. I am a lot older than you too - 55 at the time of surgery so I would think your results may be different. I didn't care about the ROM however. I was more interested in the pain stopping and getting back some use of my left hand.

    Best of Luck!
    Robin
  • Rebecca millerRRebecca miller Posts: 7
    edited 09/06/2015 - 10:15 AM
    Hi All! I am pretty new to this website but think it's great! I hate to see others going through what I am, but it is comforting to see so many folks willing to share the results of their experience! Twenty years ago I needed a C1-C2 fusion due to having 6 mm of instability in that area. As a result and as I predicted, the rest of my spine has taken a beating due to the stress of having this 50% ROM area fused. I am 51 and when I was 17 I spent 50 days in traction due to a dislocated right hip. Anyway, I began to experience severe lower back pain mainly on the right side. To say the least I need a right hip replacement, however during a recent MRI it was discovered that I have a severe narrowing at C3-C4 and a herniated polposis. B4 I can have any other surgery I am being told that I need the cervical surgery because no doctor will risk putting me under anesthesia for any surgery until I have the C2-T2, possibly T4 fusion. Now a hip replacement has turned into 3 surgeries and a year or more of total operation and recovery time. Has anyone been faced with this issue? Even just the C2-T2 surgery? If so I would love to chat and see how you are doing. Mostly all of the comments I have read go back many years. I would appreciate if someone would. Write me and tell me how things went.
    I am just getting familiar with this site but think it is great!
    Thanx
    Rebecca

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    Rebecca miller
  • Hi Rebecca,

    I am sorry that you have been faced with these issues. Obviously you already have a loss of ROM from your C1C2 fusion and have coped with it. I had a 4 level t9-t12 laminectomy to remove ossified yellow ligament that had grown large enough that it suddenly was causing me intense pain from stenosis. I am only 37 and (was and hope to be again) very active. My pre-surgery physical exam followed up by a cervical MRI and CT scan which showed OPLL, DDD, and stenosis of the cervical spine. The doctor decided that it was okay to continue with the thoracic surgery. I was healing up nicely, except for the arm numbness that I had for years was getting worse. The OPLL was only going to continue to grow and push into my spinal cord more so I opted to have what I thought was going to be an ACDF. At the consultation I found out that I would need a two-level corpectomy along with two PEEK cages for the ACDF from c3-c7. Unfortunately my neck is kyphotic(curves the wrong direction) so I would also need a posterior fusion with plates and rods to prevent further degeneration and to ensure that the front fuses. The other option was to wear a halo for 3 months. Well, I'm coming up to take my 3 month post-surgical xrays in a week, and I'm glad that I'm not wearing a halo. I was able to return to work for about 25-30 hours per week at 8 weeks post-op. I've been going to physical therapy for 3 weeks and doing my exercises at home. I was able to walk around with a soft collar for the first 6 weeks. The first two weeks were pretty painful with extreme muscle spasms. After that I was able to get on a treadmill and worked up from .2 miles to 3 miles a day to help promote oxygenated blood flow. I have not driven a car yet due to my limited range of motion, which is still improving. I can move good enough to drive when I feel good with relaxed muscles, but they usually get stiffer throughout the day, even with meds. My thoracic muscles were like that, so I am assuming that this is just a phase of the rehabilitation process. I am not a doctor, but I would think that you would have hardly any range of motion left with C2-T2 fused. Consult with your doctor about what you will and will not be able to do after your surgery. Depending on your current lifestyle, it may affect the timing of your surgery. I have a wonderful husband who has been able to help me out tremendously. You will definitely need help with basic living activities for 2 weeks minimum. I usually still need him to take off my shirts or clothing that goes over my head. Button shirts are a good option. I am planning on being back to my new normal by Christmas. That puts me a year of healing and rehab with 3 surgeries. I do recommend that you mentally prepare yourself for an exercise in patience and humility. The good thing now is that I will be able to put this behind me and not have to dread it or worry about a pending eventual partial paralysis from the growing calcifications. The bad thing is that there is a good chance that I may have to change some of my recreational activities to less extreme sports. I hope that this has helped you out some, even though it wasn't the exact surgery you're having.

    Best of luck,
    OYL
    1 in a million
  • Hi OYL:
    Thanx for your comments. Although a little different, our situations are similar. I am so happy to hear that you are getting back to being yourself! I just postponed my surgery, having many concerns and unanswered questions. Although I know what is going to be done and what to expect, my concerns are with a couple other issues. The first Neurosurgeon at UPMC is one of the heads of the Minimally Invasive Surgery Department. At first he stated that he had big plans for my neck corrections! He wanted to remove the 20 year old pins, fix the herniated nucleus polposis at C3-C4, therefore re establishing my natural curve in my neck and eliminating the need for a posterior fusion!! WOW! My parents and I were so excited! I didn't question this mans sincerity because I assumed that "things" have changed greatly since my C1-C2 fusion in 1994! We made a second appointment to schedule surgery and I couldn't believe my ears! This doctor stated that "although he could do the surgery, he preferred to perform quick 1-2 hour surgeries. Get in and get out"! Not only does it take 30 days to get an appointment with almost any of these UPMC doctors, they all perform tradional open surgery. Every doctor has wanted to perform the C2-T2 posterior fusion with the "extras" at each level! Being never married and without children to help out, I have explained to the doctors my need to maintain my independence, ie my ability to drive again! After several surgeons I have seen another surgeon at UPMC. He too believes that my surgeries can be performed with MIS techniques! I haven't seen the actual neurosurgeon. I saw his RA, resident assistant, just in case you weren't sure. I will be seeing him soon. I am starting to get concerned that possibly insurance or some type of issue like that is turning the surgeons away at the last minute! I am sick at the thought that these great minds are bent stifled by insurance companies and bureaucracy! To put someone through such a life changing and difficult surgery, as you know, if it could be done in a way that would cause less trauma to the muscles, nerves and entire area or could cut recovery time to less than half etc, etc, because of money or any reason, makes me sick to my stomach!! Did you ever see a doctor who performed MIS surgeries? If so what were you told? Since this neurosurgeon changed his mind and I have been told about traditional surgery, I have been treated like crap by many of these secretaries and receptionists in these ortho and euro doctors offices! Have you seen all if the UPMC commercials on TV? That great neurosurgeon, Dr. Okonkwa's secretary never ALLOWED me to make an appointment because I accidentally called her "honey". Granted I am only 51 but that is just the way I am! I naturally call people dear, honey etc. I can't believe how this woman blew up on me! She said, first I am 61 years old and have been here for 20 years, no one calls me honey! I couldn't believe it! You would think that these people, especially with all if these years of acquaitence with patients would let that stuff go right over their head! To stop someone in mid-sentence to " scold" them, makes me concerned about their level of professionalism! I remember 20 years ago, I didn't have nearly the concerns about this entire situation! Then to see UPMC Presbyterian with all of its cleanliness concerns lately mold, legioneers etc., I have never been more uncomfortable about anything, ever! I know I have written a lot to you but to say the least, I am pretty tough! But, I gave never been more scared in all of my life! Maybe each f these issues at face value and standing alone seen that traumatic, but put them all together And it is a big mess! I wish that I could be more confident that I was doing the right thing!
    Throughout my reading I have seen that most people have many more symptoms than the numb fingers that I am having, before they undergo surgery. So, I have decided to keep searching until I am positive that this traditional surgery is the only way! HAS ANYONE HAD MINIMAlly invasive surgery for this condition?
    Well Oyl, thanx again for your comments. I am glad to hear that you are feeling better! Keep up the hard work! God Bless!
    Rebecca
    Rebecca miller
  • Has anyone had Minimally invasive surgery instead of a tradional C2-T2 posterior fusion surgery? If interested please read about my situation above. I have several posts and welcome any and all comments, questions or concerns that you kind folks can offer. Thanx
    Rebecca miller
  • moonbeam 3mmoonbeam 3 Posts: 3
    edited 11/12/2015 - 8:54 AM
    Anterior cervical decompression Level c2 c3 This was my first surgery After an accident at work Fell from a tank proximately 15 feet Now the surgeon tells me I have to have A posterior laminectomy fusion from levels c3 to t 2.My symptoms are Extreme pain And hands arms and shoulders Weakness in left leg Have never really recovered well from the first surgerySurgeon says I need to have the second surgery to stop me from getting any worse Not saying it will make me any better Just wondering if anyone else has had similar Surgeries And what their outcome was I am new to this website Please help me

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