Surgery of the cervical spine

Posted by mincer @mincer, May 5 9:00pm

Good morning everyone, yesterday I seen my neurosurgeon and was offered ACDF surgery on my C4/ C5/6 C6/7 I don’t have the norm of weekness in my arms but I do have them in my legs I will drop things and have constant pain in my lower back I am concerned if I don’t have the surgery now it will get worse I am 58 years old and if it got worse I can loose bladder control and maybe loss contiguous my legs I know there is the unknown:( so my question is have others had the same ? If so what was the surgery like for them ? And your experiences
Take care

@mincer it sounds like you are moving in the direction of surgery but have some apprehensions from the aspect.

I'd like to bring in members such as @jenniferhunter @rjdm1 and @wilcy who have all previously discussed ACDF surgery so they can share their experiences and answer your questions.

Are you mainly curious about the surgery itself or is there anything in particular members can share with you to help you as you make your decision?

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Surgery is not an option for me. More conservative treatments like steroid injections, radio frequency ablation have provided only short term relief. That's why I am now looking at interspinous implants to provide long term relief from LSS. I would like to hear from persons who have had this procedure to hear their experiences. Would they do it again?

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@amandajro

@mincer it sounds like you are moving in the direction of surgery but have some apprehensions from the aspect.

I'd like to bring in members such as @jenniferhunter @rjdm1 and @wilcy who have all previously discussed ACDF surgery so they can share their experiences and answer your questions.

Are you mainly curious about the surgery itself or is there anything in particular members can share with you to help you as you make your decision?

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Thank you for your response, the question is that if I don’t have the surgery I will end up in a wheel chair later in life

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@mincer

Thank you for your response, the question is that if I don’t have the surgery I will end up in a wheel chair later in life

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@mincer will you please keep us posted on your care and experience?

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@mincer

Thank you for your response, the question is that if I don’t have the surgery I will end up in a wheel chair later in life

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If you are loosing control of bladder or bowels, your body is already shouting for help. If you don't help it now, logically your leg movements would follow.

There are already risks without undergoing surgery. I have a C5-6-7 fusion. First was C5. Then 5-6. And 5-6-7 was revised twice. 4 surgeries in 20 years time. And now I am looking at a much bigger surgery….spanning from C3 to T1.

Just remember, that once you go in, you will create a domino effect over long enough time. I am living proof of that.

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Thank you for your response and sorry to hear that you are having to have more surgeries:( my concern is that if I don’t have the surgery tis only a matter of time before it does happen I am 58 years old and probably wouldn’t be here in 20 years time 🙂 and I also don’t want to get to the loosing bladder and bowel control stage my legs are weak but not to bad .
Take care xx

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@mincer

Thank you for your response and sorry to hear that you are having to have more surgeries:( my concern is that if I don’t have the surgery tis only a matter of time before it does happen I am 58 years old and probably wouldn’t be here in 20 years time 🙂 and I also don’t want to get to the loosing bladder and bowel control stage my legs are weak but not to bad .
Take care xx

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@mincer I had one level C5/C6 that was compressing my spinal cord with bone spurs and a collapsed disc and I also had an uneven gait when walking. I had muscle spasms in my neck that moved my vertebrae around that caused the gait weakness and problems emptying my bladder because it increased the pressure on the spinal cord by essentially making the spinal canal smaller. This would progress to incontinence if left untreated. I did not have arthritic bone growth in the foramen (which is the space between vertebrae where the nerve roots exit the spine.) I did have pain all over my body caused by cord compression. Nerve injuries can become permanent, so it is important to have surgery that decompresses the nerves and spinal cord before the injury is permanent. Excess compression of the spinal cord kills the nerves cells and they literally dissolve and show up on an MRI as a white area. As the discs collapse the bones get closer together and can start to fuse on their own which might make this inoperable. You don't really know at what stage the damage becomes permanent. Right before I had surgery, if I bent my neck forward, it sent a electric shock down my entire body. I have seen posts of someone who had spinal cord compression and chose not to have surgery and the posts describe how she is wheelchair bound, and in constant pain. I think we are fortunate that we have a choice to avoid disability with decompression surgery. It is a big step and you need complete trust in your surgeon. Hopefully you have a good one. It took me 2 years to find a surgeon who would help me and it that time, I lost about half of my muscle mass in my arms and shoulders to atrophy. After surgery, I got a lot of muscle back, but not all of it, so I still have a deficit of about 25%. 5 local surgeons refused my case, and I came to Mayo and had surgery that changed my life. I'm planning on being around for a long time, so don't put a time limit on yourself. If you think like that, you can make it come true.

Everyone is different, and with multiple levels, your surgery would be more extensive than mine and probably a longer recovery than mine. The surgery was not as bad as I thought it would be, and not as painful as I imagined. The first couple weeks are painful with throat pain because of the incision and frontal surgical path. If you have surgery through the back of the neck, it hurts more according to my surgeon. I felt pretty good and didn't have pain at 6 weeks. I didn't want to take pain meds because of breathing issues and didn't want drugs affecting that, so I didn't take pain meds at all after I left the hospital. I was nauseated by it anyway, and then taking anti-nausea meds. I was fine without them and just slept. I felt good at 3 months, and did rehab because my neck muscles were weak from being in a hard collar for 3 months. I had a fusion without hardware which was possible because it was a single level, so I had to stay immobilized until the bone fusion began at 3 months. Recently, I broke my ankle and that was so much more painful and for many months longer than my cervical spine surgery. I had great results. I was 59 when I had my spine surgery. If you smoke, that will affect bone healing because you would have lower oxygen levels in your body. I don't smoke. Many surgeons will ask patients to quit smoking before spine surgery. That can cause a fusion to fail. Do ask lots of questions of your surgeon. I don't know if you are able to get a 2nd or third opinion, but it helps you understand and make a good decision. Let me know if you have other questions. I am glad I had spine surgery and would do it again if it becomes necessary.

Here is my patient story.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

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@jenniferhunter

@mincer I had one level C5/C6 that was compressing my spinal cord with bone spurs and a collapsed disc and I also had an uneven gait when walking. I had muscle spasms in my neck that moved my vertebrae around that caused the gait weakness and problems emptying my bladder because it increased the pressure on the spinal cord by essentially making the spinal canal smaller. This would progress to incontinence if left untreated. I did not have arthritic bone growth in the foramen (which is the space between vertebrae where the nerve roots exit the spine.) I did have pain all over my body caused by cord compression. Nerve injuries can become permanent, so it is important to have surgery that decompresses the nerves and spinal cord before the injury is permanent. Excess compression of the spinal cord kills the nerves cells and they literally dissolve and show up on an MRI as a white area. As the discs collapse the bones get closer together and can start to fuse on their own which might make this inoperable. You don't really know at what stage the damage becomes permanent. Right before I had surgery, if I bent my neck forward, it sent a electric shock down my entire body. I have seen posts of someone who had spinal cord compression and chose not to have surgery and the posts describe how she is wheelchair bound, and in constant pain. I think we are fortunate that we have a choice to avoid disability with decompression surgery. It is a big step and you need complete trust in your surgeon. Hopefully you have a good one. It took me 2 years to find a surgeon who would help me and it that time, I lost about half of my muscle mass in my arms and shoulders to atrophy. After surgery, I got a lot of muscle back, but not all of it, so I still have a deficit of about 25%. 5 local surgeons refused my case, and I came to Mayo and had surgery that changed my life. I'm planning on being around for a long time, so don't put a time limit on yourself. If you think like that, you can make it come true.

Everyone is different, and with multiple levels, your surgery would be more extensive than mine and probably a longer recovery than mine. The surgery was not as bad as I thought it would be, and not as painful as I imagined. The first couple weeks are painful with throat pain because of the incision and frontal surgical path. If you have surgery through the back of the neck, it hurts more according to my surgeon. I felt pretty good and didn't have pain at 6 weeks. I didn't want to take pain meds because of breathing issues and didn't want drugs affecting that, so I didn't take pain meds at all after I left the hospital. I was nauseated by it anyway, and then taking anti-nausea meds. I was fine without them and just slept. I felt good at 3 months, and did rehab because my neck muscles were weak from being in a hard collar for 3 months. I had a fusion without hardware which was possible because it was a single level, so I had to stay immobilized until the bone fusion began at 3 months. Recently, I broke my ankle and that was so much more painful and for many months longer than my cervical spine surgery. I had great results. I was 59 when I had my spine surgery. If you smoke, that will affect bone healing because you would have lower oxygen levels in your body. I don't smoke. Many surgeons will ask patients to quit smoking before spine surgery. That can cause a fusion to fail. Do ask lots of questions of your surgeon. I don't know if you are able to get a 2nd or third opinion, but it helps you understand and make a good decision. Let me know if you have other questions. I am glad I had spine surgery and would do it again if it becomes necessary.

Here is my patient story.
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

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Thank you very much for your informative information you make a lot of sense and yes I do have a first opinion and the dr looked at me as if I was an alien so my ruemotologist recompense then dr I am seeing now he is wonderful and kind I do like his opinion he told me it is all up to me he will offer the surgery but no guarantees xx as I know I lost my husband 2019 to cancer so I do find it hard to make decisions alone 🙁 but at the moment I just have weekness in my legs and shooting pain nerves in my big toe and arms but as I said I don’t want to wait until it is to late xxx kind regards Sharon

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@mincer

Thank you very much for your informative information you make a lot of sense and yes I do have a first opinion and the dr looked at me as if I was an alien so my ruemotologist recompense then dr I am seeing now he is wonderful and kind I do like his opinion he told me it is all up to me he will offer the surgery but no guarantees xx as I know I lost my husband 2019 to cancer so I do find it hard to make decisions alone 🙁 but at the moment I just have weekness in my legs and shooting pain nerves in my big toe and arms but as I said I don’t want to wait until it is to late xxx kind regards Sharon

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@mincer I am sorry for your loss. I certainly would be willing to talk things over with you anytime if you need an ear. Surgeons can't make guarantees to fix pain because they don't know how much nerve damage there is, and there will be scar tissue from surgery. You have to stretch that out later because neck muscles do get tight and painful when they can't move correctly. Immediately when I woke up from surgery, all of my pre-existing pain generated by the spine problem was gone, so the leg pain, body pain and neck pain was gone. the pain I had was from the incision and the surgical path, and my legs worked just fine. make sure to walk after surgery and work to clear your lungs because pneumonia is a risk after being under anesthesia and if you can't clear the phlegm, it turns into an infection. usually they give you a device to breathe into for that. I did have to go on antibiotics 5 days after surgery for a lung infection. The drugs also slow down your GI tract a lot, so you need to use fiber, etc to try to keep things moving.

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@jenniferhunter

@mincer I am sorry for your loss. I certainly would be willing to talk things over with you anytime if you need an ear. Surgeons can't make guarantees to fix pain because they don't know how much nerve damage there is, and there will be scar tissue from surgery. You have to stretch that out later because neck muscles do get tight and painful when they can't move correctly. Immediately when I woke up from surgery, all of my pre-existing pain generated by the spine problem was gone, so the leg pain, body pain and neck pain was gone. the pain I had was from the incision and the surgical path, and my legs worked just fine. make sure to walk after surgery and work to clear your lungs because pneumonia is a risk after being under anesthesia and if you can't clear the phlegm, it turns into an infection. usually they give you a device to breathe into for that. I did have to go on antibiotics 5 days after surgery for a lung infection. The drugs also slow down your GI tract a lot, so you need to use fiber, etc to try to keep things moving.

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Good morning I have a question I was wondering as my problems are more in my legs and my arms are week, Ian having the surgery as to delay the complications later down the track IE unable to walk, as I have compressed nerves xx

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@mincer

Good morning I have a question I was wondering as my problems are more in my legs and my arms are week, Ian having the surgery as to delay the complications later down the track IE unable to walk, as I have compressed nerves xx

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@mincer The nerve impulses for every body function that is controlled by the brain travels through the spinal cord in the neck and the cord is a bundle of nerve cells that have long axons like "wires" that float as a big bundle freely in spinal fluid. It just depends on what part gets compressed as to what symptoms you will have. Uncompressing the spinal cord would improve both arm and leg symptoms if the nerves and spinal cord are still functioning and presuming that the symptoms are caused by spinal cord compression. I know that I got used to the weakness and compensated with my efforts. It felt very freeing to have things work better again. It does take a bit to rebuild muscles that were lost because they didn't receive proper nerve signals. The muscle fatigue I was always feeling was gone when I woke up from surgery and my pain then was from the surgery itself. It is possible to have other sites of nerve compression that are not related to the spine in other body parts which spine surgery won't fix. It is the surgeon's job to accurately determine the source of the symptoms before they do surgery.

I knew that my spinal cord compression was getting worse because I saw the amount of bone spurs pressing into my spinal cord double in 9 months time between 2 different MRIs. I was at risk of paralysis if there would be another injury because the bone spurs were like a hard knife in front against my spine and a whiplash would push it farther into the cord. I knew if I did nothing, my future would be in a wheelchair. That also puts a burden on family members and caregivers and I didn't want to give up an active life. Even if you can walk, having a weak uneven gait creates a bigger risk for falling and further injuries which would lead to a wheelchair for safety. Having surgery is scary, and I had to overcome that, and I am so glad I did. It empowered me to choose my future, and I defeated my biggest fears and all of this experience along with a great surgical outcome completely changed my life for the better. A year ago, I broke my ankle badly and had emergency surgery, and I wasn't scared and was completely calm. That is proof of how much I changed and became stronger as a person because I faced my fears and defeated them going through spine surgery.

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How inspirational you are in your conversation, I am sitting here after a day at work (child care ) and I am feeling no strength in my legs and I am exhausted 💤 take care xx

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