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Thread: Dr Young, Input on Anterior Cervical Fusion Surgery

  1. #1

    Dr Young, Input on Anterior Cervical Fusion Surgery

    Dr. Young, would appreciate your input on MRI cervical & lumbar.
    I am 61 years old, and was injured on the job.
    After much frustration with Work Comp Doctors, I was finally sent to a Neurosurgeon. His findings were as follows which were sent to Work Comp case worker assigned to my case.

    DIAGNOSTIC STUDIES: The MRI of the cervical spine shows a significant lesion, a disc herniation at C5-6 with disc and osteophyte components, causing some apparent cord compression. The MRI of the lumbar spine shows loss of signal and height with some bulging and facet joint hypertrophy at L3-4 and L4-5.

    IMPRESSION AND PLAN: In my opinion, surgery at C5-6 is to be recommended. I would favor further conservative management with regartds to her lumbar spine.. I reviewed her MRI studies with her with reference to the spine model. We discussed the full spectrum of treatment options. We discussed anterior cervical fusion at C5-6.. All details, risks, and all questions were answered to her satisfaction. In my opion she should be on no work status pending surgery. She is not MMI.

    This is all well and good, however the only thing discussed with me was that he could fix it... My biggest concern was if I would have less pain and he said no guarantees... I think I was in shock about surgery and was loss for words at the time and just said okay, guess I will go ahead with surgery..... Anything that I learned was from the internet...
    My surgery is scheduled for September 24, 2009 and I am very scared...
    After reading about things that happened to other people, I am not sure I want to go thru with it, however I don't want to become an invalid either..

    Not only that, my lower back hip area has been giving me a way to go.. Nothing helps when that starts up... Giving you an example, just washing my kitchen and family room floor sends me into such pain and discomfort like I am being cut in half.. The pain always starts in the lower buttock almost in the hip area.... Feels like I am being cut in half by the time I finish my chores... A friend of mine thinks that I may be getting the pain from my SI joint...

    I realize that my cervical may be more serious, but the pain is so much worse in I guess what you would call my lumbar spine. I know that I have my age against me, as I am 61, and have other health issues such as insulin dependent diabetic etc....

    PLEASE HELP

    Thank you kindly
    JoAnn / Miracle

    I thought I had registered as MiracleJo, however I guess I forgot the Jo part.. Anyway, I guess it will just have to be Miracle.... LOL

    Can you please give me some of your input???
    Last edited by Miracle; 09-09-2009 at 01:04 PM.

  2. #2
    I would go for a second and third opinion. You know what the feelings/discomforts/abilities are now, you don't know what it will be like after surgery. Good luck in what ever your decision might be!
    From the time you were born till you ride in a hearse, there is nothing so bad that it couldn't be worse!

    All fringe benifits must be authorized by Helen Waite, if you want your SCI fixed go to Helen Waite!

    Why be politically correct when you can be right!

  3. #3
    Hello Oldtimer

    Thank you for your response. The thing that worries me most is the fact that my spinal cord is impringed.. Also I never new that I had a small spinal column either..
    Imagine that, it took 61 years to find out.. I never new what stenosis was..
    I know I probably should have a 2nd & 3rd opinion. Workmans Comp will not allow me to see another Neurosurgeon.
    I viewed a video on u tube of the surgery.. Also have been on a website of people who have had the surgery and what their outcomes were.. I have always been afraid of choking to death... A few of the after affects of the surgery are swallowing & choking... Some of the comments were that after a year some people were still choking and have problems swallowing and having vocal problems... Some say they could never go out to eat because of the embarrassment of choking at the table...

    I don't have much time left.. As my surgery is only 14 days away...

    Thanks for listening..
    JoAnn / Miracle

  4. #4
    JoAnn - Miracle, I am 62 & have been SCI since 1970. In 72 a group of Dr's wanted me to get a bladder stimulator implanted just under the skin to the left of my navel. They said it would prevent UTI's, bladder & kidney stones, I wouldn't need any type of catheter and if I didn't have this device implanted that sooner or later I would get all the things they mentioned. I was scared into having the surgery. Little did I know that any of these things can and do happen to anyone and you don't have to be paralized. Needless to say, the stimulator never did work, it is the size of an alarm clock rather than the watch they explained and I am stuck with this ugly scar & hunk of junk in me. I have yet to get a stone, uriary tract is in excellent condition. Ever since then I said to myself not to trust Dr.s, only have surgery if it is absolutly necessary and for sure will be ok, if not then they can stick it and I'll live with it. I would be very sceptical about your surgery if only having read about it via internet or being explained by a/one/team of doc's. If you don't feel comfortable with the situation, its your life, you have to live it, not them. I don't like writing/sounding negative but when it has to do with my life I make my own decisions. 39 years with a broken neck paralized from the chest (nipple level) down, its damn tough but livable because I know it could be a lot worse. 2nd & 3rd opinions would be well worth the $$ in my opinion. The best of luck!
    From the time you were born till you ride in a hearse, there is nothing so bad that it couldn't be worse!

    All fringe benifits must be authorized by Helen Waite, if you want your SCI fixed go to Helen Waite!

    Why be politically correct when you can be right!

  5. #5
    Quote Originally Posted by Miracle View Post
    Dr. Young, would appreciate your input on MRI cervical & lumbar.
    I am 61 years old, and was injured on the job.
    After much frustration with Work Comp Doctors, I was finally sent to a Neurosurgeon. His findings were as follows which were sent to Work Comp case worker assigned to my case.

    DIAGNOSTIC STUDIES: The MRI of the cervical spine shows a significant lesion, a disc herniation at C5-6 with disc and osteophyte components, causing some apparent cord compression. The MRI of the lumbar spine shows loss of signal and height with some bulging and facet joint hypertrophy at L3-4 and L4-5.

    IMPRESSION AND PLAN: In my opinion, surgery at C5-6 is to be recommended. I would favor further conservative management with regartds to her lumbar spine.. I reviewed her MRI studies with her with reference to the spine model. We discussed the full spectrum of treatment options. We discussed anterior cervical fusion at C5-6.. All details, risks, and all questions were answered to her satisfaction. In my opion she should be on no work status pending surgery. She is not MMI.

    This is all well and good, however the only thing discussed with me was that he could fix it... My biggest concern was if I would have less pain and he said no guarantees... I think I was in shock about surgery and was loss for words at the time and just said okay, guess I will go ahead with surgery..... Anything that I learned was from the internet...
    My surgery is scheduled for September 24, 2009 and I am very scared...
    After reading about things that happened to other people, I am not sure I want to go thru with it, however I don't want to become an invalid either..

    Not only that, my lower back hip area has been giving me a way to go.. Nothing helps when that starts up... Giving you an example, just washing my kitchen and family room floor sends me into such pain and discomfort like I am being cut in half.. The pain always starts in the lower buttock almost in the hip area.... Feels like I am being cut in half by the time I finish my chores... A friend of mine thinks that I may be getting the pain from my SI joint...

    I realize that my cervical may be more serious, but the pain is so much worse in I guess what you would call my lumbar spine. I know that I have my age against me, as I am 61, and have other health issues such as insulin dependent diabetic etc....

    PLEASE HELP

    Thank you kindly
    JoAnn / Miracle

    I thought I had registered as MiracleJo, however I guess I forgot the Jo part.. Anyway, I guess it will just have to be Miracle.... LOL

    Can you please give me some of your input???
    JoAnn or MiracleJo,

    I think you should trust your instincts and not have the surgery.

    You have a C5-6 disc herniation that may be compressing your spinal cord. The neurosurgeon's words, i.e. "causing some apparent cord compression" does not inspire confidence that the herniated disc is compressing your spinal cord or a spinal root very much, if at all. You don't describe any symptoms or loss of function that is associated with the herniation and the spinal cord does not appear to be in imminent danger of further injury. As your neurosurgeon said, the surgery is not likely to eliminate the pain.

    You don't have anything that seems to be correctable by surgery in your lumbosacral spine. Your neurosurgeon is correct in pointing out that there is no guarantee that surgery will eliminate the pain, particularly when there does not appear to be something that can be corrected by surgery, i.e. there is no compression of the spinal cord or root. Your neurosurgeon correctly recommended conservative treatment of your L3/4 and L4/5 spine.

    Your description of the pain that starts in your lower buttock and that makes you feel like you are "cut in half" by the time you finish your chores suggests that the pain occurs when you are washing your family and kitchen floor. It is not always present, suggesting that you can avoid it by not doing those chores or perhaps doing them differently. The location of the pain is consistent with something that may be happening with your SI joint. Surgery on your lumbar spine is unlikely to prevent that pain from happening again.

    Spinal fusion reduces the flexibility of the spine and places more stress on the surrounding segments. You are still young (age 61) and likely have 20 or more years to live with your spine. You should do everything that you can to preserve the flexibility of your spine, especially if you have cervical stenosis. Fusion will not change the stenosis. It doesn't make sense to fuse a part of your cervical spine to treat a herniated disc that is "causing some apparent cord compression" and is not causing any symptoms.

    You may want to get an opinion from another neurosurgeon but I would suggest that you wait and get another followup MRI scan in 6 months. If the cord compression looks worse or you develop symptoms that are consistent with C5/6 root compression (i.e. weakness of the biceps and wrist extensors, and sensory loss or pain in the arms) or cervical spinal cord compression (weakness and sensory loss in your lower body or bladder problems), you can reconsider.

    Wise.
    Last edited by Wise Young; 09-11-2009 at 06:53 AM.

  6. #6
    Quote Originally Posted by Wise Young View Post
    JoAnn or MiracleJo,
    Spinal fusion reduces the flexibility of the spine and places more stress on the surrounding segments. You are still young (age 61) and likely have 20 or more years to live with your spine. You should do everything that you can to preserve the flexibility of your spine, especially if you have cervical stenosis. Fusion will not change the stenosis. It doesn't make sense to fuse a part of your cervical spine to treat a herniated disc that is "causing some apparent cord compression" and is not causing any symptoms.

    Wise.
    I don't mean to hijack a topic but every test I've taken only gives me 65 years. I'm guessing due to being sedentary. No other risk factors. Is there a new test?

    I can say without hesitation a fused neck is not so great tryng to drive and look over the left shoulder for traffic. There are other down sides, but that's my biggest gripe.

  7. #7
    Quote Originally Posted by mingo View Post
    I can say without hesitation a fused neck is not so great tryng to drive and look over the left shoulder for traffic. There are other down sides, but that's my biggest gripe.
    Yes, that's very annoying and a safety issue. My neck is fused from C5 down to T1 so I pretty much have to turn my torso in order to see while passing. Most of the time though I rely on those aftermarket blind spot mirrors you can get at any auto parts store.

    Sorry, didn't mean to hijack the thread ..

  8. #8
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    Ryhang, since we already hijacked the topic, I would like to know more about these mirrors. I am fused from C1 to T10, so can't twist head, neck or torso. I don't feel safe with just my side view and rear mirriors, so have pretty much decided not to drive. Would like to know a little more about these?? Thanks

  9. #9
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    and MiracleJo, Dr. Young is exactly right. Once you are fused, the areas above and below the fusion start to wear due to the extra stress. And that becomes a never ending battle. If you absolutely do not require the surgery... think twice. Ask a friend to clean the floors, or your bath tub. It might be a little embarrasing at first, but you won't be able to ask your friend for a new spine down the road.

  10. #10
    thats the same as mine almost but it isnt a miracle cure you have to take the risk if you cannot live the rest of yr like like you are and I would advise that to anyone surgery can be dangerouse on the spine but it can help to the worry I have is degeneration I would like to see more on the subject once you have an op fusion or laminectomy it will only give you relief A- If it 100% works on you B - If you dont have a fast degeneration spped on yr bones like me I have stenosis it is normally in 60 yr olds not young people and the op has caused more degeneration further down my spine in T 11 you

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