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Should I have anterior cervical disectomy?

AndyWhitAAndyWhit Posts: 2
edited 06/11/2012 - 8:47 AM in Neck Pain: Cervical
New to this forum and based in England but not found any forums of this nature in my own country, so hoping to tap into your expertise.

A scan in 2006 showed disc protrusions at C5/6 and C6/7. Consultant felt no need to operate as pain not radiating down arms and operations would not solve neck-only problems.I get muscle spasms and headaches.About 10 months ago woke up with loss of strength down right arm, very strange as could not pin-point or really describe it. Low level pain...more of a sensation.

I cannot use tennis racket or go bowling as this is very painful but normal day to stuff like driving and using keyboard not a problem. About 6 months ago had about 2 weeks where swallowing really uncomfortable when neck turned slightly to right but this went and is not a problem now.

Just had another scan and consultant showed me that the disc between c5/6 is now bulging out right and left onto nerves on both sides and that it he can remove it and put in carbonfibre cage to fuse bones. Interestingly the disc below is not bulging any more.

Big question is, do I do it? Surgeon says he can sort it...operation will be free on our National Health Service.He dis my lower back and I have faith in him. I would love to get freedom from this, but level of pain is not usually high, some physio and drugs sort it it out (I have been on low levels of pregabalin for 2 years. From what I have seen on US forums lots of people seem to be in a worse state after the operation. Once it is fused there is no going back ( no pun intended)and there appears to be a theory that fusion can lead to stress on other discs later in life.

I should say, I have had lower back problems for many years (now 51 but had them for at least 20 years) and a discectomy at L4/5 in 2004.

Any thought or comments would be really appreciated. Thanks.


  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    Welcome to spine-health.

    I'm sorry you're having this problem but you've found a good place for information. This site has lots of videos and articles on neck pain and surgeries.

    You're the only one who can decide if surgery is right for you. It isn't something to be taken lightly because as you know it has risks and can contribute to more surgery being needed in the future.

    Have you tried all the conservative treatments? Physical therapy, traction, epidural steroid injections etc? Is your spine unstable? Did your doctor say anything about you facing permanent nerve damage if you don't have the surgery?

    I had an ACDF C5-6 four days ago and the arm pain I was having before is gone. It took me a very long time to get to this point though. I finally had to decide if the pain was bad enough to take the risks. I have already lost a lot of muscle in my left arm and they don't know if I'll get it back but they say that I won't/shouldn't lose more.

    It's a hard decision and I hope you can find all the answers you seek. There are many here with the same problems and they will be glad to help you in any way possible. If there's anything I can do for you just let me know. Again, welcome.

  • Welcome to Spine-Health. Like Debbie said, this is a great site for information in the form of articles and videos and the members of the forum are a great group of people who are knowledgeable, helpful and supportive.

    Deciding whether to have surgery is a very personal decision and only you can make that choice. I think it's very promising that one bulging disc has healed itself, but on the flip side, the increase in symptoms due to the other disc is definitely something to be concerned about. With that said, trying all conservative measures is always the first choice before choosing to go under the knife. But as you've read, sometimes there isn't any choice when conservative treatments fail and then there's no other option than surgery.

    Before I had surgery, I was experiencing severe spasms in my middle back, pins and needles 24/7 in my right arm and a slight weakness in my left arm. I tried PT prescribed by my PCP, but it only helped for a couple of weeks. Then after an MRI, I was referred to a fellowship-trained ortho spine surgeon (he specialized in severe cervical spine problems) who told me that my neck was so bad that it wasn't even worth trying any further conservative measures and scheduled me for surgery, with my blessing. In the month between surgery being scheduled and the actual surgery, my left arm got so bad that I couldn't even lift a glass of ice water and thought I had horrible tennis elbow, but it was my neck causing all the pain. All this pain was gone immediately upon waking from surgery.

    I tell you all this because if you find that your symptoms are escalating at a rapid rate, then your doctor may be right.

    Another thing to consider is that on this board (and I assume others as well), when members have successful surgeries, they tend not to come back because they're off living their lives and no longer need the support that's given here. So don't judge how successful surgeries are by what you read here, it's really not an accurate gauge.

    One very good thing is that you have great confidence in your surgeon and everyone here will tell you that that's a very important part of dealing with spine problems and deciding whether or not to have surgery.

    Good luck on your decision. I've had both a TLIF at L4/5 and a 3-lvl ACDF (C4-7) and can tell you that in my experience, recovery from the ACDF was ten times easier than recovery from the TLIF.

    We're here if and when you need us and whether you decide to have surgery or not, we can offer support, friendship and share our experiences during your spine journey.

    Please feel free to PM me if there's anything I can do to help you or if you have any questions. And please keep us posted on your decision and how you're doing, ok?

    Take care,
  • Cath and Debbie

    Many thanks for your advice. Good to hear that others have been through the process and come out the better for it.

    I have tried various conservative measure, chiropractors, physios, Chinese acupuncture, cortozone injections into the spine. Physio gives relief for muscle spasms, none of the others have been successful.

    Having said that, my pain levels are low compared with what I have read on your web site which is why I am questioning the wisdom of surgery, even though the neurosurgeon is confident. My GP, not sure what phrase you use in the US, (my regular general doctor) seems to think that the biggest potential problem is muscle loss if I don't have the operation, though I can and do use the arm for most activities and my job does not require physical strength. When I had my lower back operated on I couldn't stand up for more that 5 minutes without "screaming" agony so surgery was essential in the end.

    The physios seem to think I ought to delay the operation as it is not getting worse and in some ways it is a little better, my right hand grip is much better than it was a few months ago and I have no pain down the left. Problem is that it does vary from day to day, sometimes virtually no pain and others quite a lot but usually bearable.

    I have my pre op assessment on Monday, so will play it from there.
  • Howdy, and Welcome to Spine Health!! Like was already said, surgery is a very personal decision. If you aren't going to risk nerve damage, and too your symptoms stay in control, I agree, you can probably hold off.

    I jumped in here to add an additional item to consider *if* you have surgery. You stated in the past the C6/7 disk was bulging, but is no longer? My first fusion was for the C5/6. I had a hernia that was on my cord at that level and a minor bulging at the C6/7 - but that bulge was not deemed a surgical issue. The fusion for the C5/6 was 100% success as far as I am concerned. The flip side...

    A year and a month later, my C6/7 violently herniated onto the right exit nerve, and as such caused permanent nerve damage! I had a fusion there (see my wing thing in my avatar) which stopped most of the pain, but the weakness and numbness still has not returned - EMG deemed I had damage that was not recovering from the C7 nerve root.

    At around 6 months post op from that, I began losing my C8 (C7/T1), and deemed another "adjacent level failure". Would I have done all this again if a 're do' was allowed. Sadly yes, as I would have lost a lot more if I didn't have the initial surgery. One of those damned if you do, damned if you don't kind of things. :) With the history of your C6/7 (now no longer bulging) just keep in mind that level is weakened, and changing the load with a fusion above it *might* be an issue in the future...or may never be a problem. Please keep us posted on how it goes. I hope you continue to improve. Again, Welcome!!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Andy,

    Greetings from the other side of the pond. I had C5-C7 fused in March of 2009. For me it started with a lot of pain from my right shoulder blade all the way down to my hand, I had three fingers (thumb, index, middle) go numb and quite a bit of weakness in my triceps. A cyst had also developed in my spinal cord, so surgery was really the only choice for me.

    The surgery did wonders for me. I still have a few issues, I get occasional muscle spasms between my shoulder blades and my thumb is still numb. But it is very tolerable, occasionally I will take a valium for the muscle spasms but it’s rare. Recovery wasn’t that bad, the only inconvenience was that I had to wear a neck brace for a month and couldn’t drive. If not for that, I would have returned to work after about two weeks. I ended up being off for 4 weeks.

    As to whether or not you should have the surgery, I won't repeat what everyone above has said, but if you are developing weakness in your arm you should really talk to your doctor about permanent nerve damage.


  • I have recently, on 18th September 2010, had the above operation at RNOH Stanmore, Middlesex and all went very well. I am still experiencing difficulty in swallowing but have been told it will come back to normal in a few weeks time. AndyWhit please read me on neck forum. I live in Hertfordshire. Good luck and honestly there is nothing to worry about if you have an experienced spinal surgeon.
  • Hi Andy, I have had several surgeries on my spine and it was a choice I had to make. All my operations were a success too! I had to have a fusion first in 2006 from C4 to C6 b/c of ruptured disks, spinal stenosis and ddd. I couldn't live with how I felt at that time. The pain was awful and causing both arms to go numb. I started having symptoms in 2000. I did everything I could to feel better and things would just gradually get worse over time. It is true that there is a chance other parts of your spine are stressed after a spine operation. Any operation in general is a risk. There could be complications from any type of surgery not just the spine. You have to decide if your pain is controlling your life to the point there is nothing else that can be done. If you follow your doctors instructions and change how you do your daily living then there is a great chance your surgery will be a success too. Being positive is also very important. If the area being operation on is the cervical area remember the operation will only help any arm pain. In time the neck pain does improve some but its not a guarantee. There are also a good chance that this surgery may required further surgeries later in life. Again this is only a chance and most spine surgeons are very up front in informing their patients of this before they schedule the operation. I was so miserable I gave in to surgery and was so happy I did after it was over. I still have neck pain and always will but the surgery fixed the arm pain and numbness. All was well worth it :) Good Luck!!!
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
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