Severe Stenosis in C7/T1 * left perineural foraminal cyst.

*Was supposed to be & not * in the subject line.

@flyingmartini1 Hello and welcome to Connect. I think I can answer your question about spinal titanium plates. Plates are put on the front of the spine vertebral bodies to add stability while the fusion is healing and bonding bones together. The surface that will be fused in fusion surgrgery is where they take out a bad disc. The surfaces that abut the disc are called the end plates of the vertebral body and those surfaces are ground to a flat surface and fused by putting in spacer. In my case, the spacer was a disc of donor bone, but they also use manufactured cages for this. The surgeon used the bone removed by grinding the surface and bone spur removal to seed bone cells into the spacer disc which has a space inside it for this. The bone disc spacer from a donor source is the mineral matrix deposited by the bone cells, but all of the cells have been removed and the matrix is sterilized.

If another fusion is done adjacent to an existing fusion, the surgeon may remove the plate on the front of the spine from the prior surgery and attach an appropriate plate. In my case, I asked for no hardware, and my surgeon did a single level fusion with only a bone spacer. I stayed in a neck brace for 3 months until the fusion process began to stabilize.

A laminectomy is where they enlarge the opening of the spinal canal by making cuts in the bone and raising it up and attaching some hardware to hold it in place. It's like raising the roof on a home to make space for a second floor. A diskectomy is when the bad disc is removed.

Are you looking at another fusion surgery or considering a laminectomy?

My surgeon actually removed the plate, did the fusion and put a longer plate in. I am going to have another cervical fusion on Wednesday for severe stenosis and when that heals I will be having the same surgery; only on my lumbar spine. Then it's left hip replacement surgery and after that, right knee replacement surgery. I've already had 7 spine surgeries and I don't know how much more I can take. I get so tired of the pain.

Holy crap! I'm sorry for your pain. I do know what you mean; I also have Fibromyalgia and most days it's just too much. Best wishes on your your upcoming surgery.

Hi Jennifer. I'll speak with my Neurosurgeon on February 7th to go over the MRI results & to talk options. He did go through the front of my neck when he did the ACDF. It's a faster recovery than going through the back. Ironically we talked about 6 months after about another possible surgery which would have been through the back.

I'd prefer not to have another surgery but this numbness/tingling & burning sensation has got to stop. Taking Naproxen is just a temporary bandaid.

@flyingmartini1 It's good that you are talking about your options. Good luck at your appointment tomorrow.

Jennifer

Thanks Jennifer. It was a weird phone conversation. I don't think he knows what to do to help me. He doesn't think surgery will help because of the Fibromyalgia, not sure if it goes beyond peripheral neuropathy, if it's stemming from the neck issues. He referred me back to my Neurologist and sent a referral to a spine center to talk about a possible spine Stimulator. 🤷‍♀️ I'm going to make an appointment with him for a psychical. Cortisone shots really don't help much & are only temporary.

@flyingmartini1 Thanks for the update. I have been down this road before where spine surgeons don't know what what is wrong or what to do and they don't want to take a chance on a patient because they can't guarantee a good result. They don't make guarantees anyway, but they do not want a poor result and a patient complaining online about them. They are rated by insurance companies for statistics on the success rate for each procedure, and they do not want to jeopardize their careers with low grades. Be careful about giving them irrelevant information. The thing about a fibromyalgia diagnosis is that can be a catch all for when a doctor does not know what is causing pain. I'm not saying that it isn't real, but at one time, I was handed that nebulous judgement.

You may want to seek another opinion. A neurologist is a good detective for sources of pain, but they might diagnose fibromyalgia with no known cause. When you have one appointment and the surgeon doesn't know what's wrong, and says get a spine stimulator, he/she does not want to take you as a patient for decompression surgery. I got brushed off 5 times like that before I came to Mayo.

I had something they all missed called "funicular pain" which was being caused by spinal cord compression. Unfortunately, there is no diagnostic test for this, and the only way to prove it exists is when decompression of the spinal cord with surgery cures that pain. It is pain all over the body much like fibromyalgia is described. Early on, I could change the location of my pain by turning my head because it was a bone spur contacting my spinal cord that was doing it. That was proof that my cervical spine was causing that pain when I could turn it on and off, but surgeons didn't pay attention when I said that. Later, as the bone spurs grew and there was more compression, I could not turn it off, but it did change location based on my neck position. If you can come to Mayo, you will find surgeons who understand this kind of pain.

One thing that predicts the possibility of funicular pain is a spinal epidural injection that takes all the pain away. It is temporary, and when I had the injection, I had 5 days without pain, after which it slowly returned again all over my body. I charted that on body diagrams, and discussed with a surgeon, but it just scared him out of helping me because he did not understand that pain phenomena and was suggesting MS or an inflammatory condition instead. He stated he did not know if surgery would help. He was right about that, and ethically, they should not do surgery if they don't understand the problem.

Here is the literature that I found that changed the course of my spine care, and I sent this to a surgeon at Mayo when I requested an appointment with a letter explaining about the 5 surgeons who were dismissing me. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111492/

If you want to request an appointment at any of the Mayo campuses, you may use this link:
http://mayocl.in/1mtmR63
What would you think about taking this literature to your neurologist? If that doesn't get their attention, they may not understand this.

I've undergone 8 total spine surgeries, 7 with fusion. 3 of them have been within 6 months of each other this year. This May, I went in for an ACDF on C4/C5. At that time, C7-T1 was also in bad shape but wasn't addressed though I pushed for it to be taken care of. After months of agonizing upper back, shoulder, arm/hand pains, shakiness, and terrible spasms we did another MRI and a myelogram. The long wait period for this was awful. We knew C7-T1 was going to need to fused, finally. The testing revealed all the typical stenosis, arthropathy, anyklosis, etc for me with 2 other major issues. The C4/C5 segment hadn't fused at all and would need to be pulled out and replaced and one of the vertebrae was fractured (likely from a pedicle screw). So I underwent another surgery to redo C4/C5, fuse C7-T1, clean up other fused segments in between and replate everything from C4-T1. This was 10 days ago. My upper back and shoulder areas hurt so badly, particularly in the early morning. My shoulder blades feel like they're shattered. I understand changing the biomechanics at T1 will cause disturbances and the nerves take time to heal. But holy cow, this is so painful. I've been taking pain medication which helps but I thought I'd be further along by now. I have a guilty mind about asking for more pain medication but I'm not sure what else to do when I run out in a day. I'm allergic to steroids and have an autoimmune condition which makes me react to most things unusually. After so many surgeries I've tried about all there is. My question: Am I unreasonable for reaching out to ask for more pain medication? I'm not sure how to get over the hump (however long that is). This is a tough surgery for me. Thank you, I appreciate any insight.