Persistent pain post-anterior cervical fusion C4-C7?

Yes it is spinal cord compression. She cannot even do an epidural as there is no space to put the needle. The pain would ebb and flow. I treated with all types of treatment. Physical therapy, traction, aqua therapy, biofeedback. Hypnosis. Was advised against chiropractic. But it never affected my ability to function. Many years ago a neurosurgeon told me not to have surgery because all levels were involved and would never be pain free. He did say if I noticed any change in my gait I would have to be seen. I’m now having a problem walking due to leg pain and weakness. It’s not sciatica it’s coming from cord compression in my cervical spine. I’m terrified of spine surgery. I worked for orthopedic surgeons for 20 years so I know what bad outcomes look like. I will have a second opinion on June 7 with another neurosurgeon. I would never go to an orthopedic surgeon for spine surgery

Yes it is spinal cord compression. She cannot even do an epidural as there is no space to put the needle. The pain would ebb and flow. I treated with all types of treatment. Physical therapy, traction, aqua therapy, biofeedback. Hypnosis. Was advised against chiropractic. But it never affected my ability to function. Many years ago a neurosurgeon told me not to have surgery because all levels were involved and would never be pain free. He did say if I noticed any change in my gait I would have to be seen. I’m now having a problem walking due to leg pain and weakness. It’s not sciatica it’s coming from cord compression in my cervical spine. I’m terrified of spine surgery. I worked for orthopedic surgeons for 20 years so I know what bad outcomes look like. I will have a second opinion on June 7 with another neurosurgeon. I would never go to an orthopedic surgeon for spine surgery

@karen1103 I was also terrified of spine surgery. It was only a single level cervical fusion, and it was not as bad or painful as I expected. After surgery, they give you pain meds, and that nauseated me as well as the after effects of anesthesia, so I stopped taking pain meds altogether and took none after I left the hospital. Yes, I had pain from the incision and surgical path, but all the pre-surgery pain in my legs and body was gone when I woke up. I thought the pain would be 10 times worse than it actually was. From here on, it was only healing pain from the surgery itself, so I saw that as a good thing. It takes about 6 weeks for incisions to heal completely, and about that time, the new scar tissue starts to tighten which might increase pain. The first 2 weeks were the most painful starting a couple days after surgery because of inflammation kicking in, and in an anterior (front) approach, there is some trouble with swallowing. I had to be careful not to swallow wrong because it was like one side didn't know what to do. It was also like a bad sore throat, but that all resolved. It is however, a risk of this surgery that a patient can have trouble swallowing or loose speaking ability due to vocal cord paralysis. They will tell you this. I had an excellent surgeon at Mayo. There are procedures at Mayo to treat vocal cord paralysis with an implant so vocal cords will meet again to restore the voice, and he told me that at my consult.

You may want more opinions, and you may get different answers about how many levels should be addressed and how. There are different cages, plates, and implants that can be used and some surgeons prefer certain manufacturers. I chose surgery with no hardware and all I have is a donor bone disc that was implanted. That is possible with a single level fusion, and I stayed in a neck brace until the bone had fused. I have found that my body doesn't like metals and I developed some sensitivities to them, so this was the right choice for me. Implants that fill the space after disc removal can have spaces for bone growth inside to help anchor it, and likely can't be removed later if there is a reaction to it. This doesn't happen a lot, but I had warnings from my body when I had to give up pierced earrings because I reacted to every type of metal I tried. I even reacted to titanium plates when broke my ankle later on, and I was able to have them removed. These are questions to ask about what can cause immune reactions from implants when you are considering surgery.

My fears were mostly the fear of pain and some fear of loosing the coordination in my arms. I knew I had to have surgery to get back my arm function and it meant a lot because I am an artist. After spine surgery, I found I could tolerate it just fine without medication, and I had given myself the mindset to be able to do that. If you fear pain, your fear can increase pain a lot, so it's better to accept it, and work on strategy to relax and lessen the pain. I did that with some music therapy and deep breathing, and I trained myself to lower my blood pressure by breathing slow and deeply in time to relaxing music. I can use this anytime I need it. Later I added in thinking about things and places I loved, so I had imagery to assist in comforting me.

I had an excellent neurosurgeon and that makes a big difference in the success of a spine procedure. Some surgeons excel and others do not, and I am always looking up everything I can about what literature a surgeon publishes, if they are a respected presenter at spine conferences, what research they do and area of interest, where they trained and if they have received awards from their peers for their spine work. I had an advantage because of having a biology degree so I can understand medical literature and have an exceptional physical therapist who I have learned a lot from. She rehabs patients after surgery, so she sees the surgical outcomes for specific surgeons and she was a great source about what to reasonably expect after spine surgery. I understand that now you are at a turning point and need to make a decision. Let me know how I can help work through the fear, so you can make an educated and well thought out decision.

You may also be interested in this discussion about facing fear.

Just Want to Talk - "How can I defeat my anxiety about medical tests and surgery?"
https://connect.mayoclinic.org/discussion/how-can-i-defeat-my-anxiety-about-medical-tests-and-surgery/

Jennifer

Thanks for your support Jennifer. I don’t expect the pain will go away because every level of my spine is so deteriorated. He actually wants to do cervical, thoracic, and lumber surgery. I will live with the pain but I need to preserve the use of my arms and legs. Right now my legs are so weak I can’t stand for more than 5 minutes. Also I will find out June 4 if my cancer has returned. I’m on medication for 10 years that causes bone loss. Thanks for your input it was very helpful

@karen1103 I'm sorry you live with the uncertainty of a cancer re-occurrence. That must be worrisome. My husband had an in situ melanoma on his hand that had not spread, and he goes through annual scans and frequent dermatology checkups. Having bone loss is also a big game changer if you need spine surgery because when they build a spinal construct with rods and screws, your bone quality has to be able to support that without the screws pulling out. If bones are weak, there is possibility of compression fractures. That happened to my mom who has severe osteoporosis. She is not a spine surgery patient, and this was spontaneous. It didn't happen because of a fall.

I hope that whatever the doctors talk about is not an extensive reconstruction. Surely you do need to talk to spine specialists who also understand osteoporosis and spine surgery. Sometimes, at the top or bottom end of a construct, screws can loosen. I have been communicating with a member here who has a similar situation and will be having a revision surgery.

Take your time with your decision and I suggest get several opinions. You'll need to define which area is the most urgent for possible surgery, and how to minimize the risks that come with the procedure given all your health conditions . It may be the cervical, but your doctors need to figure that out. Bone quality has to be taken seriously, so you need some surgeons with post surgery statistics that relate to that problem. Because of more weight wearing at the lower end of the spine, bone quality may be more important there, but that is for the doctors to decide. Are you on any bone building medications that can help increase bone density? Are you able to do a pool therapy for walking where the water can help support your weight?

Jennifer

Cervical spine is most important because I may become paralyzed if not done due to cord compression. My concern also is the stability of vertabrae above and below as they are also deteriorated and this hormone blocker I’m on for cancer causes bone loss and I have to take it for 10 years. At this point I’m tempted to never go to a doctor again. I’m pushing for a death with dignity act to be passed by the Pennsylvania legislature