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vertebrectomy rare for first surgery?

welshladywwelshlady Posts: 121
edited 06/11/2012 - 9:02 AM in Neck Pain: Cervical
the more i am reading on this site the more curious i am becoming as to why my first surgery seems so radical? I was expecting the discectomy and fusion until the pre-op assessment when they looked at mri again, and told me that i need this major surgery, c6 vertebrectomy. any ideas how rare it is to have this as a first op?


  • It is kind of odd to have that as a first surgery. Have you checked your surgeons credentials fully. How many opinions did you get? If you only have the one opinion, I strongly encourage you to get more than one opinion. If you have more, what is the reasoning they are giving you for doing the vertebrectomy? I think you should be asking your doctors this question. The concerns from this surgery, would be what is your fusion rate? The one thing you don't want to do is risk a non-fusion and have to have the repair surgery as it is even a longer recovery and comes with more risk.
  • i only know that this surgeon has a great reputation and is supposed to be one of the best in the country (UK) i really dont have time now for a second opinion as surgery is due next wednesday and if i turn this slot down heaven only knows when i would be able to get it done. (i must say that i feel totally invisible as a person to the surgeon, i know the hosp i am going to is under a huge strain and has had to cancel so many operations this year, its made the tv news and radio news in the last month) it leaves me feeling very vulnerable, especially as i am down to a shuffle rather than a walk and my hand is doing its own thing more and more and the back of my head is so painful i would like to pass out but never do! i dont take any pain meds at the moment, tried tramadol and they made me feel worse and codeine dont touch the pain so not worth taking. i am hoping that post op they will make sure i am pain managed.
  • Welshlady,

    I have already had a L4-S1 laminactomy & diskectomy followed by an L4-S1 Fusion w/ an alograph (cadaver bone tibula), rods, screws and cages on November 11, 2009. I ended up in intensive care because of how bad the pain was. Three days later I was released. Since then I have used epidural injections in the post surgical area. I'm have chronic pain everyday. Up until recently I was able to use Norco 10/325 for most of my pain, and when the pain became unbearable, I used 20mg of Oxycotin.

    Then last November, I believe a disk ruptured in my neck (cervical) and my upper back (thoracic). Since then, my pain has increased ten fold. After several MRI's, a Diskogram, an Esophagram, an ENT consult, and multiple chronic pain consults, I was told that I have DDD, bulging disks in my entire thoracic and cervical areas, a severely herniated disk at T2, and at the moment more than likely more herniated disks in my cervical disks that aren't showing up with an MRI.

    I would highly recommend having a pain consult before your scheduled surgery. I now use an TENS/IF device to help, a large gel ice pack, 750mg Robaxin 2x daily, 8 mg Dilaudid 3x daily, and lots of rest (read: can't do anything).

    You need to manage your pain, before your surgery. I pray that your surgery goes well.
    Respectfully yours
    Laus Deo Semper,

    "Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go.”
    Joshua 1:9 NIV84
  • You and I have conversed a little about this. Given what you told me with your cord compressed so extensively, I would assume the need for the vertebrectomy is to remove the pressure off of the cord. I am assuming that it is the veretebral structure pushing against the cord rather than the disc. If it is the only disc pinching your spinal cord, then I have no idea.

    Yes, I have read of very few having complete vertebrectomies. Some have corpectomies (partial vertebrectomies). I know mine wasn't common at all when I had 2 full vertebrae removed, but I trusted my doctor when he told me the pressure needed to be removed from the cord completely.

    A second opinion would be a good idea, especially with such an invasive surgery. But if there is no time and your decision is made, call your doctor's office for his email address and send him a list of your concerns so that you can get answers to calm yourself. At least that is what I would do. A big part of having a successful surgery is the patient having confidence in the outcome. One good thing is that your surgery is all being done from the front, which means your doctor doesn't have to cut through the posterior neck muscles. Do you know what kind of a cage or strut graft he will be using in place of where the vertebrae is now? Something will have to tie your C5-7 since they are completely removing C6.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • all i took in was the titanium cage, synthetic bone, top plate and screws, have no idea what else. sending an email seems a good idea! i do realise they wouldnt be doing it unless they thought there was no option, he did stress its a major op. i was pleased it was synthetic bone as i didnt fancy a poorly hip on top of everything else! my hubby thinks i should have shouted louder much earlier and maybe he has a point. if this op doesnt sort my legs out i will be shouting loud for an mri on my lower back thats for sure. the effect on my walk and hands are getting worse quickly now so am hopeful it is all from the neck and this will sort it. i was playing badminton 5 weeks after i had an hysterectomy, ok it was 20 odd years ago but i think i do have a positive attitude to recovery, expecting more pain temporarily, but long term gains and at least not to be paralysed! i know i will appreciate the support of this site (i already do! i dont like to talk about this too much to my hubby, as he likes to stay positive too. many thanks
  • Has your doctor told you your let symptoms will go away, or just that the surgery will stop it from getting worse? I'm just curious what he thinks. Sometimes we do surgeries for myelopathy only to stop the symptom progression, others it helps bring back a degree of function.

    One other thing to ask him about. Since he is removing your vertebral structure (bone), why not grind that up and put it in the cage. Your own bone has a much higher percentage of successful fusion than does a synthetic or cadaver bone. My surgeon used my own bone, but he also used BMP in the back of the site when he turned me to finish the surgery. Also, whatever synthetic they are planning to use would be nice to know. There is a product called bone morphogenic protein that is not FDA approved for use on cervical spine surgeries, though some physicians will use it in the back (like mine). I know they shy away from the front approach with it because of many cases of swelling, cutting off breathing, etc. from it when it has been used anteriorly.

    I do wish you well. The UK does things a bit different than here in the US. Possibly the products here are different. So don't worry by what I wrote above, but I would suggest you do ask so that you know what you are doing. And it makes total sense to use your own bone in that cage rather than a synthetic one. There should be plenty coming off of your vertebrae that they won't have to go to your hip for more. At least that is what I think.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • the surgeon was quite clear that the operation was not to help with pain but to prevent further symptoms,his 'fellow' was more hopeful and said that although the operation was for prevention it wasnt unreasonable to hope for some improvement of some symptoms but to look on them as a bonus not to expect them. the surgeon mentioned several times that at my age (i am only mid fifties!) the spinal chord is very unforgiving. (now i am wondering if it being without fluid for at least the last 6 months and maybe much longer might be a contribution to that too!?). it was you saying it was rare that got me looking, i am so ignorant i had no idea it wasnt the usual progression, but you were so right, not many that i can find... maybe its because they are all successful and no one needs to come on here? or is that me with my optimistic glasses on again? your neck looks horrifyingly impressive if you dont mind me saying, i cant even begin to imagine the pain that you have been through and still going through. it amazes me that the skill is there to put us back together in this way, i know its not perfect but the alternative doesnt bare thinking about. i wish you a good day today, and thank you again for your support, i think my hubby wants to stay in ignorant bliss and just trust the doctors, he would rather i didnt think about it til the day... mmmm not going to happen as i am human after all, but i can try to spare him my worries and moans i guess, (bet there will be plenty of time for that post op!)so thank you. :H
  • I know your surgery is tommorrow, and you may not see this in time, but your symptoms sound like central cord syndrome. It's caused by cord compression, and it may take up to a year before you will know how much of your symptoms will be resolved.

    Nerves heal really slowly. I had the syndrome from compression with no fluid around the cord where the fractured piece from C4 was pressed on the cord. My symptoms progressed rapidly (I stopped breathing & had CPR), and I had urgent surgery.

    Most of my symptoms from that resolved, but I have problems from the other cervical & thoracic fx. But as you said, we're walking etc. For me, I'm very grateful.

    Best of luck, I'm praying for you,

  • got a couple of days yet, surgery on this coming wednesday the 16th. looked up central chord syndrome and i think you are right, sounds just right,but never looked at my congenital fusion as being lucky before but maybe it is, you sure have had some scary times!! goodness knows i am scared enough without going through anything compared to you! i have to say in some way i am perverse cos the realisation of how bad it is has eased my anxiety cos now it is a matter of handing myself over and just trusting the docs to do the business. trusting that my hubby and friends will support me for as long as it takes to recover from this, but the closer it gets the more ready i feel to tackle whats to come, even knowing that may well be horrendous for a while. thanks for the support, when i came on here i was in total panic, panic now down to dull roar allowing postitive thoughts to re-emerge. i hope that today is a good day for you, that any pain in manageable and that something lovely happens to you today. :-) x
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    because they were toast. Damaged by a previous fusion attempt. So in my case it wasn't during the first surgery .... but the three days of surgerys to repair what the first surgery did - or didn't do as the case was.

    Good Luck,

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