Spinal Fusion issues

@mylesheath17 Hello Myles, and welcome to Connect. I am a cervical spine surgery patient. You are very young to be going through all of this. A microdiscectomy is removing a portion of a disc by trimming off what has herniated. The herniation tends to reoccur because the wall of the disc is weakened. That can only remove something herniated outward. If the herniation goes into the central spinal canal, there is no way to get to it except by going through the disc and removing it, leaving a space that needs to be filled. When vertebrae are fused, typically, the disc is removed completely. I've never heard of partial removal of a disc and fusing bone. To fuse the bone, something must be inserted into the space like a cage or a bone disc spacer to allow new bone to grow through it and fuse the vertebrae. L5S1 is a difficult location to fuse because of bearing most of the body weight there and a partial fusion there doesn't sound like a good idea to me, but your doctor has to give the official opinion on that. I think your newest opinion is valid in that the disc should have been completely removed. That is always the way surgeons describe this procedure. Do you have imaging and a radiology report that shows the disc was partially removed? It's possible that the level did not fuse at all and has some movement which could cause pain and more problems.

I don't know what is best for you, but there are also artificial discs that will allow some movement in the spine. It's never going to be the same as before surgery or before an injury. Not all surgeons do artificial disc surgeries, and they also have risks just as fusions do. Foreign materials in the body can cause immune responses. Bone can grow around an artificial disc in an attempt to stabilize it. I'm not saying that to worry you, but it does happen to some patients. There are environmental medicine doctors who can treat immune problems from surgical implants. You'll need to do your research to find the best surgeon who takes your insurance. If you are able to come to Mayo, you will find many expert surgeons. I had my surgery at Mayo and was very impressed and I had great results. It is worth traveling to get the best surgeon you can. They are all different and don't all have the same training or skill set. Already, you have a problem to solve that will require a revision which will require a better surgeon. My surgeon was Jeremy Fogelson at the Rochester, MN campus. He is a spinal deformity expert and does both fusion and artificial discs. Artificial discs are not appropriate for every situation, and I was not a good candidate for one and I chose fusion.

Recovery can be a long difficult road and I'm sure you know his already. I hope you find the answer you need to improve the quality of your life. You should get several opinions before choosing a surgeon. You have one chance to get this right.

Jennifer

@mylesheath17 Hello Myles, and welcome to Connect. I am a cervical spine surgery patient. You are very young to be going through all of this. A microdiscectomy is removing a portion of a disc by trimming off what has herniated. The herniation tends to reoccur because the wall of the disc is weakened. That can only remove something herniated outward. If the herniation goes into the central spinal canal, there is no way to get to it except by going through the disc and removing it, leaving a space that needs to be filled. When vertebrae are fused, typically, the disc is removed completely. I've never heard of partial removal of a disc and fusing bone. To fuse the bone, something must be inserted into the space like a cage or a bone disc spacer to allow new bone to grow through it and fuse the vertebrae. L5S1 is a difficult location to fuse because of bearing most of the body weight there and a partial fusion there doesn't sound like a good idea to me, but your doctor has to give the official opinion on that. I think your newest opinion is valid in that the disc should have been completely removed. That is always the way surgeons describe this procedure. Do you have imaging and a radiology report that shows the disc was partially removed? It's possible that the level did not fuse at all and has some movement which could cause pain and more problems.

I don't know what is best for you, but there are also artificial discs that will allow some movement in the spine. It's never going to be the same as before surgery or before an injury. Not all surgeons do artificial disc surgeries, and they also have risks just as fusions do. Foreign materials in the body can cause immune responses. Bone can grow around an artificial disc in an attempt to stabilize it. I'm not saying that to worry you, but it does happen to some patients. There are environmental medicine doctors who can treat immune problems from surgical implants. You'll need to do your research to find the best surgeon who takes your insurance. If you are able to come to Mayo, you will find many expert surgeons. I had my surgery at Mayo and was very impressed and I had great results. It is worth traveling to get the best surgeon you can. They are all different and don't all have the same training or skill set. Already, you have a problem to solve that will require a revision which will require a better surgeon. My surgeon was Jeremy Fogelson at the Rochester, MN campus. He is a spinal deformity expert and does both fusion and artificial discs. Artificial discs are not appropriate for every situation, and I was not a good candidate for one and I chose fusion.

Recovery can be a long difficult road and I'm sure you know his already. I hope you find the answer you need to improve the quality of your life. You should get several opinions before choosing a surgeon. You have one chance to get this right.

Jennifer

Myles, I agree with Jennifer. I have a 17-inch titanium rod with four new discs at the 3,4,5 and S1. It has answered my prayers to being able to play golf again. My surgery in 2019 was a two-day surgery with a very talented orthopedic surgeon in Charlotte, NC who implanted 12 inches of rod. He put in the new discs from the front and the next day put in the titanium rod. He had to add 5 inches to T4 due to a fractured disc in 2020. I also have a Spinal Cord Stimulator put in March 2023 from Boston Scientific. I am very active and very pleased with a successful return to activity. I will admit it does help to work and with a Trainer, I follow the instructions working with balls and rollers, bands, and stretching with walking. I am so much better since having the surgeries.
Best Regards,
Judy

@jenniferhunter, I had a cervical acdf spinal fusion in May of 2020 c5-c6 really nothing has changed for the better, started getting same symptoms and more worse started a couple years ago, now my neck stays sore and stiff all the time, can't turn my neck have to turn my body to look at anything, get lightheaded out of nowhere ears ring 24/7, still have problems swallowing even pills, my arms and hands go from burning with needle prick feeling to cold, the back of my shoulders hurt and burns, had MRI of my head and brain came back normal, nuclear stress test with images came back normal, nerve conduction study with shock shows mild carpel tunnel, ulnar never compression on left side which I had surgery on that on July 1 2020, and multiple pinched nerves in neck, seen ENT for last 3 years and he can't find anything that is causing all this and tells me it's all coming from my neck, cervical MRI shows to much to remember but my neurologist tells me everything is fine sent me in for nerve injection that made things worse and now wants me to try spinal cord stimulator that I will not do from my research and talking with others, had l5/s1 fusion January of 2021 that resulted in permanent nerve damage from my knee to my toes on right side and all my problems were back, buttocks, groin and left leg not the right, I feel I'm being used as a lab rat

@jenniferhunter, I had a cervical acdf spinal fusion in May of 2020 c5-c6 really nothing has changed for the better, started getting same symptoms and more worse started a couple years ago, now my neck stays sore and stiff all the time, can't turn my neck have to turn my body to look at anything, get lightheaded out of nowhere ears ring 24/7, still have problems swallowing even pills, my arms and hands go from burning with needle prick feeling to cold, the back of my shoulders hurt and burns, had MRI of my head and brain came back normal, nuclear stress test with images came back normal, nerve conduction study with shock shows mild carpel tunnel, ulnar never compression on left side which I had surgery on that on July 1 2020, and multiple pinched nerves in neck, seen ENT for last 3 years and he can't find anything that is causing all this and tells me it's all coming from my neck, cervical MRI shows to much to remember but my neurologist tells me everything is fine sent me in for nerve injection that made things worse and now wants me to try spinal cord stimulator that I will not do from my research and talking with others, had l5/s1 fusion January of 2021 that resulted in permanent nerve damage from my knee to my toes on right side and all my problems were back, buttocks, groin and left leg not the right, I feel I'm being used as a lab rat

@borders74 Welcome to Connect. What you're describing of not being able to turn your head, lightheadedness, pain in arms and shoulders sounds like symptoms from thoracic outlet syndrome. I see that you did have ulnar nerve compression, and TOS also compresses the ulnar nerve in a different location perhaps where it passes through scalene muscles at the side of the neck or between the collar bone and rib cage in the upper chest. There is also scar tissue from surgeries that can make things tight.

You might want to consider myofascial release which is physical therapy by a specially trained therapist that will stretch out scar tissue, release tight fascia, and get your body moving better again. A lot of doctors don't think about fascia getting stuck and these are not problems that would show up on imaging. I have done a lot of this MFR work, and I do have TOS in addition to a C5/C6 spinal fusion. You should be able to turn your head if that is the only fused level. It sounds like you have muscular spasms or restrictions or perhaps scar tissue interfering.

Here is a discussion where you can learn mote.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
The nice thing about MFR is it's just PT, and not surgery. It doesn't cause pain unless something is really stuck and it is gentle.

Have you heard of MFR before?

@borders74 Sorry you are still going through so much. I feel for you there. Your symptoms are almost spot on to mine since a C5/C6 fusion 3 years ago. Still trying to figure out whats going on. It is definitely going down hill and seems like there is no hope for a fast fix. Knowing other people are going through similar issues makes me feel like we will get it figured out eventually. Let me know if you notice any improvement and I will let you know of anything of mine gets better.

@jenniferhunter I have not heard of MFR, done pt 3 times in the past and it really didn't do anything is this completely different pt, I had ulnar never transposition where they moved the nerve around my elbow to a different position