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Question on Cervical Discectomy Fusion

GreyEagleGGreyEagle Posts: 350
edited 06/11/2012 - 8:50 AM in Neck Pain: Cervical
I'd just like some opinions on how to decide whether and/or when to go through with a cervical discectomy/fusion surgery.

Last May I had a 4 lvl lumbar laminectomy. I could not return to that neurosurgeon this year because my insurance changed. He had recommended based on ct scan/myelogram and mri's that I should have a 2 lvl discectomy fusion next with titanium plate and screws.

I saw my new neurosurgeon about a week and a half ago.
Based on his review of these studies and my medical records he recommends the same. I really like him. He took his time, he explained matters in plain english. Bottom line, he left the decision to me.

I've had fairly severe nerve pain in my arms for about 4 years. It is controlled so its tolerable with nerve pain meds. My concerns are possible chronic swallowing problems, fusion complications if I go through with it.

What have some of you others decided with this sort of scenario? I'm just looking for opinions. As far as I know none of us are doctors.

Thanks much,

Ken GreyEagle


  • Hello,

    I had a 3 Level ACDF back in November 2010. The surgery went fine and I left the hospital the next day. I never had any pain in the upper area such as the neck or arms. I had burning, weakness and numbness in the right leg that radiates up to the right side of my hip and sort of a partial parylsis in the left leg. Normally this type of issue is usually caused by the sciatic nerve which focus on the Lumbar area, but those areas were fine. I had a Large Herninated Disc that was pressing on my spinal cord which causes symptoms in other areas of your body to include the legs. Other than that doing pretty good. I just takes time because the nerves were damaged because I was dealing with those symptoms since September 2010.

    Hope this helps

  • Making the decision for spinal surgery is a very personal thing.

    Have you tried more conservative methods to deal with your problems? Physiotherapy? ESIs?

    I think I would try everything else possible before resorting to surgery. However, sometimes surgeons seem to advise that, with a tight spinal canal, there is a risk to the cord, and then surgery is necessary to avoid paralysis.

    If your surgeon didn't say that things were urgent, and there were still things to try, I think I would do that first.

  • I am very interested to know more about how your cervical diagnosis was made.

    I am having symptoms from my neck and thoracic areas. I am also having increasing pains, tingles, spasms and cramping in my feet and legs. I had a lumbar laminectomy and fusion last March to deal with problems in my lumbar spine. One doctor did say he thought my leg symptoms could be coming from my neck. I am waiting to get the results of a cervical MRI.

    What tests did they do before your diagnosis?
    Did they do a complete spinal MRI?
    If your symptoms started in September 2010 and you had your surgery in November 2010, that was pretty quick. (I'm in the UK where we have to wait for ages for everything!)

    I would love to know more about your story. :-)

    I am pleased to hear how well you are doing. Keep that up.

  • This is always a tough decision. I'm assuming your laminectomy was done posteriorly. Typically an anterior (front) approach is much easier on the patient. Obviously you are still having serious issues or you wouldn't be considering this surgery. I remember when they did your laminectomy and I was surprised they didn't do a fusion at that time.

    I too had a 3 level ACDF, and then almost 2 years later I had a revision plus vertebrectomies and more.

    I had almost no throat issues. I remember being told it would feel like I swallowed a golf ball. Sure it was a little tender, much like being sick with a sore throat, but for me swallowing was not a problem. Eventually I developed scar tissue in that area and I feel a small lump, but it is more of an annoyance than problematic.

    There is always a risk of complications, so you are wise in considering this. But I think one has to find a good surgeon and trust in him if it becomes inevitable that you do the surgery. Many many people have this surgery with no problems at all. My sister had a one level and was back to work within a week or so. I wasn't as fortunate.

    Which levels are you considering to have fused?
    Does the doctor say things will get worse if you wait? If there is no risk of causing further damage by waiting, I personally would wait, unless the pain interferes with your life. I see people say all the time that the longer you wait, the more damage you cause, but my doctor said that isn't always the case.

    I'm C5 to T1. I have a problem with looking down, can't put chin to chest, etc. I can move my neck side to side, but can't quite look over my shoulder. This limits me in some things, but you learn to turn your whole body rather than just your neck. Side to side rotation comes from levels higher in the cervical spine, up and down motion comes from lower. If you post which levels you are considering fusing, maybe others will give their experience.

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

    Thanks much for your comments. I did go through several years of physical therapy, including traction, I think its called. None of those methods did anything for my pain.

    I do have a narrower than normal spinal canal. My surgeon did mention that and said it was a definite problem. So it is looking like the next step should be this surgery.
  • Neck of Steel said:
    I too had a 3 level ACDF, and then almost 2 years later I had a revision plus vertebrectomies and more.

    I had almost no throat issues.

    Which levels are you considering to have fused?
    Does the doctor say things will get worse if you wait? If there is no risk of causing further damage by waiting, I personally would wait, unless the pain interferes with your life.

    Hi there:

    I believe in my case it is C-5,6 and C-6,7.

    I don't remember if the surgeon said matters would get worse if I didn't go through with this. I need to see him again. He did say to call anytime I had more questions. I'm going to have to do that and ask him this question.

    Currently I can handle the pain. Whether my narrow spinal canal is going to force me to this surgery, I couldn't say at this time. That is a good question.

    Thanks for your valuable comments!

    Ken GreyEagle
  • GreyEagle,
    Having noticed that you have type 2 diabetes, another question I would ask your surgeon is, does he have any strategies to aid the fusion?

    I believe that diabetes can be something that makes fusion problems more likely. Some here wear a bone growth stimulator to encourage the bone to grow.

    I also have a small spinal canal. I don't think that in itself, it is a problem. However, when 'things' take up more space than they should (bulging/herniated discs, ligaments etc) then, with less space to start with, there is a greater risk of pressure on the spinal cord, which is not good.

    I would love to hear how your surgeon answers your questions. I think that learning as much as you can about spinal problems and possible treatments, is the first stage to moving forward towards surgery when it is necessary.

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