combined anterior and posterior cervical spine surgery

Posted by sksdl @sksdl, Oct 20, 2021

I am new member, please excuse any rookie mistakes. I have 2 conditions. 51 yr old male. One is causing me current pain in my neck, right shoulder blade, right triceps area...with tingling in my right forearm and some numbness in my right hand. It is believed from CT scan, MRI, Xrays, and examination from neurologist that I have bone spurs and a bulging disc causing issues with C5-C7.

Secondarily I have OPLL - ossification (calcification) posterior longitudinal ligament - with some stenosis pressing on my spinal cord. My surgeon and his team are recommending a combined anterior and posterior approach. Anterior to fix the bone spurs\bulging disc (my most serious current pain) and Posterior to correct the OPLL\Stenosis issue. This is a mouthful but my upcoming surgery is called "c5-c7 anterior cervical discectomy and fusion and C2-T2 posterior spinal decompression and fusion". With the combined approach and many levels its an estimated 6-7 hour surgery 4 or 5 days in the hospital.

My question is if anyone on this forum has had a combined anterior\posterior cervical spine surgery? and if so what was their experience? anything regarding expectations post surgery...both short and long term would be appreciated. I know it won't likely be positive, but I have experienced difficulty finding information regarding patient outcomes of a similar procedure. Good or bad, I can't find it. It just appears to be rare, though my neurosurgeon tells me he does many of them each year.

Any advice on how to find folks with a similar experience to learn from?

Interested in more discussions like this? Go to the Spine Health Support Group.

My recovery 7 months post fusion of L3,4,5, and S1: generally positive to this point- pain has been minor, and I have gradually weaned myself off from heavy pains meds pre-surgery to the lowest doses of two meds. I've had some insomnia from this process, but it hasn't been debilitating. I feel stronger now that I am working with an exercise therapist and doing aqua size. I can once again walk fair distances pain free, and even for 30 min+ if I use Nordic poles. I feel I have my life back!

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@sksdl

Your ACDF and posterior decompression with fusion C2-T2 sounds very similar to what the surgery that I am having a couple weeks from now. Only difference is I am C5-C6, C6-C7 on the ACDF. Can you give me any insight into your experience after surgery and your recovery? I am curious how long before you were able to get off meds....narcotics, never pain meds, muscle relaxers, etc...? how long before you started physical therapy? how long before you were able to return to somewhat normal activity?

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It’s been one year now and I’m finally feeling like I am healing well. I’m not going to lie…the first 2weeks post-op was the worst 2 weeks my life by far and I equate it with torture. Then there were a few months of spasm, and then tightness in my upper back and neck since. The good news is that I am now 12 1/2 months out and I am seeing the light at the end of a very long tunnel. Just had a Cat scan and x-rays which all look good. I have an appointment with my surgeon mid-month who will let me know if it’s fully fused ( it was partially fused 6 months ago.

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Interesting to know (and I wish I knew this earlier), I was finally told by my surgeon that because my operation was complex ( involving 7 levels, and 8 hours of surgery time, 3 rods, posterior-anterior and posterior combined surgery), it’s normal to have a recovery time 12-18 months rather than most folks that take 7-8 months.

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@rico175

Interesting to know (and I wish I knew this earlier), I was finally told by my surgeon that because my operation was complex ( involving 7 levels, and 8 hours of surgery time, 3 rods, posterior-anterior and posterior combined surgery), it’s normal to have a recovery time 12-18 months rather than most folks that take 7-8 months.

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Good evening @rico175. Wow....that must have been a shock to find out the recovery time after you have already had the surgery. I just went back over my two surgeries this summer. The surgeon for the TKR did talk with me about recovery time. And I was determined to beat the norm......so I worked hard at exercises and was told I was "off the chart". I am 4 months post surgery and my body doesn't even know that it had knee surgery. '

Now the hand surgery......and I was not told anything. Because I had the surgery 10 years ago on the opposite hand I thought it would be the same. I am sitting here now with a cast on and dealing with some pain. I will be dealing with the cast for three more weeks.

It appears that you really did have complex surgery. I hope everything is going according to plan at this point. Happy New Year........and please let me know when you are OUT!

Have you had personal care for the entire recovery time or at least some of it?

May you have contentment and east.
Chris

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@rico175

It’s been one year now and I’m finally feeling like I am healing well. I’m not going to lie…the first 2weeks post-op was the worst 2 weeks my life by far and I equate it with torture. Then there were a few months of spasm, and then tightness in my upper back and neck since. The good news is that I am now 12 1/2 months out and I am seeing the light at the end of a very long tunnel. Just had a Cat scan and x-rays which all look good. I have an appointment with my surgeon mid-month who will let me know if it’s fully fused ( it was partially fused 6 months ago.

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So glad you are feeling better.
Have your symptoms which you had surgery for resolved?

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Hi, I am 9 weeks post op from C2-T2 posterior fusion. May I ask when you were able to drive again. I will be in hard collar for another 3 weeks and praying the upper back / shoulder pain will fully subside by then. I can’t use my arms a lot or the radicular pain is bad (all the way into my hands).

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@rico175

I have had ACDF at C4-5, C5-6, and posterior decompression with fusion C2-T2 11 months ago. I’m new to this blog. Just wanting to know if it’s normal to still have tightness in my lower neck/upper back and will that ever go away?

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I think we may be related ! I do not meet many people who have had almost the same amount of surgery that I did . My surgery was done about a year later than the surgeon wanted , bc I had an infection that was thought to be dessiminated . I was so sick up until surgery ; we hoped the infection was gone or I could be in bigger trouble than I already was .
I had become very weakened prior to surgery / the infection plus several other conditions made me feel so awful that by the time I had my surgeries I really couldn’t cognitively handle even what the details of the surgery entailed . I knew my chances of making it were slim due to all my issues . I had been inactive for so long and had endured so much to get to this point , I was just ready to do it . My biggest concerns post op were that I would be able to walk
better ,that my head and neck would be straightened back to normal placement and my newly developed urinary incontinence would be cured .
I had C3-C5 ACDF done first ; when I became aware of just being awake after surgery , I immediately knew the incontinence problem was over . I also was aware that the positioning of my head and neck was better . I recovered pretty quickly from that it seemed . I was pleased at the progress that had been made . I wore a collar /brace they went to my waist . I was still in a precarious situation until I had the rest of my cervical surgery done a month later. This part was more serious and took around 10 hours I think . I am a nurse practitioner and I was acutely aware of all the things that could go wrong , plus my surgeon had been very blunt that my surgery and /or recovery might kill me. I would say I was just more uncomfortable after the posterior surgery . (C2-T2) Because of my previous problems and still being on IV antibx ; I stayed in the hospital 2 weeks then I went to a rehab facility for two weeks. It was hard to be away from home but I needed the extra security so that I didn’t fall and I received intensive PT /OT . I had pretty extreme weakness of my upper body . Just lifting my toothbrush up and brushing for a decent amount of time was really hard for me . I prob developed some gingivitis during this time . The area around the incision was pretty numb but weakness just plagued me . I guess you could call it tightness too . My upper body would tremor like I was just exhausted when I tried to do anything. And everything involves your upper back and neck . However it just seemed like one day a few months later , I realized the strength was coming back slowly but surely . The tightness and just absolute weirdness that I felt in that area improved . Unfortunate Covid and a hip surgery complicated things and I lost some of the strength i had gained. I felt like I literally had been living under a dark cloud for years by then . Even though my therapy was delayed some , it seemed to be helpful that I went back even though it wasn’t a new problem / I just needed to get stronger and work on my wimpy upper body and just generalized weakness . I really noticed a change then and felt I had become a much stronger person . I remember thinking it had taken me 18 months to recover from they surgery . However I had very complicating factors that made my situation a disaster. But considering eveything going against me ; the surgery was a success . I would have liked to have returned to normal and been the old me , but that will never happen . My surgery was to save my life and prevent paralysis .
I don’t know about you or anyone else reading this , but I was misdiagnosed and looked over for years while I endured terrible pain , brain fog , and proximal weakness of my body . It was like no one would listen to me . My surgeon said it was something like RA had eaten up my spine. My family and I had moved during the start of this nightmare and that also created more confusion and no communication from my caregivers . I remember when I started to realize that I was being tagged as a nutcase - and yes , that description was correct bc by this time I had caused a huge disruption in our family life , lost my career , caused great financial distress with all the medical bills and the lack of my salary . I was also on steroids which was the only thing that touched my pain but it made me less then nice , you might say . I think the hardest thing about this has been the lack of time specialists spent with me and the time that was lost while I was trying to get someone to listen to me . Then I am referred to this orthopedic spine surgeon by accident / I was supposed to see an orthopod who specialized in feet - anyway he became my doctor and was I surprised when he told me how serious my situation was . How I got to that point I do not know how , and I ask myself every day how this happened and here I was a NP and I could not get help .
Could I ask you or anyone reading this ….what kind of shape are you in now ? What activities do you do ? Just fill me in on your story whoever is reading this . I literally have not known a soul who has gone through what I have !

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@sprasatek

Hi, I am 9 weeks post op from C2-T2 posterior fusion. May I ask when you were able to drive again. I will be in hard collar for another 3 weeks and praying the upper back / shoulder pain will fully subside by then. I can’t use my arms a lot or the radicular pain is bad (all the way into my hands).

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In my case ; I had a lot of issues other than just my ACDF and PCDF , however I think I could have driven in about 6 months - I just had this weakness in my upper body that made me really shaky and after awhile it became painful to keep one of my arms on the steering wheel . The OT I was seeing offered a course in returning to driving after a major neck surgery bc some things change . You really need to keep your wits about you and be able to see out of your car well and the ability to turn your neck enough when you return to driving . I knew instinctively when I was ready . So don’t be discouraged at my experience ; I was so weak before I ever had surgery . Every one heals differently. Good luck !

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@sksdl

Your ACDF and posterior decompression with fusion C2-T2 sounds very similar to what the surgery that I am having a couple weeks from now. Only difference is I am C5-C6, C6-C7 on the ACDF. Can you give me any insight into your experience after surgery and your recovery? I am curious how long before you were able to get off meds....narcotics, never pain meds, muscle relaxers, etc...? how long before you started physical therapy? how long before you were able to return to somewhat normal activity?

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Did you leave the hospital with pain meds in hand?

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@alaskajbm

Did you leave the hospital with pain meds in hand?

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@alaskajbm I just wanted to jump in here because this is an older conversation and the member you replied to may not be active. Here’s another tip. If you type the @ symbol with their user name like I did here for you, that member will be sent a notification of your response.

I am a spine surgery patient and pain management after surgery is standard practice. If you are thinking about surgery, I can understand your concern.

Are you consulting a surgeon about a spine issue?

Jennifer

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