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Disk below prior fusion is now ruptured

BunkerBBunker Posts: 15
edited 06/11/2012 - 8:50 AM in Neck Pain: Cervical
Hello,

My name is Rick and I live outside of Boston.

I had a C5-C6 AD with fusion in 2005.

Now after developing pain and numbness in my left shoulder/arm a recent MRI shows that C6-C7 is now ruptures and pressing on the nerve root.

I am waiting to see the Neurosurgeon but was curios if anyone else has had a 2nd fusion?

From what I have read I know it is not uncommon for adjoining disk to go bad after a fusion, but haven't been able to find much about the treatment for a 2nd bad cervical disk.

Am I looking at another fusion, possible disk replacement?

I am sure I may have to endure the non-surgical circus of PT and possibly injections but would like to hear other stories.

It took three years to get my c5-c6 problem diagnosed correctly and finally treated via fusion, and I did feel better after surgery.

I am hoping to skip some of the BS this time around.
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Comments

  • First let me say welcome Rick, have a look around. You will find many here whom have gone through multiple surgeries including myself. Keep in mine while conservative treatments failed you the first time, your situation may be different this time and they would work. Now should you need to go to surgery the good thing is you know what to expect in the surgery and the recovery.

    They can actually do the same procedure that has been done before although they may need to remove the hardware used in the prior surgery. I don't recommend them bridging the plates together as there just isn't much room in the cervical spine. Not to mention if your fused in the other level you don't need that hardware any longer.


    But first and fore most is to see what the surgeon has to say about your condition and what is going on and his/her recommended treatment. Hopefully they won't take very long to arrive at a conclusion and can resolve your issues rather quickly and you can't be out enjoying a normal busy everyday life.

    Keep us posted on how your appointment goes and what they recommend. Once again welcome to spine-health.
  • Howdy and Welcome to Spine Health!!

    In March of '08' I was fused like you at C5/6. A year and a month later (yeah, wrong warranty!) my C6/7 went. The surgical "game plan" was to use the same entry location as my C5/6 scar, remove the hardware and put a new plate/screws/graph in for C6/7. Didn't happen! See my avatar.

    5 or 6 months post op, my C6 vertebra cracked clean through between the hardware just below the bottom screw. Somehow the 2 hardwares are keeping it fairly secure, there is movement. Also, most of my C5-7 symptoms are back now! I see my Neurologist in March to see what we are going to do next. I was put on "hold" for a year to see if the crack would heal on its own - it didn't.

    I bring this up because my Neurologist, ENT and GP feel the dissimilar stress of the different hardware caused the crack. If they find it best to give you another fusion, stay away from the wing thing! My surgeon stopped using the 'wing' after my crack, and I've only run into one other with a similar wing in their neck - but they only had the wing, no other hardware, so no problems with it.

    About 7 months post op from the C6/7, my C7/8 is now going...sigh. Fingers crossed for you that they don't have to fuse you again, but if they do, let us know and we'll send prayers and positive thoughts your way.

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Join the club! I'm so sorry you are facing this. I have a similar issue. I had surgery for C5-C7 in 2008. I now have issues with C7-T1. I do not want surgery and my doctors are actually understanding of that. I had a spinal cord stimulator implanted in 2009, before the C7/T1 problem developed. I am fighting against surgery with everything I can and am being relieved through a reprogramming of my SCS as well as medication and regular exercise. Hope it can last for a while longer. My NS told me that she knew what the problem was based on symptoms and results of EMG and nerve conduction tests, but wanted to confirm with CT with mylogram, but only if I were willing to go to surgery and fix it. I was not and am fortunate that my PM doctor is helping me to be comfortable and able to function pretty well right now.
    Best wishes to you! Just know you are not alone.
  • Thanks for the welcome.

    Now if I could only get such a quick reply from a neurosurgeon to review my case I would at least feel things are moving forward (I was told I would get a call with an appointment on Friday, still nothing after several messages left)

    If nothing else Boston is a good place to need medical care, I will be calling around to more hospitals today.
  • I myself am 3 weeks out of three level fusion of C5,C6, and C7. The disc ruptured causing massive migranes and blurred vision. I am hoping this is the only fusion I will ever have to have. The recovery has been pretty stable so far. I'm having problems sleeping and I wake up in pain.
    I see the dr tomorrow for my follow up appointment.
    The problem was so bad it was causing nerve damage and depression. Now that I have had the surgery, I actually for the first time feel normal.
    So I have not had to have multiple surgeries but I'm thankful for the surgeon I had. I put if off for 2 years trying to be strong and "hoping" the problem would go away. It doesn't.
    I know how you feel Rick. The pain is excruiating but listen to your surgeon. He knows whats best. Good luck to you. I hope you get better very soon.
  • I too am a 3 time neckie, waiting on the 4th sugery just due to my families schedules and not having transportation for the surgery. Waiting is the pits no matter if its for a test or a date or whatever. These folks don't feel our pain or our depression. For the most part, they are all normal functioning people that think you are like them and they don't get in any hurry. I have also had 2 lumbar surgeries just a year before my C5/6 herniated. Two months after my fusions surgery, my C4/5 herniated. During the one of these two fusions, the screw into my
    c5/6 was put in too low and ruptured my C6/7 disc causing collapse. So I've been on hold for year waiting for my C4/5/6 to grow together (I'm a slow bone grower) March, 2010, I had posterior neck surgery to stabilize C4/5/6 since they weren't fusing. I changed surgeron's right before the posterior part, cause my previous one keep saying there was nothing he could do for me, sign up for disability. Now, even after I'm waiting for spring break to get here in March so my daughter can drive me to/from to get my C6/7 surgery, It's been a long year. I see a PM doctor and have been on fentanyl patches, but they keep running out the 2nd day after upping to the 50 ones. I'm without for 10 days now because I misued the patches and was taking just a tiny bit in my mouth to ease the pain more, but that cause the patches not to last as long. I don't really call myself abusing the drug, cause I needed more pain relief, but I wasn't following the prescribed method. Without the patches though, I am a invalid just about, staying home in pjs and having to really make myself do anything. I take an antidepressant and neurotin, and tylenol...but it's not enough. I've been cold turkey before just to see what it was like since my surgeron said the fentaynl could be causing more pain and now I can tell him he'll full of it. :)

    I'm sorry that I can't offer my support to you other than to say you are not alone. With degenerative disc disease, any disc can blow at any time if there is stress or wear/tear on it/movement. Fusing one level, causes the other above and lower to more more to compensate. Stay positive and hopefully you will have a great outcome with your second fusion. I was a bit sorer due to them taking out the small plate and putting in the larger one to cover two. but then he put that screw in too low in my C6/7 disc space. Makes me want to sue, but you always sign this deal that you know things can happen and nothing is a sure thing. Ha! Oh well.

    Cynical hurting Candle99
  • Bunker said:
    Hello,

    My name is Rick and I live outside of Boston.

    I had a C5-C6 AD with fusion in 2005.

    Now after developing pain and numbness in my left shoulder/arm a recent MRI shows that C6-C7 is now ruptures and pressing on the nerve root.

    I am waiting to see the Neurosurgeon but was curios if anyone else has had a 2nd fusion?

    From what I have read I know it is not uncommon for adjoining disk to go bad after a fusion, but haven't been able to find much about the treatment for a 2nd bad cervical disk.

    Am I looking at another fusion, possible disk replacement?

    I am sure I may have to endure the non-surgical circus of PT and possibly injections but would like to hear other stories.

    It took three years to get my c5-c6 problem diagnosed correctly and finally treated via fusion, and I did feel better after surgery.

    I am hoping to skip some of the BS this time around.

    Hi Rick,

    I think we are in the same boat mister! I am headed

    for a CT myleogram next week, my recent MRI shows a

    herniated disk at C7 for me. In 2005 I had C3 to C5

    fused with a corpectomy. Then in 2009 I had to have

    a Laminectomy at C3 because my left arm started go-

    ing numb again. After that MRI & CT myleogram it was

    suggested to have a C3 and C7 laminectomy but at

    the time the C7 wasn't a problem. Well now its the

    right arm pain and numbness again. After the Ct

    myleogram the discussion of surgery will be next.

    The surgeon said something about another fusion but

    then I wanted to try the injections first. The in-

    injections didn't last long. I can't answer your

    question really, just thought I would let you know

    your not alone. :)
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • Thanks all for the replies and commiseration, if nothing else your stories have given me a glimpse of how bad things can get.

    After finally getting an appointment from the surgeon I was referred to for early March (here's a week's worth of pain meds, see you in a month :( ). I mangaed to get copies of my records and all my films put onto CD and spent a day calling and faxing the various Hospitals at my disposal (thankfully I have a PPO that lets me go where I want as I think I am now registered at 4 different hospitals).

    I was lucky enough to get an appointment for a Cat scan and further evaluation at the Spine Clinic at BI in Boston next week with a surgeon who looks very promising.

    So, I at least feel better that I pushed to be seen and didn't just take the first offer for an appointment and wait around in pain for a month.

    I fully agree that anyone who has not experienced this just cannot be communicated with. I have had more than one person (including my father) tell me I should just be patient, it's only a few weeks, you shouldn't take so much pain medication.

    Then I show them the burn marks on my arm from reaching in the oven and not feeling the contact until it is too late and try to explain that it take a mixture of ambien and vicodin just to get 4 hours of sleep a night and they just look at me dumbfounded.

    Bunker
  • Rick,

    Unfortunately *most* people are use to surgery "fixing" us, and as such weeks or even months later we are fixed, pain free, and free of medications. Spine surgery most times doesn't work that way, and too becomes the "invisible pain generator" - that is what many of our friends and family don't get.

    If you had cancer, "everybody" seems to understand or know that chemo and all those meds make you sick, and there is pain in many types. I guess too, thanks to TV, surgery, bada-bing "NORMAL" / "FIXED"...sigh.

    I hope you have answers soon, and a plan to find relief. And yep, "we" understand and are here for you. Take care.

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I saw surgeon #1 today.

    He said I definitely need surgery, the disk is too far gone and there are no non-surgical options that he can see.

    He also said because of my age and history that I am a very good candidate for a disk replacement, the problem is getting BCBS to approve it.

    Otherwise he will have to remove my existing fusion and fuse C5 - C7 together.

    I see surgeon #2 on Thursday.
  • Rick,

    I'm with BCBS Federal, and never had problems getting approved for surgery, procedures etc. Are with with it via Federal, or State?

    Please let us know how your 2nd opinion goes. Are these Neurosurgeons or Ortho? Or one each?

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • BCBS of Massachusetts.

    I am dealing with Neurosugeons now, not Ortho.
  • Bunker said:
    BCBS of Massachusetts.

    I am dealing with Neurosugeons now, not Ortho.
    I've seen down here (Florida) that BCBS State vs Federal are different in what needs to be pre-approved and such. Hopefully yours will go through without a hitch.

    So far I've stayed with the Neurosurgery side myself. If they have to revise my mess, debating on an Ortho since more 'bone' work would be needed. Fingers staying crossed for ya Rick. :)

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,300
    Welcome to the (maybe) or post revision club.

    One comment from my history .... A Neurosurgeon had a hand in my "less than optimal" outcome from my first 2 level ACDF - It was an orthopedic surgeon who cleaned up the "mess".

    I am a firm believer in the concept of "we have orthopedic issues that are causing neurological symptoms - not the other way around" so I am an advocate for orthopedic doctors fixing our bone and disc problems - resulting in freedom from nerve impingments.

    Just my opinion. Good luck with whichever route you take and hope you have outstanding results!

    Best Wishes,

    D

  • Well, still waiting for the paperwork to catch up for the surgical request and what I will have to do for the appeal, but I managed to see my regular Dr. earlier in the week.

    He agrees it is worth the fight for disk replacement and took over the pain management portion of the battle so at least now I now have a supply of Vicodin and Gabapentin (with refills)so I don't have to worry about running out while I wait.

    It sucks being in this medicated fog all day but it is better than being in pain.
  • Hello to all!!!

    In 1993 I had C/5 and C/6 fused. My doctor told me that C/4 and C/7 were bad but did not warrant surgery at that time. However, I felt very good for the first time in a long time. Before my surgery I was getting dizzy and nauseous when walking. My discs were pushed into my spinal cord and I was at risk of it severing my cord if I were in an accident or bad fall.

    In 2001, I had C/4 and C/7 fused but have never felt like I did before I developed disc problems or right after my first surgery.

    In 2006 or 2007 I had another MRI at my request and due to more pain. My Neurologist informed me that C/2 and C/3 were affected however he said that I would not find anyone to operate on me again and that I had to live with it. He was a friend of the surgeon who operated on Christopher Reeves (Superman)

    I wonder if his response was dictated by my medical group or the fact that they were C/2 and C3. I retired on disability from my job as a letter carrier in 2004.

    In 2008 I had microscopic surgery on my low back which was less invasive but wasn't effective. Of course my doctor told me there was a 50/50 chance it would not work.

    These days I still have pain in my neck and back, I can't stay awake for long while reading at my computer and I am still on pain meds.

  • If your still in need of a really good surgeon I could message you the name of the surgeon from MGH who perormed a ACDF C6C7 for me March of last year with excelent results.
  • BeantownRN said:
    If your still in need of a really good surgeon I could message you the name of the surgeon from MGH who perormed a ACDF C6C7 for me March of last year with excelent results.

    I will let you know, but one question; where is he located. I live in Orange County, Ca.
  • Thanks, I am sticking with the surgeon I chose working out of B&W.

    He has done dozens of disc replacements.

    Now I just have to get BCBS to play along.
  • New to this forum. 2004 c567 anterior lami/discectomy. Never full resolution of right arm pain and rt scapula pain, but it was good enough.

    Dec 2010 - had right lateral epicondyle release (elbow). that is healing well but now my neurological sx have intensified and changed in location. I fell 4 weeks ago, about the same time this pain began.

    My question is this... can anyone comment of the range of motion that is lost with a c7 8 t 1 fusion in addition to a c456? Saw the neurologist yesterday and I anticipate this is the route I will find myself on.

  • Bunker, when you write "disc replacement" I assume you are talking about an artificial disc. I have CIGNA and they turned me down saying it was "experimental". A surgeon I saw later was of the opinion that no insurance company would approve an artificial disc next to an existing fusion because the ADR devices are not approved for that. If an insurance company approved it and something went wrong, then someone could possibly sue them saying they should not have approved it. In fact, some surgeons who do artificial disc replacement surgery won't even do the surgery on a patient who has already had a fusion. My surgeon said he had performed artificial disc replacement adjacent to a fused level for some of his patients, but the patients for whom he had done it were very wealthy people who were able to pay for the surgery out-of-pocket. I am not trying to discourage you, just telling you what my surgeon told me. I would be very surprised if you get it approved. There is a web site all about artificial disc replacement. Google ADR support.
  • I got a call yesterday that I have been approved for an artificial disk replacement!

    I won't fully believe it until I have the paperwork in my hands but it looks like it is a go.

    CM - Interesting, my surgeon said he thought I had a good chance for approval on appeal because I had the prior fusion and evidence that the first surgery contributed to my current condition.

    Like I said above, I will believe it when I have the admitting papaerwork in my hands with the words "artificial disk" somewhere in the description.
  • I'm pretty sorry when it comes to some of the jargon, so I apologize in advance if I'm missing something obvious. Are you saying that your surgeon will use artificial disk material rather than cadaver bone when you refer to artificial disk replacement? What is the advantage? I'm trying to learn since I will eventually have this surgery myself, most likely. I am fused at C5-C7 (as I posted earlier in this thread) and that was done in 2008. At that time my neurosurgeon said that the artificial disk material was not recommended for use when more than one level was being replaced so in my case she used cadaver bone. I just assumed that the same would be true when the C7-T1 level is done. Technology could very well have improved enough that multi-levels are now done with the artificial disk material and I just don't know it yet.
    I'm glad you're on your way to getting fixed. I've decided to wait as long as I can be kept relatively comfortable through pain management and there is no danger of paralysis at this point. So far, so good.
  • Bunker said:
    I got a call yesterday that I have been approved for an artificial disk replacement!
    Rick,

    So happy to see this finally coming to fruition for you. Congrats man!!! <:P

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,300
    Like a dinosaur .... a throw back to before ADR was even a consideration. I like many others have heard that ADR isn't typically considered for a multi-level especially post failure.

    Maybe things do change ... hopefully for the better ... I have a disk on top of my fusion that is just a matter of time. Maybe in time it maybe a possibility for me?

    d
  • I don't have all the specifics yet

    I will have the paperwork by the end of the week. My pre-op is next week.

    Yes, it is a little daunting to be this close and not have all the details, but I do prefer this to sitting around for months in pain waiting for an answer.
  • Hello Everyone,
    I also had surgery in 2007 on C6 and C7. The neurosurgeon told me that I would probably have problems with C5 in 2 years. He was right. I started having pain again in 2009 then it stopped. It was off and on since then. My doctor doesn't want to do an MRI because, he said, I had too many MRI's and he don't think I need to get another one because it's harmful. He prescribed tramadol and flexeril. It calms the pain but it comes back. He also wanted me to take Gabapentin but I don't want to take it because of side effects. My brother took gabapentin and gained 25 pounds. I have hypothyroidism and I'm already battling my weight and don't want to gain any more. There's a big lump in the back of my neck. My doctor said, it's the bone and it's normal. Does anyone have this problem?


  • Hello Everyone,
    I had surgery in 2007 on C6 and C7. The neurosurgeon told me that I would probably have problems with C5 in 2 years. He was right. I started having pain again in 2009 then it stopped. It was off and on since then. My doctor doesn't want to do an MRI because, he said, I had too many MRI's and he don't think I need to get another one because it's harmful. He prescribed tramadol and flexeril. It calms the pain but it comes back. He also wanted me to take Gabapentin but I don't want to take it because of side effects. My brother took gabapentin and gained 25 pounds. I have hypothyroidism and I'm already battling my weight and don't want to gain any more. There's a big lump in the back of my neck. My doctor said, it's the bone and it's normal. Does anyone have this problem?
  • with the thyroid condition and the "lump" have you discussed Cushing's with your Endocrinologist?
  • Sorry to OP for going off topic!
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