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Making multilevel cervical fusion decision

bookcatbbookcat United States Posts: 66
edited 06/11/2012 - 9:03 AM in New Member Introductions
I am in the middle of choosing whether to have a multilevel cervical fusion surgery with conflicting opinions from 4 neuro/ortho surgeons and a very conservative neurologist who wants me to wait until something better comes along. I am seeking advice on factors to consider in making my decision. I am now on oxycontin 20 mg every 12hrs after no success w/esi, nsaids, pt, yoga,exercise. I just had a C4 nerve root block this am and experienced some relief from the local anesthetic. I have at least a week to see if the steroid kicked in.

My cervical mri shows all the cervical discs worn down and at C5-g bone on bone. There is a huge disc herniation at C3-4 extending into the spinal canal and causing cord compression. I have 4 levels of ddd from C3-C7, with foraminal stenosis and central canal stenosis, bone spurs, and general arthritic overgrowth. The technical term is "you have a very ugly neck".

I also have left arm radiculophy and mild myelography in both arms, the left one being worse. I walk w/ walking sticks or a cane for poor balance and have bilateral leg weakness. In addition I have 3 lumbar fusions (L2-L7). I have incurable cancer and last year finished treatment for a second cancer. I am in remission from severe depression and continue in therapy.

I have gotten consults from 4 surgeons, 3 neuro docs and an orthopedic doc. All said I was a candidate for surgery sooner rather than later. Recommendations varied from 4-level anterior/posterior fusion of C3-7 to 2-level fusion anterior at C5-7. I am currently considering a 2-level anterior fusion at C5-7 and either a posterior foraminotomy at C3-4 or a 4-level posterior fusion at C3-7. My neurologist initially believed surgery was necessary but changed his mind after he discovered how extensive the surgical recommendations were. Less is more when it comes to surgery is his belief. Since he's a pm, he's seen many failed neck surgeries.

I have been living with the pain and worry about loss of function for 6 months now from the combined neck pain and left arm radiculopathy, a year with neck pain only. It's affected my daily activities, increased my fatigue, and led to a significant deterioration in quality of life. Driving has become problematic and, as I live alone, managing daily life has become harder. I've even had to miss music playing and singing sessions. I just don't want to live like this anymore. I'm currently thinking of going for the big surgery and have read the FAQ s, searched the forums, read the articles on this site etc. Finally decided to stop lurking and ask for support and help. It feels like a true support group here.

PLIF L1-3 6/13
ACDF (C5-7) 8/12
PLIF (L2-5) 2003/05/08


  • jlrfryejjlrfrye ohioPosts: 1,110
    I am fused from c3 to c7. I have had a total of 5 cervical surgeries. They did 2 levels at a time which all failed due to the disc below and above the fusion site were so bad it caused non union of the fusions. The last surgery my surgeon had to go in a break all the old fusions out at all levels and redo all the fusions. i am finally fused. So for me it was the only way to go
  • Welcome to Spine-Health.

    Having surgery is a big decision, one only you can make. But I can tell you that I was basically in the same position, only with 3 levels, with the arm problems and muscle spasms in my upper back.

    My surgeon said it wasn't a matter of if I had surgery but when, so I decided I'd go ahead and get it done. Like most here, all my arm symptoms were gone when I awoke from surgery.

    Anterior surgery is also preferable as posterior is a much more difficult recovery. So if you get two done now, it's likely that the next would be posterior.

    Please don't make your decision based on all the problems posted on these forums. Most members who have had a successful surgery move on and no longer post because they don't need the support any more.

    The most important thing is to trust your surgeon, whichever one you choose. You need to know you'll have good after care and won't be dropped after 6 months, that they'll continue to monitor you for a year or so.

    Take care and let us know what you decide.
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