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??? Anyone C-4/5/6/7 T-1/2 Fused

JoydancerJJoydancer Posts: 463
edited 06/11/2012 - 8:44 AM in Back Surgery and Neck Surgery
Wondering, if anyone has had surgery/fusion of two or three levels of C-Spine and into T-Spine one or two levels?

I have C-4/5/6 ACDF bone implant fusion; diagnosed with needing C-6/7 into T-1/2 plates/screws. Told it is complex to have to that junction cervical & thoracic fused and surgeon would not want to do unless "severe neuropathy and/or myelopathy cord compression"

It's not that T levels, of course, are not done, it's having the junction of C-spine having to be fused to T-spine with instrumentation = more complex and serious surgery. Al
so told prognosis "high risk and more compromised".

Not seeing anyone with this history - - anyone have same issues of C-4/5/6 fused now needing that C-7 T-1/2 because of severe DDD?


  • Janelle,

    Presently I am with hardware and fusion C5/6/7. C8 is going, and C2/3 is a future issue. They are trying to figure out what is causing my Neuropathy in my right arm and both legs, once that is identified, revision for the C5/6/7 and adding C7/8. Mine will be 360 - front to revise the hardware and add the C8 (C7/T1) and then in the back to add stabilization with rods and such. C3/4 is my only level with most NOTHING going on! (G) C2/3 spooks me more than a revision plus a level...:( My C7/T1 is loss of disk height, osteophytes and DDD, almost identical to my other levels that went.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Janelle I had a microd at t1/t2. Now I have issues going up to c7. Waiting to find out more detail of what needs to be done. Three docs have said fusion but don't have details yet.

    I'd love to hear more as you find out.
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  • Brenda, good to hear from you.

    I had tried to pm you but not sure if you received, guess not, not sure what I'm doing wrong?!

    You and I are so similar that's awesome!!! - - C-spine issues, same levels, complex bridge required with severe advanced DDD, neuropathy, pending surgery and further assessment.

    I believe we are going into these many levels and that bridging c-spine to t-spine.
    But thought I'd post the ? if any one is has had that critical junction surgery.

    My orthosurgeon up north, past 7 yrs has discussed the pending surtgery for past 2 years since mva recovery and more degenerated changes, but my symptoms improved after 14 months. He briefly described his plan of procedure:
    laminectomy, plates and screws posterior, but we got a whole nother ball-game now with the nerve compression on two levels C-6/7, 7/8, worse at 7/8, and was told it would require anterior approach to be done right. I did not confirm with him since his re-consideration of not doing the surgery after my big appt. with him with the MRI CT flexion xray films reviewed and diagnosis, of him doing surgery.

    I do know he said anterior with plates and screws was what he preferred to do and commented I had a 60/40 chance it would not successfully fuse and then it would require posterior surgery (not specific) what hardware would be done if that would occur.

    Have appt. with my orthosurgeon here in FL on Fri. I am concerned with things will go as a second opinion. Like to chat with you prior to Fri if possible.

    Like to chat with you further of surgeon assessment of hardware and complexity, especially in regard to prognosis.

    Getting focused for ?'s to address with my appt on Friday.

    Hope to catch you on-line or pm if possible before my appt.

    It's so great you being here !! Never dreamed over these many years of having such a "unique complex" C-spine- - that I'd find a "twin" = we're "twin-spineys" (lol!!!)

  • Kris,

    Hi, good to hear from you!

    So it looks like you're going into C-spine with the T-1/2 being done, did you have c-spine degenerating prior to rear-end mva.

    The factor of compromise of adjacent levels because of surgery is also certain as well I suppose.

    I am facing some serious dilemmas with those two surgeries being proposed and then being re-considered by my #1 ortho-surgeon.

    I can't see me not having resolve with the disability and nerve compression problems knowing surgery is the resolve = and to have to face those two surgeries with hardware and rare bridging.

    I understand many of them are not done.

    It may never be seriously actually done, as I have complex compromise to it leaving only one level, which all my life has been the most vulnerable and most deformed since birth; severely malformed two
    level upper spine, which is a partial hemi-vertebrae that is tethered and is doing all the movement of my head with everything fused.

    Not sure where this is going to go...

    See orthosurgeon #2 locally closer to home not as experienced, but have to have him jump in with me on the compression nerve stuff that's now been unfolding and no epidurals helping. He'll review my recent scans and see what he may want to assess in regards to surgery/prognosis - - believe me I have questions ???'s.

    Will keep you posted.

  • I believe we are quite rare- - having this many levels done and bridging c-spine to t-spine.

    But thought I'd post the ? if any one is has had that critical junction surgery.
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  • Howdy Janelle,

    :) The easy way would be click on my name near my avatar. My profile comes up, and then you scroll down to 'write a message" and then you can PM from there. :)

    Be very happy to chat with you woman, looking forward to it. My last 2 fusions were completed with different hardware, and my hubby and I think the crack is because of different direction of forces on the bone. The crack matches the screw threads perfectly. My surgeon basically pooh pooh'd it! I don't think he wants to admit this hardware (the wing) is the cause. He hasn't used it again on anyone though...hummmm..

    My surgeon told me mine would be front and back. I think a lot of that is due to a revision as part of the equation, but not sure. I am hoping I will get another MRI within the next few weeks. I get mine via 'positional' (stand up) MRI. I have no curve in my neck (lordosis) so if I get a 'regular' lay down MRI, not much shows, when they do the positional, you can see most all of it! The quality of the films is very good too.

    Sleeping is getting to be a bugger again! If I sleep on my side (left) I awake within 2 hours in major pain at the base of my skull, and the bottom of my neck below my fusion. If I sleep on my back, I awake a little over an hour later and can't feel my arms! The right gives me some relief. When I put this with my lower back, oh yeah...arrgh! :)

    I hope you are feeling better today. Chat with you again. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.

  • Reading your symptoms during the night Brenda, more or less confirmed something I'd been wondering lately.

    Since my lumbar fusion (and before come to think of it), I have been waking every couple of hours, needing to change my position and pillows to try to get comfortable. At first, I assumed that it was due to my fusion.
    Now, however, I am beginning to think that it is caused by my neck. I often wake with extreme pins and needles particularly in my left hand, aching arms from the elbows down and a headache, often at the base of my skull.
    My neck is very noisy and I get pain in my neck and shoulders. I also experience some visual disturbance and sometimes dizzyness. Could this be neck related too?

    Wishing you all a comfortable day :D
  • Howdy Jellyhall!!! :)

    It very well might be from your neck! My lumbar is spine levels L2/3/4, but the nerves affected are L2/3 presently. My neck has been bad since 84, but intervention needy since 2002! I know mine is from the neck as I have experimented a bit. I propped a pillow up as it usually is if I sleep on my back. Laid down on my back, and within just 10 minutes, both arms started to go numb, so it wasn't a fluke waking up that way. I did the same for my side sleeping. Right is okay - wake with an ocular headache this way 2 out of 10 times, but to the left always a headache there when I wake. I hurt at the base of my skull (mainly on the left side of the skull), and then the very top of my shoulders and base of the neck kill me! It is akin to either a frostbite pain feeling to a ice pick type pain.

    This really started ramping up about a month and a half ago, so I know more changes are happening. I only get real nervous that the large bulging (about 12mm) at my C2/3 might be starting to fail. I was warned by my last Neurologist that the fusion area for me, and C7/T1 - Some call it C7/C8 is going to be (if it weren't already - but it was - Ulnar issues) more and more prevalent in causing symptoms. I was also told so far anyway - each level I have going in my lower cervical is "adjacent disk disease" as they feel that they are going more quickly due to loading change. I was also told that more likely than not, it won't go past C8 - Gawd, I hope their right!!! Theory given to me there was that the "T" spine is rigid thanks to ribs and the breast bone, so less likely to fail due to fusion changes. Sniff...hopefully that is true!

    Noisy. ...I have what my hubby calls a "Rice Crispy" neck! He can hear the loud pops across the room! The regular ones I have when I move my head, he has to be next to me...those noises he calls rice crispy! (G) It is probably a good idea to bring your symptoms up to your doctor. I wouldn't be surprised if he does a thorough physical and hopefully imaging to find out if anything is going on. Another thing that happens is like now as I type this, I have to take my right arm away from the keyboard as it starts getting really tired in the outer shoulder down to the elbow, if I don't, it starts to hurt. Please let us know what you find out. Support *HUG* :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Well the surgeon I saw on Friday is saying he could fix everything by doing a posterior surgery. I'm guessing that means removing the parts that are causng pain, facet joints and some ridging, and then stabilizing with rods. He specifically said he wouldn't go in the front but we didn't get to the details of fusing or what not.

    So if he is correct mine will be bridging the junction. I'm going for a new MRI and then he wants facet injections to see if that is where the pain is coming from.

    I'm curious about where you went up north. This surgeon was the head of neurosurgery at a hospital in NYC. I will PM you his name.
  • Joydancer,
    I had C4 through T1 fused last week, posterior with rods and screws. They also cleaned out the foramen(spelling?) on 5 of the foramen canals. I can tell you it was much more involved than the one level laminectomy I had in 2006 and the 2 level ACDF I had in 2008. Biggest problem I had was when I woke up I was in really bad pain and they couldn't seem to get it under control. This went on from Wednesday at 4pm (recovery room) until Friday morning about lunch. Got so bad that I asked them to put me in a medically induced coma until something could heal or they could figure out what was wrong. The final answer came from the surgeon's PA when she figured out the medication problem. My pre-op information had as clear as day on it that my doc had me on 40mg of Oxycontin twice per day with 5mg Oxycodone IR for breakthrough. The hospital staff had entered it as if I was on 5mg IR Oxycodone 2 times per day only. so she said the amount of whatever they were giving me was equal to a drop in a bucket of water compared to what I needed. They changed the medicine and within 2 hours I had relief. I've got to tell you though that now that the problem of the medicine was solved, the recovery so far (1 week and 2 days post op)is very similar to the one level posterior laminectomy I had in 2006, only more intense.

    I hope you do okay and I just hope that having that C7 bridged to the T1 doesn't present new problems over time. Also, please forgive me if my spelling/typing is slightly off today but the combination of the medicine and the spasms, etc are taking a toll on my cognitive abilities!!
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