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HELP ME decide whether to opt for the surgery.

I have cervical severe stenosis (on C5-C6) and moderate on (C4-5, C6-7). I see neurologists for other issues and get their feedback on the issue as well.

1) Neurologist says I should only get surgery if I am crawling or my hands stop working (not for numbness or pain). To them its too risky to go for a fusion.
2) I saw a neurosurgeon who sent me to see a peripheral nerve -neurosurgeon. Peripheral surgeon says the surgery is needed to stop the damage to the root nerve, its already scary to him.
3) My PCP is a sports med doctor, he says 20-30% cases it can detoriate suddenly. But he thinks I should be ok.
4) I saw an othropedic spine surgeon. He says I should wait as long as I can, because fusions going to the next layer and resurgery is too common. He is worried about neck move-ment. I hardly care about that. He also thinks I have to get a surgery some day.
5) I have sent my MRI to one or two other surgeons who thinks I should get surgery.

The risks
I have asked the PA of a neurosurgen about the risks. She was going through
1. leak/tear to CSF (spinal fuild) sac & possible complexity.
2. lordosis or instability of spine.
3. non-fusion
4. infection
5. allergy to instruments
6. surgical risks of heart-attack, death, anesthesia-risks
7. C5 palsy or similar issues
8. damage to the spinal cord during surgery.
9. broken crews, instrument failure
10. reoperation for nonfusion, DDD to another level

My layman's estimate for nonfusion with cadavar is more than 7-8% for multi-level fusion, C5-palsy can also be similarly high. Each of other risks are 1% or higher (more like 2% or higher). Also reoperations risks are 10%. If I add them up, it looks like there is more than 30% chance of something going wrong. Is that correct?

In medicare propublica data it shows only 3-5% have immediate problem (in 30 days). So it should not be that bad. Only non-fusion and reoperation are not seen in first 30 days. Most of the other problems should be seen in first 30 days? Am I right?

MRI shows C4-C7 severe steonosis. Pain in hand.


  • dilaurodilauro ConnecticutPosts: 9,832
    edited 08/13/2015 - 4:37 PM
    Its more important that everything is viewed as you, the patient, not a number.

    You should get all the pertinent information from your doctors (which you seem to be doing), then evaluate all of them. You need to view all the Pro's and Con's of having surgery, or not having one.

    Cervical surgery has become pretty common. Fusions (ACDFs) across multiple discs seem to be happening so often and the results seem to always be very good. If you read some of our surgical forum categories, I think you will see that cervical surgeries seem to be very high in success and in long term views.

    Now, as you know, I am not a medical professional, so anything I say here is based solely on my personal experiences and research. Spinal stenosis is one of those conditions that do not always require surgery. Its always more important when there is a nerve root that is being compromised. When that happens, surgery is generally the answer, sooner vs later.

    I can understand you listing the risks. These are the same type of warnings that you will read with many different medications. They always need to identify the potentials.

    Cervical surgery can be so successful, that the will eliminate the original problem and you can look forward to years of being relatively pain free. (but that is always a subjective area). I had ACDFs done back in 1996 and 2000. It was multi level fusions, with titanium plate and screws.
    I have had nothing but good fortune in my cervical area after those surgeries.

    Talk things over with your doctor. The ultimate decision is always yours, but just make sure you can make that decision based on medical facts, pros/cons and not just emotional issues.

    But always remember, there is no one on the forum side of this site that is medically qualified to provide you with advice as to having the surgery or not.
    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
  • SukhreSSukhre San Diego, CAPosts: 181
    Thanks for the response. This is exactly the type of response that makes me happier.

    Pain is becoming a regular part of my life. Neurologists say "live with it" and surgeons are ok to do the surgery. Life has almost becoming very limiting.
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • Sukhre, only you can decide if you want to have surgery. You seem to be doing all right things to make an informed decision, gather all the information you can, then see your surgeon and discuss with him, (her) what your chances are to lead a healthy normal type of life. I'm 12 weeks post op from a 5 level fusion cervical spine surgery, and I'm doing excellent. I'm a 58 year old male, and I've also had lower back surgery, L5-S1 25 years ago. You have to decide if you want to live with the pain you're having, and also think about if you do not have the surgery, can you do more damage to the nerves if you don't have the surgery. I wish you the best of luck in your quest to try to live a normal, decent quality life.
  • SukhreSSukhre San Diego, CAPosts: 181
    I do think I have more weaknesses in my hand and leg than before. My issue is I have spinal cord damage. It says myeolmalacia on C5-C6 and some dark spots on C4-C5. I am scared about them.Different doctors have different opinions on them(They all agree its risk, how much of a risk thats where they differ).
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • SukhreSSukhre San Diego, CAPosts: 181

    When did you have your first surgery & where? Was it a fusion? How many did you do after that?

    MRI shows C4-C7 severe steonosis. Pain in hand.
  • dilaurodilauro ConnecticutPosts: 9,832

    • 2015 Left Ankle Achilles Tendon reconstruction
      2013 Complete Right Hip Replacement
      2011 Complete Left Hip Replacement
      2010 Complete Right Shoulder Replacement
      2010 Complete Left Shoulder Replacement
      2000 ACDF C6/C7
      1994 ACDF C4/C5 & C5/C6
      1989 Hemilaminectomy Lumbar L5/S1
      1985 Hemilaminectomy Lumbar L4/L5
      1982 Partial Hemilaminectomy Lumbar L4/L5
      1978 Partial Hemilaminectomy Lumbar L4/L5
    Back in the late 70's, the overall thought process for lumbar surgery was ( 1 ) Fusion for Blue collar workers and ( 2 ) Non-Fuson for White collar workers. Well, that turned out to be a mistake, because blue collar workers are generally in better shape than white collar workers, while the white collar workers could benefit from the extra strength.
    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
  • SukhreSSukhre San Diego, CAPosts: 181
    edited 08/19/2015 - 6:39 AM
    Thats a lot of them.
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • Gabriella20GGabriella20 Posts: 18
    edited 08/20/2015 - 5:12 AM
    Sukhre- I am 6 month post ACDF and surgery was the best decision I've ever made. Every surgery has risk but you have to focus on benefits. I have weakness in my arms and hands and currently take cymbalta to ease the pain. Surgeon says it may take up to a year to see if the numbness goes away, it might not. My recovery wasn't as easy as I anticipated, developed migraines due to muscle spasms, but they eventually went away. I was referred to see a neurologist who is against any type of spine surgeries. I also have a spondylolisthesis and I'm deciding whether or not have another fusion at this point. Back pain and leg pain is unbelievable. Doctors are urging me to wait but they are not the ones who have to live with pain 24/7. I am seeing a neurosurgeon next weeks for another consultation. My life has been very limited for the past 2 years since my car accident and I am willing to take the risks associated with another fusion to get on with my life, I'm 25.
  • SukhreSSukhre San Diego, CAPosts: 181
    Thank you. I have a pretty bad MRI & XRAY where a huge bulge is hurting my spinal cord over C4-C7 severe stenosis. I aggravate mine by overdoing things. There is just too much limits...
    MRI shows C4-C7 severe steonosis. Pain in hand.
  • I have suffered from lumbar and cervical pains for a lifetime. In January, I had the lumbar fusion on L4-L5, then physical therapy. The second problem was the neck area and I came to the conclusion that nothing but surgery would help, after trying epidural shots, decompression, manipulations, etc. I am feeling fine now: wearing a collar brace and resting at home. I am experiencing some trouble swallowing and pain in the area of the incision, also muscle spasms along the neck and shoulder. My main problem was feeling of tingling and numbness creeping along the right arm and that seems to have subsided! I talked to several persons who have had the cervical fusion very successfully, and this gave me the confidence to proceed. I also trust my neurosurgeon who performed the lumbar fusion, I think that he and his team are excellent. I am taking Flexeril (muscle relaxant) and hydrocodon (pain killer) as needed and extra Vitamin D and calcium. I am also drinking "bone broth", a broth made from boiling beef or chicken bones, to get extra collagen, amino acids, etc. into my system.
    Lumbar fusion TLIF L4-5 Jan 12, 2015
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