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5 weeks post-op C1-C2 fusion (second go-round)

achyneckaachyneck Posts: 163
edited 06/11/2012 - 8:00 AM in Recovering from Surgery
Just had my revision surgery 5 weeks ago - posterior C1-C2 fusion using rods and pedicle screws. My last surgery was in April 2011 and failed....the bone resorbed and the cervical wiring ended up rubbing on my C2 nerve root due to instability. Unfortunately, I didn't keep a log of my progress last time, and am hoping things are looking up this time. I have my 6 week post-op appt next week and am hoping for good news. However, I received good news the first go-round at 6 weeks, so I know it will take longer to know whether this surgery will be a success.

The surgeons (both initial and team that did my revision) don't know why I didn't fuse....I'm in my 30s, non-smoker, active and healthy. To promote fusion this time, the surgeons used BMP (bone morphogenic protein), which has not been approved for use in cervical fusions, however, this is my "last chance". The only other method for this type of fusion is using transarticular screws, and the anatomy of my C1 is to narrow to try without significant risk of hitting the cranial artery (fun!).

Prior to surgery, I had constant occipital neuralgia and was barely able to function. I was taking 60mg Kadian/day and 10mg Norco every 3 hours during the day while I was up and around (working and being a mom), so probably 5-6/day. I was a mess.....

After surgery my headaches were gone :) Last time, I only wore a soft collar for 2 weeks and started intense PT (2.5 hours/day, 3 days a week and walking other days). It seems like once the surgical pain subsided my headaches started creeping back up. At about 3 months post-op I was prescribed a bone growth stimulator 4hours/day. Anyway, to no avail because 9 months later I went under the knife again.

So I guess I'm just wondering how other folks feel at 5 weeks post-op....I have decreased my Kadian from 60mg to 15mg and am now taking Norco 3x/day. I typically walk a total of 3 miles/day (broken up into 2 walks) and try and take a 2 hour nap between walks. I haven't had very many muscle spasms, and haven't taken any muscle relaxers during this recovery (last time I relied on them a LOT). I am still in my Miami J hard collar, so mobility is limited. I still feel pretty tired and my neck burns and feels painful if I am up and around for more than a couple hours. A trip to the store wears me out.....

Any comments or feedback is appreciated. I just hope I am recovering well, but am a little disappointed that I still have neck pain and weakness........

Thanks in advance!
Monica
April 2011 C1-C2 Fusion (Brooks wiring)
January 2012 C1-C2 Revision Fusion (Harms Technique)
2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
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Comments

  • I did not have this surgery, but I do remember that you replied to my posts in the past. I just wanted to wish you much luck in your revision surgery. It must be hard to undergo another spine surgery less than a year apart. I really understand your concerns since my toes started tingling again a year post-op. I will be getting a new MRI of my cervical spine next week. The doctor is concerned that scar tissue might be pressing on the cord again. Keep walking and stay positive and hope this time fusion will take! :)
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • I am so sorry you are having neuro symptoms again......it gets to be so hard sometimes. I don't know how other with chronic pain do it. Up intil February 2010, I had maybe had 5 headaches my whole life. Up until my surgery, I had occipital neuralgia 24/7. My heating pad was my best friend. I have almost forgotten what its like to be "normal", running, bakpacking, playing with my kids and laughing. I am getting back to that place, and am glad to say that today i was free of pain for more hours than i was in pain, so that's a start. I hope this surgery works, and I hope your tingling feet is a temporary flare up that can be remedied with rest or PT.
    Monica
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • jlrfryejjlrfrye ohioPosts: 1,110
    I also was a non-fusion patient of the cervical but mine being c3 thru c7. They used BMP on my neck as a last resort. This made my 5th cervical surgery. I have fused 100%.I am almost 2 years out from this surgery and my neck remains stable. I have had my 6 month check-up and everything looks good. Every 6 months a MRI is done because of the BMP. used during surgery. I know it is not approved for cervical patients but it something for me that even stem cells didnt do. It fused my neck. you are still very early in your recovery and I think patience is needed. That was a big surgery and I think you should give yourself more time before wondering how successful the surgery was.
    Susan
  • Thanks so much, and it is good to hear from another person who had BMP used in their neck. I've tried looking on the internet, but all I find is horror stories from people who had allergic reactions. Patience is not one of my virtues....I need to work on it.
    One question, why do they do a MRI every 6 months because of the BMP?
    I am looking forward to my 6 week postop appointment this wednesday. I am hoping for good news, and think I will get it since I am still headache-free.
    Monica
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • Yes, those nasty headaches. I have them all the time and the heating pad is the best, as well as a hot shower! Glad to hear that you were able to enjoy your pain free moments with your kids. Treasure each of those moments. Do keep me posted on your recovery! :)
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • RangerRRanger on da rangePosts: 805
    hello friends,
    I am almost 5 years post-op of a multi-level C-spine fusion and have just learned BMP was used along with my own bone to fuse my neck. My fusion went real well and still looks good. I too read all the horror stories related to use of BMP in the cervical spine and I still have some concerns in the back of my mind. But I have total trust in my Dr's and surgeons, I do my part to recover and build core strength to support my spine. When I have my next fusion I will for sure discuss more in detail what is being done. I have certainly learned a lot through experience over the years.
    ranger
  • Ranger,
    it is good to hear from someone who has had BMP used in their c-spine a while ago that is doing well. I hope I also have successful fusion. I am 7 weeks post-op now and have been gradually improving, but recently (this week) started having headaches again periodically. I hope this is just a side effect of weaning off the pain meds!
    thanks for the encouragement!
    Monica
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • I did not have a fusion, but I did have two posterior surgeries at C1 and C2 and the recovery from that was the most difficult of all my spine surgeries. What you describe as your routine of walking and resting is very similar to what I did and it made my recovery go faster than I think it would have if I would have given into the desire to just sit back with my head supported.

    As a result of my surgery I lost two major muscles in my neck and it made for a life full of spasms, burning, aching and out right agony. Fortunately as an unexpected side effect of my SCS, it helps control the Dystonia that developed on the non-atrophied side.

    Anyway, I can relate to what your recovery must be like. I pushed myself to walk and rest and eat well during recovery. Made a huge difference.

    "C"
  • We spoke a few times online about our surgeries - I had the same as you - posterior C1/C2 with screws & rods - in October 2011, so I am 5 months post-op. They used bone from my hip and at my 3 month checkup, he said I was fusing already. I feel completely fine & normal (except I can't turn my head like before but Oh Well). I got migraines for the first 3 months around my cycle but the last 2 I have not had a migraine at all. I used diuretics and I think that helped.

    You are still very early on to expect to not have weakness & pain. My neck weakness went away probably around week 12 so you have some time to go. Remember, they cut the huge muscles in the back of your neck - they take time to recover. I'm just starting to get feeling back!

    Best of luck & take your time - don't push yourself.
    2011 C1/C2 Fusion due to os odontoideum & fracture from motorcycle accident
    2014 L4/L5 Herniation
  • I am almost 11 weeks out now and still wear my lovely Miami J collar full time. We have a love/hate relationship at this point :-)

    I have successfully weaned off the long-acting pain meds (Kadian aka MS Contin) and am now working on weaning off hydrocodone. It has been rough, and makes me think my pain is coming back, but it is one of my goals to try and be free of narcotics. I was previously on 60mg of Kadian and Hydrocodone (10/325 mg) every 4 hours during the day (probabl 5-6/day). I have been off the Kadian since 7 weeks post-op and currently take 4 hydrocodone (7.5/325 mg). Next week I plan to wean down to the 5/500 strength. Wish me luck and strength!

    I am going to PT 2x/week and had my first 'real' massage since surgery last week.....it was amazing and the urning between my shoulder blades is gone. The tightness in my neck has caused my scaps to freeze up, and also affect my rhomboids in my midback. I do a little cardio at the gym, usually 20 minutes on the recumbant bike. I was proud that I hiked 5.2 miles with my dogs last week! It's rough since I can't move my neck in the collar, the the terrain is very even.

    My next check up is next Monday (April 2nd), fingers crossed for fusion!!
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • I guess they are keeping you in the collar extra long to make sure you remain stable. I was out of it by 6 weeks inside my house, 8 weeks outside of home. My PT did an awesome massage each visit and then I did strength & stretching exercises - went for a month or so.
    Since I had no pain before the surgery, I didn't have a problem getting off the narcotics & I send you lots of zen & positive healing energy to carry you through! I am not even taking advil or anything so there is light at the end of this tunnel for you. :H
    2011 C1/C2 Fusion due to os odontoideum & fracture from motorcycle accident
    2014 L4/L5 Herniation
  • Congratulations on doing better the 2nd time round! Sounds like things are going well for you and I wish you the best in your recovery! Keep up the PT and keep doing the cardio, too. :)
    2011 ACDF C5-6 for Spondylosis with Myleopathy
    2012 L4-5 herniated disc and hernated disc at C4/5 2013 Taking Amitriptyline for headaches
  • I had my 12 week post-op visit 2 weeks ago and the surgeons said everything looks good. They only did an x-ray, so they could not tell for sure if fusion was taking place, but my hardware looked good and they were encouraged. I was told that I can return to work part-time and begin weaning off the neck brace by 1/2 hour every 3 days. I was also concerned because I had heard a loud "pop" at the base of my skull 3 times and the burning on the back of my head has returned if I am up for too long. They think the popping was either scar tissue or a tendon, and after showing my Physical Therapist where it pops, he also concurred with their opinion. He said that nerves run through that area, and they cold be inflammed and causing my pain/burning.

    Fast forward 2 weeks.....I have been working 4-7 hours/day (usually 6) and going to PT twice a week. I have also been getting a weekly massage (in addition to the massages at PT). Both mentally and physically this recovery is taking its toll on me. I have been trying to go the the gym or walk my dogs on the days I don't go to PT, but most of the time I just want to curl up in bed.

    The burning on the back of my head and pressure/pain in my temples has returned, although not as bad as before my surgery. The pain does subside if I lay down or apply pressure to the back of my head. I am hoping that this is just due to being upright more hours during the day. Unfortunately, due to the increased pain, I haven't been able to discontinue the Norco during the day.

    I hope I get some pain relief as my muscles strengthen. I will just continue to exercise every day to try and keep my mood positive, and take it one day at a time.

    Monica
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • I returned to work at 13 weeks post-op fulltime. It was very hard to get through the day sitting up for 8 hours. My company bought me a high-backed executive chair that has a pillow like top and it was my savior! Whenever I am feeling tired or stiff, I just lay my head back. It took a few weeks longer before the stiffness & muscle pain wore off, as my neck got stronger. I think you're on track except for the burning and pain, which is something I didn't have. Take it one day at a time -
    2011 C1/C2 Fusion due to os odontoideum & fracture from motorcycle accident
    2014 L4/L5 Herniation
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