Pardon the long post, but I figured more background information is probably better than too little. I've posted here before about my lumbar issues which led to a microdiscectomy earlier this year.
Lately I'd noticed numbness in some of my fingers and thumb on the left side, and I've had some degree of neck pain and stiffness off and on for quite a while, but it is worse lately. So I approached my surgeon for an evaluation. He ordered an MRI and nerve conduction testing, so he had more information to go on. He also did a cervical X-ray during that first visit, which showed DDD at three levels.
A few days ago I got his assessment and suggested treatment plan by mail, in advance of meeting with him a week from Monday. I was pretty shocked, since I assumed he'd recommend a course of conservative treatment before diving in to surgery. Here is a summary of his findings:
His review of the MRI scan shows advanced spondylosis at C4-5,C5-6, and C6-7. At C4-5, C5-6 the AP canal dimension is down to 6 mm. There is definite flattening of the cord and loss of cerebrospinal fluid surrounding the cord, and no major signal change that he can determine.
I also have bilateral foraminal stenosis at those three levels (particularly at the top two discs). The AP dimension at C6-7 is about 7 mm. So he is diagnosing advanced degeneration and spondylitic spinal stenosis, central and foraminal.
Nerve conduction testing showed evidence of a chronic, old left C5 radiculopathy (I had shoulder pain and weekness in 2001, and her findings were similar back then). She suggested that C6 sensory issues could be on a central basis, but his clinical exam did not find evidence of myelopathy at this point.
Due to the degree of stenosis, at some point he believes I will develop progressive myelopathy, and I am at increased risk of cord trauma if any high velocity forces are exerted on it. So I guess no more downhill skiing, roller coasters, etc. for me. And hope I don't get in a car accident!
He says at this stage I could be considered for an anterior cervical decompression and fusion at three levels with allograft plate. If I progress to myelopathy, I may require a more extensive posterior decompression and fusion to maximally decompress the cord, which would be more traumatic.
Like I said above, I need to meet with him to get the full scoop, see how soon he would recommend this, etc. Given the nature of the surgery, I will seek a second opinion.
In preparation for my meeting with him, I've got a bunch of questions, some of which I'd like your insights on. Specifically:
1. Has anyone else elected to have surgery in a case like this? I don't have horrible pain, but I don't want the numbness to get worse. And of course I don't want this to progress to myelopathy, which based on other postings sounds horrible.
2. Can anyone clue me in on how long the recovery period usually is for a 3 level ACDF? How long typically in the hospital? How long is the typical time off of work? I work at a desk job in an office.
3. Clearly you'll loose your flexibility at those levels, so after healing, can you turn your head enough to safely drive, etc.?
4. If things go well with an allograft, how long does it typically take to fuse?
5. I've never gotten a second opinion and don't quite know how to go about it. I asked the neurologist who she'd recommend, if it turned out I need surgery, and she recommended I ask the surgeon directly. That way they two of them could discuss the case, and share thoughts about the best way to proceed. My PT also provide the name of someone she recommends, but does my neuro's approach have merit. Any suggestions?