Balance, high blood pressure medications, and …

Good morning, Ray. Yes, a paralyzed vocal cord is a risk of anterior cervical spine surgery because of possible nerve damage due to the proximity of the nerves to the surgical path. If you damage a nerve it causes muscle atrophy, and the vocal cord goes slack. This would make the voice sound like a whisper because the vocal cords don't close together to control the sound. During anterior spine surgery, they will retract the esophagus and trachea to the side so they can access the spine right behind it, so that gets stretched a little bit. My voice was a little hoarse for 2 days after surgery, but I could speak fine. My throat was sore (2 weeks) and swallowing was tricky for a few more weeks after that. It does help to stretch the muscles and skin on the neck where the incision will be. I asked my surgeon that ahead of time and he showed me what to do that could make it easier for him. You can ask your surgeon what they would do differently if you were an opera singer and depended on your voice for a living. Sometimes there is a posterior approach to the cervical surgery which hurts more and has a longer recovery, but it all depends on where the surgeon needs to access the spine, and how to get there with the least amount of risk of damaging other areas. I knew a lady from another online group who did have a paralyzed vocal cord after spine surgery. She had multiple spine surgeries before that with out vocal cord issues. She did go to Mayo and get the implant which is a triangle shaped device that takes up some space and pushes the vocal cord to meet its mate. She had posted a video of her speaking after that and her voice was normal again. I don't think that happens to a high percentage of patients, but your surgeon needs to answer that. It is best to seek several opinions before you decide on surgery, and you could get a 2nd opinion from a surgeon who has operated on people who depend on their voice professionally.

I like that you are seeking information to make an informed choice and keeping an open mind. I did that too, and I even watched surgeons giving presentations to other surgeons online about spine surgery, and management of the issues that arise, and what make a good or poor candidate for a procedure. To have a great outcome, you need an excellent surgeon who you can trust with your life, and to get onboard and embrace the situation. Having a positive attitude really helps, and it helps you heal better and lowers your stress. Stress and worry over surgery will just increase fear and pain. I expected something much worse than it was for me. In the hospital, the day of surgery, the pain meds just nauseated me. They didn't take all the pain away anyway, and it wasn't horrible. After I left the hospital, I managed just fine without pain meds and just accepted some healing pain. The more you know about something, the less it will worry you. Do ask the surgeon to explain your MRI imaging to you and explain everything on the report. My opinion does not count since I am not a medical professional, but I think you will be offered surgery, but keep in mind, you may not be offered surgery if the surgeon is afraid to take your case if it looks too complicated. At that point, a deformity specialist might be a good consult. My surgeon was that, and also taught cervical procedures at spine conferences. You might look up the credentials of the surgeon you will see ahead of time and look for any videos or research papers they have written. I don't know if you can choose a surgeon yourself, but it helps to shop around and see what is out there. I had to do that until I found the right one.

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Hi, Jennifer (@jenniferhunter). I can't begin to tell you how grateful I am to learn about the role of vocal cords in cervical surgery! I'm an actor, stage and voice-over, so I earn my living with my voice. This doesn't mean I would refuse surgery if it's presented to me as my best option and if I've convinced myself that surgery is the best way to go. At least now I'll have learned of a critical component of the procedure. What you've told me further deepens my resolve to find a good surgeon––if surgery is in my future. I've so much to learn. I've been waiting for almost two days now to receive a call from the surgeon who's been suggested (my neurologist told me: give his office a week to call, but then if you have to, call the office); I'm glad for this little in-between time so that I have got a chance to educate myself. I'm also using this time to do some of the cervical stenosis exercises I've found online (basically, isometrics to help the neck muscles to relax). In the meantime, my 3-ring binder is slowly filling with information! ––Ray

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Thank you, all (@artscaping, @elizm, @njh, @jenniferhunter, @amandaburnett) for having replied to my posts! Your words have been immensely helpful. I met with my neurologist yesterday and now have what seems a clear diagnosis of my problem: cervical stenosis. Finally, I have a name to put to what has been troubling me––and getting slowly worse––for something like ten years. (Can any of you relate to this?) The immediate plan is twofold: neck PT, and a visit with a neurosurgeon––not necessarily to arrange surgery but to learn what if anything besides PT might be the wisest way to tackle this cervical stenosis. ––Ray

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Good evening Ray. What a welcome and meaningful post. Congratulations on understanding that there are no miracle "fixes". I think @jenniferhunter's story pretty much covers the waterfront so I will just say that I had several years of painful and troubling cervical stenosis.

Finally, when I could no longer get much-needed rest at night I turned to my shoulder surgeon for help. He immediately took me to meet the surgeon who saved him from similar pain and tragedy. I had cervical surgery complete with titanium fusions that essentially turned my life around.

Good luck to you and it would be very helpful if you could keep us updated on your PT and neurosurgeon visits.

May you be physically well
May you be mentally well.

Chris

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@ray666 If you want to consider Mayo and if your insurance is in network, you will find the best of the best there. They have done awake brain surgery on musicians and had a patient play the violin during surgery. The violinist had spasticity in his arms and they were finding the spot for electrical stimulation to stop the shaking so he could play his instrument. That was in the Ken Burns documentary on Mayo Clinic. It was excellent and very educational. The good thing about Mayo is they don't waste your time because they are very efficient in getting all tests and imaging done. I wish I had gone there first. If you saw my surgeon there and asked him who was the best to make sure to save your voice, he would give you an honest answer. Why not go to the #1 neurosurgery hospital?

If you would like get a second opinion from Mayo Clinic, you can find the contact information for the Minnesota, Arizona and Florida campuses here http://mayocl.in/1mtmR63

You can request to send records and imaging to a specific surgeon. I did, and I chose Dr. Fogelson because his interests matched my needs and because when I read a paper he had co-authored, it led me to medical literature with cases like mine, so I knew he would know what all the other non-Mayo surgeons had missed.

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Good morning, Jennifer

I may very well want to talk to someone at Mayo. A sensible Step One, I would imagine, is finding out if my insurance is compatible (Medicare + United Healthcare Advantage). I'll start doing some research on that later today.

I have a friend who went out of his way and flew to Rochester for some tricky heart surgery––"tricky" in that my friend sensed hesitancy in his local surgeon. My friend returned not only with a healthy heart but also boundless praise for the care he received at Mayo.

Merry Thursday!
Ray

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