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

Discussion: Should surgery be a last resort, or a preventative measure?

KenAZKKenAZ Posts: 12
edited 06/11/2012 - 8:58 AM in Neck Pain: Cervical
Hi All
Figured this would be an interesting discussion topic.

My surgery is coming up quickly. I was a bit caught off guard when getting my pre-op clearance from my GP last week. He indicated that most of his patients wait until they NEED surgery and it is a 'last resort.'

My story? I have been dealing with cervical pain consistently for the past 2 years - prior to that it was intermittent. I have had stinger episodes, the worst being about 4 years ago when I (voluntarily) snapped my head back to catch a piece of food in my mouth (I did catch it!) -- but ended up blacking out and having my upper extremities go numb for a few days. Had an MRI back then but just showed some mild stenosis and disc bulging.

Fast forward to the constant pain. New MRI last May showed SEVERE stenosis and discs bulging -- causing CORD COMPRESSION at C5-C6 and C6-C7. Saw 3 surgeons -- all 3 recommended surgery. I have also been through 2 or 3 rounds of PT.

SO here's the deal -- I can live with my pain. Of course, given enough pain killers and muscle relaxers, I can 'survive' with my pain. But I am not active any more. I walk, do some yoga and that's about it. At one point I was a triathlete, and was really getting into cycling when the diagnosis of late came along. So, haven't been on my bike since mid summer b/c frankly I am a bit frightened that a fall could cause permanent damage.

So my surgery is almost a 'preventative strike.' I am doing it so I can recover at a fairly young age (48) and have the ability to get back to things I want to do. I am afraid that if I wait, it will only get worse and not better.

Just curious on folks' thoughts on when surgical intervention is warranted? (I know it's a personal thing, just would love to know peoples' perspectives)...



  • dilaurodilauro ConnecticutPosts: 9,839
    I think that differs from person to person. Sometimes, surgery is the only option for certain situations. Failure in having surgery will only call for more serious problems in the future.

    But who are those and what situations does that fit?
    Sorry, but thats where only you and your doctor can identify.

    Personally, after 7 spinal surgeries, I knew that I had no other options, only because I had tried so many other approaches.

    But honestly, my first on in 1978, I really didnt know much about back problems, forget about discs and sciatica. I had no physical therapy or any other conservative treatments before surgery.

    After that I made it my business to understand as much as I could about the spine, the conditions, the treatments and the surgical procedures.

    I read so many posts where members indicate that they can live with the pain, deal with all the pain medications and other treatments. That is a personal choice. And it really comes down to the decision about what is the quality of life you really want.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I've had two fusion surgeries, a 3-lvl ACDF and a 1-lvl TLIF, and each one was done for a different personal reason.

    My cervical surgery was done because the problems were so bad that my doctor told me it wasn't a matter of "if" I would have surgery but "when". I also knew nothing about spine issues and trusted him. Now, having learned so much more about the spine and spinal issues, I look at my cervical pre-op x-rays compared to my post-op x-rays and my goodness, it's amazing that my head was still attached to my body. So that surgery was preventative basically, because any fall or car accident could have paralyzed me. And three of my discs simply weren't there any more - I had a waddle (extra skin under my chin) that was ticking me off thinking it was aging but was gone after my surgery. So bonus - a facelift. LOL

    As for my lumbar, it came down to quality of life. I was unable to stand or walk for more than a few minutes and knew I couldn't live like that. When my surgeon (the same that did my cervical surgery) saw my MRI, he said my spine had so much stenosis, as well as facet swelling and spondylolisthesis that surgery was basically the only choice or live with severe limitations. As it turns out, he said that once he got in there, my lumbar spine was much more unstable than he'd though via the MRI and that he was very glad I had the surgery when I did.

    So basically, the cervical was done to prevent paralysis and fix some problems whereas the choice to do the lumbar was to increase my quality of life, but both ended up saving me severe problems in the future.

    Take care,
  • Good question! I tried every option and ended up requiring emergency surgery both times. Both times they were a last resort(of course, being no alternatives and had to have surgery asap) and the last one was too late leaving me with permanent nerve damage. Even my dr. told me in hindsight he wishes we/he hadn't waited so long. He told me I will need more surgery(many of us do)and this time he wants me to wait as long as I can but he doesn't mean it literally because he knows me and my pain levels now, high tolerance....so when I say let's go or he says let's go ahead and do it now I repect him enough to know what's best for me and hopefully we'll both know when so it will be preverntative instead. In my situation and have heard others mention that in retrospect maybe we could have had better outcomes had we not waited so long. Don't get me worng, I think we should try alternatives first but then sit down and decide the pros/cons of your surgery.

    Everyone has to listen to their own heart and what their body tells them along with their drs opinions.

    I think it's a great question and interesting to see what other spineys think about it. My answer is:
    I prefer (and hopefully it will work out in my favor) to have preventative surgery instead of last resort in the future.

  • I began my pain journey years before my surgery. I was like you, in that I was physically active weightlifting running, kayaking, aerobics. I started to scale back on my activity level , as the slightest physical exertion could trigger a flare and I would pay for it for weeks. I am happy I had the one level surgery it did buy time, although having new Issues. I based my decision on being healthy and young enough to recover and heal, and with modifications be able to participate in the activities I enjoy. For me staying on pain management drugs and coping was not good enough. That is how I made my choice. Of course it is a personal decision , but for me 48 was too young and also when I chose to have my surgery.
  • I say go for it. I had very similiar experience with c3-4-5 and had surgery after I could not lift my arms to do even the smallest of chores. The nerves are compressed and that is a fact. Without surgery they will stay compressed and eventually wear down the nerve everyday alittle more. Until something really bad happens and you wish you had the surgery. Even thought I had the surgery I still have a c5 palsy. A new MRI shows no stenosis at c5 yet my nerve was so compressed it needs more time to adjust to lack of stress. EMG tests show no permanent damage to nerve and expect usage back within year.
    Now I have same condition in lower back that I have been fighting the last 8 years. I have severe bilateral forminal stenosis and an atrophied calf that is causing me to limp. I will be scheduling surgery for January as a quality of life decision as well as to prevent further damage to calf and back from limping!!!! I am not waiting for the next set of symptoms to appear. Just my two cents.
  • Hi KenAZ,

    I started out in 2003 with the fusion of C7-C6 Then two months later I had to have C6-C4 fussed. Then I was back in 2005 to have C7-C6 re fussed. At that time I was told about Cervical Degenerative Disc Disease (which by the way is not rally a disease) It seams that when you have one Disc fussed it put more stress on the disc above and below causing them to degenerate faster,(what an oxymoron)I wish someone had told me about this when I was having my first fusion as I may have chose to wait on surgery. You know what they say about hind sight. Also once you have had a disc fused then neck traction and some other physical therapy can not be used to help with pain.
    My Mother found out after my third sugary that her neck was BAD (referred to as an ugly neck by more then one surgeon) and still she put off surgery for another 2 years.(Though I don't know how she dealt with the pain.) They ended up removing all of her bone and disc from the top T-Discs to C-3 and replacing them with a metal cage. She has had less post oppritive pain then I have had to deal with. I Don't intend to tell you when to have your surgery but I hope this helps you to be better informed to help make your choice.
  • Bob
    your message has inspired me.
    I have lost my mobility & activity levels and I want them back!
    I feel like my mind is like a ping pong ball going back & forth about having this surgery or not. Out of fear of coarse.
    I'm feeling a little more positive about it now because I believe some damage can't be fixed & if I wait, that can get worse. I don't want to risk permanent damage or becoming paralized at the slightest accident as 2 doctors have told me I'm at a very high risk right now.

    So, was your neck surgery a success for you? Were you able to go back to your normal activities?
    What is palsy?
  • Hello Ken,
    Have to say that your question is a very good topic to bring up. I agree with that we are all different and that the time for having surgery or not in most cases is a personal decision.

    Sometimes we have no choice as in my case with a job injury. The next surgeries that I have following the first one were to prevent the progression of things, or to try and keep worse things from going on.

    I know that we all want to get back to doing the things we used to do, sometimes we can and sometimes we don't. Am I pain free, no, but I am very happy to have much less pain than I did.

    So in my mind and my Surgeons, the right things were done. He told me after the first surgery that it was a life changing surgery, he was right in that, but I am very happy to be where I am at today.

    Good luck with your upcoming surgery...

  • Do you think the new issues are because of the surgery?
    Where you able to go back to the things you liked.

    For me this surgery has been very difficult. I feel like a totally different person.

  • In my case I wish I have waited and have felt worse... before surgery c5 - c6 I am still in shock that I am writing about this. I guess that I think I had possibilities to get better without surgery.

    But I have heard a lot of people that do get better.
  • Agreed that the ultimate decision is between you and your surgeon. The problem is deciding on what's best for you and when, it's not easy even when it's a complete success. It takes time, and the patience of family and friends as well.

    My first surgery was to be an "emergency" surgery, that ended up a discectomy only. He had said that I'd be in a wheelchair within 2 years if I waited. I hadn't researched and later found this particular surgeon had a high rate of excessive scar tissue issues with his worker's comp pts. Long story, but I saw another pt. in this surgeon's office who was having her 6th surgery in 18 months?? I ended up having that area plus the level above fused 2 years later (by a different surgeon). Since scar tissue was a concern to me with my history, I always ask about it. Both surgeon 2 and #3 said scar tissue is also greatly influenced by the surgeon. The scar tissue had hidden the extrusions that were cutting my nerves. Had I not waited for the second surgery, I think my recovery would've been better/faster, but I still consider it a great success. You can regenerate nerves mostly within 6 months, but at 2 years from my understanding it's unlikely to heal much more. I eventually regained most of the feeling, and have had no pain there since. I was 40 at the time, and everyone else on the floor were geriatric spine surgeries. Bless their hearts! I decided that if I ever needed another, I'd remember how much harder it was on them, and not wait.

    It wasn't 10 years before my neck needed surgery, and it felt better immediately following. It took time to be able to do "everything" I wanted, which was considerably less than Plan A (without back problems).
    I know that my condition will only progress as does everyone's who gets to get older, so I'm trying the last "conservative" measure before surgery #4 (and hopefully the last one). So far, so good with the epidural injection (day 3). Hope it lasts for years!;)

    It's great that you are examining this thoroughly first.
  • I too think it depends on your situation as well as how you and your doctor feel about it. For some spineys including me, physical therapy improved my pain to the point where my quality of life is good. I'm grateful for that, because my choice is to avoid surgery rather than face the risks of surgery and a lengthy recuperation. I might feel differently had I been athletically inclined, but I've always had the coordination of an ox when it's come to sports. I make up for that with tasks requiring fine motor coordination, such as sewing and detailed artwork, so my hobbies thankfully keep me out of trouble (lol). I wish I could still walk long distances, but I know I can't have everything. My little dog is a blessing, too. Oops, I'm digressing...sorry.
Sign In or Register to comment.