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Laminectomy cervical, with fusion and Instrumentation , 1-4 levels
I'm scheduled to have a Laminectomy cervical with fusion and instrumentation, 1-4 levels posterior. I've had 2 cervical surgeries to correct pinched nerves and the last surgery was suppose to take away my pain and almost parlyzed arm according to my EMG report. The last doctor was a well known orthopedist/neurologist in the area. I should never have assumed but then again I put all my trust in him to listen to my complaints and fix the problem. My arm was beginning to lose muscle tone and strength at that time. After the surgery I started right away with physical therapy. PT ended up doing nothing at all. I finally called UCSD and got an appt with a Neurologist who after a year of weakness, tells me he is going to do all he can to get my strength back. I'm scheduled for surgery on Weds, July 16th. This time it will be more involved. First of all, it's done posterior not anterior. That means the muscles are going to be cut and there's a lot of pain in the recovery. I'll be in the hospital for 3 days. There are 2 things that could happen. 1. he lifts the pinch off of the part of the spine that is causing me weakness in both arms. I wake up and can start moving again or at least I might have to wait for it to heal. And #2- It doesn't relieve the weakness but no more damage can happen since it has been corrected and the nerve is free of blockage. It's been a long journey and I want off this train ride! I will be 68 the day I come home from the hospital and hope to have a Happy Birthday starting a new life free from pain and gain my strength back. I sometimes wonder what I understand and what I don't understand about what the purpose of the surgery is. I clearly told the fist doctor that I was having muscle loss in my arms. I've searched it all on Google and found info about the surgery and recovery. I feel frustrated that the dr that fused my neck less than a year ago, didn't correct the right area. At the appt he told me he could " NOT help me anymore". Why would a doctor say something like that? Did he feel he wasn't highly experienced enough to do the surgery I am now scheduled for in 2 days?
I have a new Neurologist, here we go again. If anyone has any thing to mention to me , please do. If you have been through this and especially having posterior , how did it go? Did you feel restriction when turning your head or looking up/down. How long was the recovery before you started to feel better with less pain?
Shout out to Jessica here on the board, Hello Jessica!
Thankyou, Jan
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@janagain I have had situations where surgeons dismissed me. The surgeon who did my carpal tunnel surgery missed that I had thoracic outlet syndrome. I still had tingling and pain in my hand and my hand was turning purple. He took my pulse, told me I was fine and accused me of malingering in his records. When I got a TOS diagnosis from another doctor and went back to him, he wouldn't authorize physical therapy and said he wouldn't be able to judge if I was improving. At least that part was true.
With spine surgeons who wouldn't help, I was told they didn't know if surgery would make me better or worse and that my symptoms could be an inflammatory problem like MS.
It is definitely an uncomfortable situation, and if the doctor has any responsibility for an unfavorable outcome, they want to make sure not to increase their liability in the event of a possible law suit. Even when they just miss the diagnosis, you're at a dead end, and really just need to start over with another doctor.
Hi Jen, EGD stands for esophagogastroduodenoscopy. It's a procedure where a thin, flexible tube with a camera (an endoscope) is inserted into the upper digestive tract, specifically the esophagus, stomach, and duodenum (the first part of the small intestine), to examine their linings. I have an auto immune disease called Esophageal Lichen Planus and Lichen Sclerosus.
I was in the past, involved in body work- well aware of MFR, and it's great! I just wasn't sure if you meant bodywork, chiro, or possibly EGD. Very painful condition and the treatment causes other complications.
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1 ReactionI will have surgery shortly for C5 C6 bone spur that is clearly impinging my nerve. It will be frontal to shave off spur and put a titanium plate in between these 2 vertebrae. I have constant vertigo/balance issues, chronic back pain and terrible fine motor control of hands. Surgeon feels surgery will help with fine motor control and vertigo but no help for back pain which is all arthritis. I have had acupuncture, ablation, spinal decompression and epidural of nerves in thoracic sine. None of this helped and MRI of thoracic and vestibular spine look great. I get feeling that each specialist will try their fix without serious thought or diagnosis. My spine surgeon gave serious consideration to all my symptoms and medical history.
Your note to Jan helped me enormously.
My path has been unusual. I'm sitting here with 5 joint replacements needed over the past 40 years. Degenerative arthritis has been the cause of it. A few years ago, the arthritic attack was beyond the pain scale. My rheumatologist put me on steroids, then a biologic.
I was in steroids too long!
NOW~I am headed for back surger, after the Evenity bone builder makes my back strong enough for surgery.
Two neurosurgeons proposed
a laminectamy only, since the
DEXA scan showed osteoporosis. I knew my MRI
revealed bulging discs, some
spondylolisthesis, average
scoliosis and severe stenosis.
Then I went to the orthopedic
back surgeon with a great
reputation. Thank goodness, he said I wasn't
ready for back surgery and
needed a bone-building medication. "Are we talking
about a fusion?, " I asked. He said yes. I started Evenity last
week and can be on it for a
year. No stranger to pain, it is hard to walk with a searing pain in the outer left quadricep.
Your suggestion to see a neurologist to pinpoint where the nerves are impacted is a gift to me. Thank you for your kindness, knowledge a specificity.
I'm in Maryland and want to know who is the best diagnostic neurologist to see.
Take good care. May we all truly be able to trust our doctors before and after surgery.☮️
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2 ReactionsThankyou for your response. I also have the vertigo/balance issues. Sometimes I just can't get my balance for the simplest things. My head can navigate and all of the sudden my balance will be off just from a simple move. If I am navigating a walk through the garden and I will see the hose layed out in front of me. I know in my head it's there but I trip over it. I get so frustrated I've completely stopped all the work I used to do in the yard/house etc. I hired a housekeeper to keep up with things so that it would not drive me crazy. I'm tired of this, it's too much sometimes. I just hope my surgery is a success because there are no promises made in this situation. They found white spots a year ago in my brain. ALOT of them and I may have had small stroke. No one is addressing that issue so, it could be from all the migrane headaches I have had. I too have osteoarthritis everywhere. The next surgery for me will be on my thumbs. They are down to bone on bone in both hands. I am having severe pain shooting through my thumb to wrist and up the arm. Carpal Tunnel issues and a large cyst in one hand. I'm a piano player and I sing too. That's another issue, I have a nodule on my thyroid. It could be awhile if possible, for me to have to work really hard to come back and be able to play piano and sing again. I feel like I am whining when there are so many people fighting tougher fights. This is just my story and the chapters to continue. Thanks
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1 Reaction@wishingwell
I'm glad to hear that my previous suggestions have been helpful to you. I had spondylolisthesis as well and fusion was required to stabilize my spine since the vertebrae were slipping over the vertebrae below.
Given your situation and the need for a diagnostic neurologist in Maryland, here are some highly regarded options:
1. University of Maryland Medical Center (UMMC)
Specialties: Comprehensive care for neurological disorders, including spine and nerve conditions.
Contact: Call 410-328-4323 to make an appointment.
Location: 22 S. Greene Street, Baltimore, MD 21201.
Reputation: Known for its pioneering work in neurology and close collaboration with neurosurgeons.
2. Maryland Neurological Center
Services: Full-service neurology practice focusing on prevention, diagnosis, and treatment of neurological disorders.
Location: 11085 Little Patuxent Parkway, Suite 212, Columbia, MD 21044.
Website: Maryland Neurological Center
3. The Neurology Center
Overview: A premier independent provider of neurological services in the DC Metro area, offering a range of diagnostic services.
Physicians: Includes several board-certified neurologists with excellent patient reviews.
Website: The Neurology Center
4. MedStar Health Neurology
Notable Physicians:
Dr. Jerold Fleishman: Highly rated with a focus on various neurological conditions.
Dr. Anvi Gadani: Specializes in movement disorders and memory disorders.
Location: Multiple locations across Maryland.
Website: MedStar Health Neurology
It may be beneficial to schedule consultations with a couple of these specialists to find the best fit for your needs. You may ask your orthopedic surgeon which neurologists/neuromuscular specialists they recommend for EMG/nerve conduction studies.
Check with your insurance provider to ensure coverage for the neurologist you choose.
I hope this information helps you find the right neurologist to address your concerns. Wishing you the best in your journey toward better health!
P.S. Here is what AI says about how steroids and biologics affect bone health.
“ Yes, both steroids and biologics can have significant effects on bone health, but they do so in different ways.
Steroids
Impact on Bone Density: Long-term use of corticosteroids (like prednisone) is known to decrease bone density, leading to an increased risk of osteoporosis and fractures. This is because steroids can inhibit the formation of new bone and increase bone resorption.
Mechanism: Steroids affect calcium absorption in the intestines and increase calcium excretion in the kidneys, which can lead to lower calcium levels in the body. They also interfere with the function of osteoblasts, the cells responsible for bone formation.
Biologics
Impact on Bone Health: The effects of biologics on bone health can vary depending on the specific medication and the underlying condition being treated. Some biologics, particularly those used for autoimmune diseases like rheumatoid arthritis, may help improve bone health by reducing inflammation and preventing joint damage.
Specific Biologics:
TNF Inhibitors (e.g., etanercept, infliximab): These can help reduce inflammation and may have a neutral or even positive effect on bone density in some patients.
IL-6 Inhibitors (e.g., tocilizumab): These may also help in reducing inflammation and protecting bone health.
RANKL Inhibitors (e.g., denosumab): These are specifically designed to prevent bone loss and are often used in patients with osteoporosis.
Conclusion
Monitoring: If you are on long-term steroids, it's important to monitor bone health through DEXA scans and consider preventive measures such as calcium and vitamin D supplementation, weight-bearing exercises, and possibly medications to protect bone density.
Consultation: Always discuss with your healthcare provider about the risks and benefits of your treatment options, especially regarding bone health, and consider regular assessments to manage any potential side effects effectively.”
@janagain I have a thyroid nodule too that is associated with Hashimotos. It has actually decreased in size as my thyroid function improved in that my body is not attacking it anymore. That seemed to be linked to metals in old dental work of root canals, crown s and silver amalgam fillings. All of that was removed which lead to improvement. My nodules were benign. I did have a needle biopsy that cleared it years ago. I do take thyroid medication as the hormone levels are low.
I also had vertigo before my cervical fusion. It happened because muscle spasms were independently rotating my vertebrae. My physical therapist was able to realign my spine to stop it. Since my surgery, it doesn’t happen anymore.
Hang in there. One step at a time.
Jennifer
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1 ReactionThank you! I will pursue these resources. I'm on Ilaris for Adult Onset Still's Disease. It all started in 1982. Fortunately, I was working in NYC and my amazing Rheumatologist knew it was not RA and diagnosed it as polyarthritis. I was pain-free after bilateral hip replacements until one needed a revision after 10 years. As the years went by, now and then I had joint pain, needed a replacement in another joint, but no systemic symptoms other than non-negotiable fatigue. Flash forward in 2021, out of nowhere, I was in a raging, all-body flare and fever that led to the AOSD diagnosis, hence the steroids and biologic. They were necessary to stop the intense pain and joint destruction which still resulted in a knee replacement and bent fingers.
I wonder if I should even allow a surgeon in MD to operate on my back. The best appear to be in NYC at HSS. That would entail an incredible cost, and maybe rehab in NYC. All this, and I still have a sense of humor. My creative and logical mind keep me strong and resilient. Hopefully, the Zepbound (I gained 25lbs on steroids and have sleep apnea) will get rid of the weight and
the nerve pain will go away. A girl can hope and dream! No back surgery and the ability to walk more than 15 minutes again is possible, yes? 😊 Thanks for your support and sharing vital resources.
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2 ReactionsI did have an EMG/nerve conduction study. It showed that I have lost 90% of 3 muscles in my left arm. I am unable to raise my left hand over my head. Extremly weak to the point I am unable to open a new jar lid. I'm losing dexterity in my fingers. It's difficult to get dressed because everything you put on bunches up and my arm won't reach behind me to straighten it out. I drop everything all the time. It's a very frustrating feeling and just want it repaired.
I did have a DEXA bone scan and it was normal. I've never been on steroids and I hope I never have to. When I had the EMG/nerve conduction study, the technician told me they are able to repair nerves by grafting a part of a healthy nerve and cutting the bad nerve open and placing it inbetween and stitch it up. Well ... that sounds dreadful. I'm going to the UCSD doctors and I won't be contacting other doctors at this time. Thank you for your leads in the medical field of Neurology. You have great knowledge, I'm impressed with your information, thank you.
Jessica, I just found out about the thyroid nodule and I'm not sure if I'm going to have time to deal with that prior to the surgery. Is that a mistake on my part? Do they always put you on thyroid meds if you have a benign nodule?
The sized is 1.2cm. I'm experiencing a bit of a raspy voice. I would just say I'm ready to move forward and get beyond this if possible. Surgeons want to know everything about my health. If I tell him I had a biopsy, he may want to wait even longer to do the surgery. If I call an Endocrinologist, how soon will I get an appointment? Thanks for your information Jennifer. That's amazing you physical therapist was able to realign your spine to stop the muscle spasms.
Hugs, Jan
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2 Reactions@janagain
I also had a thyroid nodule accidentally found on ct scan when preparing for my first ACDF cervical spine surgery in 2022. I found it on the report when paying a surgery bill. My sister had thyroid cancer at age 26 and a full thyroidectomy and radiation. My ultrasound and fine needle aspiration biopsy showed suspicious cells/characteristics so I decided to get a lobectomy of my right lobe later that year. At the time, I was having difficulty swallowing, even liquids, and would choke. Sometimes it affected my speech. The nodule was 2.5 cm and high on the right side so it may have been contributing to my symptoms. Luckily, the large nodule was benign but they found a micro cancer during pathology. Now, I need to have my left lobe monitored due to calcifications as well as my full neck checked regularly for regrowth of thyroid tissue. My mom and cousin had Hashimoto’s thyroiditis and now, so do I along with hypothyroidism (take 100 mcg levothyroxine daily).
You may be able to delay addressing your thyroid until you address your other pressing/higher priority issues. You can have your doctor check your blood with a full thyroid panel (TSH, T3, T4, TPO) to see how your thyroid is functioning with the nodule. They do not usually treat with medication unless thyroid function is too high or low and if nodules get so large they cause breathing, swallowing and speaking issues.