Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Looking for answers - surgery required (cervical)

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in New Member Introductions
I am a 22 year-old male in very good health, but have had chronic neck pain since playing football about 7-8 years ago. In early February of this year, I began to suffer from numbness and tingling in my right arm. An MRI of my cervical spine revealed multilevel disc degeneration. The summary is as follows:

C2-C3 disc shows no bulging.

C3-C4 disc shows broad-based degenerative protrusion with endplate osteophyte spurring resulting in spinal stenosis with cord compression upon the cervical spinal cord, as well as mild bilateral proximal neural foraminal spondylitic narrowing slightly worse on the right.

At C4-C5 there is prominent broad-based degenerative disc protrusion with endplate osteophyte spurring resulting in spinal stenosis with cord compression and bilateral neural foraminal spondylitic narrowing.

At C5-C6 there is also broad-based degenerative disc protrusion with endplate osteophyte spurring resulting in spinal stenosis with cord compression and slight bilateral proximal neural foraminal spondylitic narrowing.

At C6-C7 there is mild degenerative disc bulging unassociated with any spinal stenosis or cord compression or visible foraminal narrowing.

The C7-T1 disc remains normal.

In the cervical spinal cord at C4-C5, to right of midline, there is a small focus of increased T2 signal intensity measuring approximately 7 mm maximal size. This is nonspecific, but the possibility of developed myelomalacia in the midcervical cord is raised.

There is no evidence of syrinx. There is no cerebellar tonsillar herniation through the foramen magnum.

The cervical vertebrae show no fracture and no suspicious marrow infiltrative mass lesion. There is a reversal of the cervical lordosis centered at C4-C5.

Impression: Degenerative cervical spondylitic changes resulting in multilevel spinal canal stenosis with compression upon the cervical spinal cord at C3-C4, and more pronounced at C4-C5 as well as C5-C6.
At C4-C5 the possibility of developing myelomalacia in the cord is raised.

That MRI report is from February 9. I went to see a spinal surgeon who recommended 3-level ACDF of C3-C6 as soon as possible. He said that I was at risk for paralysis or worse if I experienced any trauma to the area. I asked about alternatives (with ADR in mind) and he said that as a doctor who does have replacement experience, I was not a candidate. My knowledge on the subject at that time was far less than it is now, so I did not ask why (i.e. number of levels only, or presence of cervical kyphosis). I initially scheduled the fusion, but canceled it soon after to look into other options. The numbness and tingling I had experienced subsided for about a month at that point.

Then, about 2 weeks ago, my condition worsened significantly for a short time. My right arm and hand felt cold constantly and nerve pains were often present. Also, I began experiencing nerve pains all along my right side -- right leg, foot, and buttock when seated –- something that had never happened before. The same feeling of coldness was often present in my right foot as well. The symptoms lasted for 3 or 4 days, subsiding after extended rest. All that remained then were some slight sensations in the right hand. The symptoms have since returned -- but to a much lesser degree -- in the last few days, although I would not be surprised if they faded away again soon as they seem to come and go in waves now.

Being only 22 years old, I find this all quite shocking to deal with. Nearly every case I have read about refers to patients much older than me. I have no way of knowing how much of my condition is due to sports injuries, congenital issues, or simply poor posture, but I do have great concern over fusion surgery after reading about the high occurrence of adjacent disc degeneration. With mild bulging already present at C6-C7, it wouldn't be long before I'd find myself on the operating table again. I hope to have many decades remaining in my life, and I'd rather not spend them all repairing subsequent failures every few years. I feel that I must act soon though -- regardless of the chosen course of action -- for two reasons. The most obvious one is the seriousness of the risk I face each day in my condition (i.e. paralysis or death). The other is that I am scheduled to enter law school in the fall which will require a recovery from whatever procedure I decide upon by August.

I have read in studies that the reversal of lordosis in my cervical spine makes me a poor candidate for ADR, but my fears about fusion have made me check into it anyway. I came across Germany's Stenum Hospital in my research and sent them my case information. They responded by email -- in a somewhat canned manner -- saying they think they can help me using the Spinal Kinetics M6 cervical disc. They are in the process of reviewing my medical documents and I'll probably get a final response within the next couple weeks. In perusing these forums, I see that there seems to be a great split between those who trust ADR and those who don't. While I'm not one to dwell on a couple bad stories, I do want all the information I can gather before making a decision. I've also read that Bogen Hospital in Germany is well-regarded and I may now check with them as well. Any concrete anecdotes about the procedures and hospitals would be appreciated.

To summarize, I'm looking for unbiased thoughts (if such things exist) on what to do. My surgeon here tells me "fusion", and whoever I talk to in Germany will say "ADR". I just need to know that I'm doing the right thing when it comes down to it. Should I trust the foreign technology for multilevel cervical disc replacement, or is that just asking for more trouble down the road? Which hospital is truly the 'best' and yields the highest success rate? What kind of recovery am I looking at from each of these procedures and is my law school start date likely to prove problematic? As an active 22 year old, am I going to have to limit my activities for the rest of my life after surgery?

I apologize for the length of this post, but I wanted to get everything out there. Any answers or suggestions would be most appreciated. Thank you for your time.



  • Welcome to Spine-Health. You'll find many wonderful people here that understand what you're going through.

    As you can see by my signature, I've had a 3-lvl ACDF. Although nobody can tell you what you should do, you have things you need to consider. One of those would be, if you go to Germany to get the ADR, what happens with follow-up care or of something goes wrong? You can't just get in your car and see your surgeon.

    My surgery was successful and I'm glad I had it done. Yes, there's a chance that I might have to have surgery again, but any time you have problems with your spine chances are that you will continue to have problems as time goes by.

    If you choose to have ACDF surgery, you'll want to research the best surgeon for you - it may take you to quite a few before you find the one you have 100% confidence in. As young as you are, I would think the recovery rate would be quicker than someone older and I think it's likely that if you had your surgery soon, you could go to school in August. Of course, these are only my opinions and ultimately the decision is yours to make.

    Good luck with your decision. Feel free to PM me if you have any questions or need to talk.
  • I think you are at the right place. There are many people here pre and post fusions. Also an ever larger growing number of ADR people, successes and failures all represented.
    Being 22 as you are, I think you are indeed doing the right thing by very carefully researchin what may be best for you. Just be very careful with yourself while you do this research. You don't want to take any chances with your spine while you decide what to do with it!

    Again, welcome and please ask many questions.
  • Just keep in mind that just because we dodge a bullet today, doesn't necessarily mean we won't get hit tomorrow. For all you know your spine may have exhausted it's personal resources and some seemingly innocuous incident will prove to be too much for it to handle.

    Please be careful is all I'm trying to say.

  • I greatly appreciate the posts here already. I'm moving this to the surgery forum now to gather more thoughts.

    Cath, I appreciate your views as your case appears to be quite similar to mine. Thank you for presenting those points. I absolutely intend to weigh all my options before making a decision. If I have any further questions about ACDF, I'll certainly take you up on your offer.

    Wrambler, thank you for your concern. I do remain cognizant of the dangers posed by my condition. While I've taken certain precautions to protect myself, I'm also aware that there's only so much I can do. My surgeon said that simply driving in a car puts me in danger of paralysis from an accident. The fact is that it's likely I've unknowingly had this condition for some time, and have partaken in activities ranging from impact sports to skydiving over the last few years. So I'd like to think that for all its deficiencies, my spine has been pretty resilient. Thus, I'm hopeful that by eliminating those high risk activities, I can stay safe until whatever procedure I choose is performed.

    Once again, thank you both for your comments. I'd love to hear from some more people also, especially any who can present the hitherto unspoken for ADR perspective. Thank you.

  • haglandc said:
    Just keep in mind that just because we dodge a bullet today, doesn't necessarily mean we won't get hit tomorrow. For all you know your spine may have exhausted it's personal resources and some seemingly innocuous incident will prove to be too much for it to handle.

    Please be careful is all I'm trying to say.

    Fully understood. As I said, I'm aware that some things are simply out of my hands. Believe me though, I'm not taking any chances these days. Thank you for your concern.

  • Hi Alex

    I would ask your surgeon why you can't have ADR and then perhaps get a second opinion closer to home. I was hoping to have an ADR initially, but two surgeons have said that I am not a good candidate because of the state of my back in terms of facet joints etc

    I agree with what someone else said on the aftercare if you go to another country. I also agree that you should be careful in what you are doing in the meantime.

    Good luck with everything
  • I appreciate that Julie. That's likely the route I'll be taking in the short term.

    I must say that I'm surprised by the relative dearth of ADR accounts on this site. I've found a bit more info at ADRsupport.org, but that site has far less activity than this one, so answers are slow in coming.
  • I've seen a lot of posts lamenting post-op pain 1-2 years after surgery. I understand that spinal surgeries are highly sensitive so this isn't particularly surprising, but it does raise a question.

    Are the referenced pains the same type experienced before the operation (similar nerve pains), surgery-related (from incision or hardware), or entirely separate (resulting from new mechanics of body)?
  • Long-term post-op pain happens mostly in lumbar and thoracic surgeries. Basically, lumbar surgery, for the most part, is an easier surgery, but a more difficult recovery. On the flip side, cervical surgery is more difficult, but an easier recovery.

    The pain I have post-surgery is not the same pain as pre-surgery, except for the muscle spasms. Pre-op, I had numbness and tingling in my right arm 24/7 and severe weakness and muscle pain in my left arm. Those were gone immediately after surgery. I also had muscle spasms in my back, and those are still there. I think those would've gone away if I was able to continue with PT.

    I have a dull ache in the back of my neck that ranges anywhere from mild to severe. I'm still trying to figure out what causes the severe episodes - maybe weather, maybe turning my head too far, maybe turning and looking at something too long, maybe all of the above.

  • Thank you for clearing that up, Cath. And I'm glad to hear that your old symptoms were at least taken care of with the surgery. Also, it does make sense to me that lumbar surgery would cause more long-term issues, since it's supporting the whole upper body rather than just the head. Thanks again.


  • I had 2 M6 placed @ C6-7 C5-6 in Stenum Germany. I am pleased with outcome. When I contacted them I to was a little apprehensive. They just do things like Germans unlike Americans. Type Turbodog in the search at the top of the page and it will direct you to my previus postings on the subject. It has been 10 months and I'm still doing great. Good luck
  • My experience with lumbar and cervical surgery is the opposite of yours. It may have to do with the difference between anterior and posterior cervical surgery. My cervical surgeries have all been posterior.

  • HI Alex
    I had cervical fusion two weeks ago and prior to it I was extremely nervous but I was given the same warning has you. Because my spinal cord was compressed I was risking paralysis if I was in a car accident etc. I am fifty, a lot older than you, but I didn't want to live in fear, and in pain any longer. My surgeon told me this was his favorite type of surgery and that he had absolutely no doubt I needed the surgery right away. I have two lumbar fusions and the recovery was far worse with those. Although it is a very serious surgery as long as you are with a highly qualified surgeon I believe you will do just fine and because you are young you will probably heal even faster than us old farts. Good luck to you. MAC
    p.s. good luck with law school! my husband is a judge and loves his work!
  • ah, you are so young to be facing so much surgery!

    I don't have an opinion really on ADR vs ACDF, except to say that if you do go the ADR route, please make sure that they remove the bone spurring (osteophyte) at the same time. It is conerning that you have cord compression and what sounds like the beginning of myelopathy. The short episode of leg symptoms you had is likely because of the myelopathy, so you should probably act relatively soon with whichever decision you go. The surgery will not take away the myelopathy, but rather stop the progression. Basically that means that once your cord is damaged, it is damaged, so I would suggest that you get it taken care of before it gets worse. Cord compression is not the same thing. Once they decompress your cord, it should open back up and the symptoms will improve. it is the interior damage (myelo) that is irrepairable.

    I hope this helps somewhat. I have permanent damage to my cord and will always struggle with the right side stuff similar to what you described.

    A 3 level in the cervical spine is a big surgery, but it sounds like you are researching and trying to make the best decision possible. You have great aspiriations in life, and I wish you the best recovery possible. Please keep us informed on how things go.

    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Hey Alex,

    I am only 34 and very fit, I just had ACDF surgery done 5 days ago and feel pretty good. One thing about ADR, There are a few professional wrestlers out there, John Cena, Edge, Chris Benwa (Dont know how to spell his last name), they all had fusion done. John Cena was just this past November. If rich and famous athletes are doing ACDF and not ADR there has to be a reason. They do look very tempting, and I was one who was really interested, but there is not enough studies done to convince me. If you are getting worse with your symptoms do not let it go too far. I only waited less than two months and I may never get the strength back in my chest. But it has only been 5 days. I am just way too impatient.

    Good luck and God bless you in your decision.
  • Alex.

    Compression of the cord can cause symptoms to get worse fast.
    Sometimes this doesn't get better,and can happen over night.

    Wishing you the Best.

    My opinions..Patsy

  • I stumbled on your posts while researching all aspects of cervical surgery. The surgeon who reviewed my MRI and x-rays last Friday told me I need to have surgery on C-5, C-6, and C-7 (Plates inserted). Like you, I'm a bit skeptical and have researched my options. My doctor told me, the same as you were told, that I was at high risk for paralysis with any sort of neck trauma, such as falling or tripping down steps, car accident, any form of whiplash (minor or major. Because of this high risk, I decided to schedule surgery the first week in June, even though I'm very concerned about the possibility of having esophagus or vocal cord damage, as well as the risks of paralysis due to the surgery itself. I'm 53 years old and I have always been very active, working with technology in a HS-JH school setting, traveling,and hoping I can continue to live a full, active life.
    By the way, I had lumbar disc surgery 15 years ago. The recovery was scary because it took several weeks before I felt normal. I was told the cervical surgery recovery will not compare with that one, and is usually complete in 4 to 6 weeks. Since I suffer from degenerative disc disease and my symptoms have increased in severity over the past 6 months, I am hopeful the surgery will be successful and I can return to normal activities within a couple of weeks afterwards. I wish you well in whatever treatment you choose.
  • At 22 I would not even consider fusion. I was fused at one level in 1995 at age 33 and the surgery is not bad but the result is not good . You become stiffer and stiffer and eventually have other disc go bad. You should consider a foramenectomy at all levels. In addition you do not have to go to Germany to have a multilevel performed. The la spine institute does multilevel adr with great results. Do the search and watch the Army officer candidate get three levels completed and leave the hospital the same day with plans to return to officer training school where he is jumping out of airplanes!! doctor says it is ok!!
  • NJShamrock said:
    Hey Alex,

    I am only 34 and very fit, I just had ACDF surgery done 5 days ago and feel pretty good. One thing about ADR, There are a few professional wrestlers out there, John Cena, Edge, Chris Benwa (Dont know how to spell his last name), If rich and famous athletes are doing ACDF and not ADR there has to be a reason.
    That Wrestler Chris Benoit (Benwa) who had neck fusion... Hung himself..(Suicide)...and killed his wife Nancy who In December 2005 also had neck fusion surgery..

Sign In or Register to comment.