Spine SPINE - Fusion, Microdecompression, Other Procedures - What to Expect

[Grammy57]

I am scheduled for 3 level cervical spine fusion on Monday

 

[NightQuilter]

We will be cheering for you Grammy!! I know for me, my OS didn't even prescribe physical therapy for 6 months to allow the grafts to fuse thoroughly - just walking. Keep us posted - I wish you a great surgeon with skilled hands and wonderful relief!!

 

[Grammy57]

Sorry for the delay. I had my surgery 11/8/21. All went exceptionally well. I wear a bone growth stimulator 4 hr a day and am 92 days into the 180 prescribed. I started my PT in January and am finished with that. All in all this was probably one of the easiest surgeries I've had. I have my 6 month check up in May and a CT is scheduled for April to see how well I am healing. My shoulders still hurt some but that's because the foraminal stenosis was not addressed.

 

[NightQuilter]

Its so good to hear from you Grammy and to hear how well you are doing! I've not heard of a bone growth stimulator - it is amazing how scientific developments continually improve our prognoses. Hopefully they will be able to resolve the stenosis issue once you have fully recovered from the spinal surgery. Can you add that surgery into your signature? Keep up the great work!

 

[sistersinhim]

@NightQuilter, what were the symptoms of your needed cervical spine surgery? I'm facing that in the near future, but am putting it off as long as possible. Right now, the worse I have is 50% of the time I have tingling in my chest, neck, shoulder, and arm. I experience some neck pain, too, but not too bad.

I've will begin PT tomorrow for an ultrasound and massage. I've already been doing exercises, which have diminished the neck pain but not the tingling and numbness.

 

[NightQuilter]

I am sorry you are facing that surgery @sistersinhim . I suspect symptoms can differ widely, depending on the location and extent of deterioration. The tingling sounds quite suspect! In my husband's case, he often couldn't fully flex his right foot and would trip while running or walking. They found that the issue was an impingement in his neck that caused significant bruising of the spinal cord at the C4-5. In my case, 24/7 massive headaches coupled with frequent rhomboid spasms in the back led them to find deterioration at the C3-4. They considered fusing 3 levels but figured they would do one and then see how I responded. Fortunately, so far, so good. Pre- and post-surgery, they had me doing a lot of neck strengthening exercises as well. I find even now that when I get headaches, doing them a few times - well, muscle memory kicks in and typically resolves the issue within a couple of days. I can certainly understand wanting to prolong getting the surgery, but you know what we preach on here - if it is enough to affect your quality of life.... Post both spinal fusions, I wasn't even prescribed PT for several months. My OS wanted to be sure the grafts had fully taken before putting any stress on them. Just normal daily activities.

 

[sistersinhim]

I have stenosis on C5, 6, and 7. I will have to have it done because it's getting worse. Even my eyesight is getting worse now. Thank you for the information. Yours and your hubby's have been successful so that's encouraging for me. The fear of having my neck operated on, especially will all those nerves there in really scary. It sounds like it's not too bad, though.

 

[NightQuilter]

Spinal or neck surgery is certainly scary. But they have become so efficient with it. Are they discussing fusion or just cleaning out the spurs and decompression? In terms of recovery, it is much less difficult than a knee (though a little more than a hip).

 

[sistersinhim]

We haven't discussed the types of surgery yet. All he said was that he'd go through the front. I told him that I want to try other things first. I'll be starting PT tomorrow.

 

[NightQuilter]

That may be a fusion - they often feel they can insert a better/larger graft in from the anterior whereas from a posterior only approach they can only access enough for two smaller grafts either side. The worst part of the anterior approach is a sore throat for a couple of days as they have to move things to the side to access the spinal column. The incisions conveniently hides in our aging "sag lines!'' They then go in the back to insert the screws and hardware to support it. For both my cervical and lumbar fusions he inserted the graft through the front and then hardware in the back.

Good luck with the PT - I hope you get significant relief from it!! No one wants a surgery if it can be avoided!

 

[sistersinhim]

The PT is giving me exercises for the nerve, too. She called it flossing the nerve. I messaged the OS and what he will do is an ACDF of the c3-4. If these exercises work then no surgery! I just have to be careful with how I move and lift things. He also said that my worsening eyesight is not coming from this nerve, but my headaches and dizziness are. I'm stepping out in faith that the exercises will improve me!

 

[NightQuilter]

What a relief (in a way) to know the neck issues are not the cause of the eyesight weakening. I'm looking at macular degeneration surgery in the near future, followed by cataracts.
ACDF is the anterior decompression and fusion. Lifting prayers the PT exercises work and give you the relief you so deserve. Love the sound of "flossing the nerve!"

 

[sistersinhim]

Thank you for your prayers.

What kind of surgery do they do for macular degeneration? I had no idea they did.

 

[NightQuilter]

I won't know until next week when I see her again. I believe it depends on the type of AMD and apparently mine is treatable. My ophthalmologist said something about removing the gel and straightening out the retina and that it has become very routine. I can't imagine what that means and the thought of only being slightly sedated for it gives me the willies, but I will be interrogating my OS pretty thoroughly next week!

 

[sistersinhim]

That sounds encouraging. Be sure and let us know what you find out next week.

 

[NightQuilter]

@Grammy57 , it seems a few of us have been away from here for a bit! Glad you do not have osteoporosis! And what an interesting procedure to insert wedges into the facets. Good luck with the knee!

 

[Grammy57]

@NightQuilter Thank you. Yes, it's been a bumpy few years. My hip and then both thumbs. Then my cervical spine and now my knee. I'm hoping surgery is not needed but not holding my breath.

 

[Grammy57]

Well, after my shoulder and back pain slowly worsening I had a myelogram that I had put off because I chose a different route with my original surgeon (ortho). The new Dr is neuro. The conclusion is:
Cervical
1. ACDF spanning the C4-C7 levels is seen with mature bony fusion between the C5/6 vertebrae. There is partial bony fusion across the C6/7 disc space with incomplete bony fusion laterally. There is no evidence of bony fusion at the C4/5 level.
2. Bilateral facet joint fusion hardware is seen at the C6/7 level without evidence of bony fusion of the facet joints.
3. Minimal grade 1 anterolisthesis at the C3/4 and C7/T1 levels.
4. Mild to moderate right neural foraminal stenosis at the C6/7 level due to hypertrophic change of the facets.
5. Mild right neural foraminal stenosis at the C3/4 level due to broad-based disc bulge with right paracentral/foraminal zone protrusion.
6. Mild bilateral neural foraminal stenosis at the C5/6 level due to uncinate and facet degenerative change.
7. Broad-based disc bulge with small central protrusion at the C7/T1 level.

Thoracic
1. Moderate right sided neural foraminal stenosis at the T1/2 level due to facet arthropathy.
2. Degenerative disc disease from the T6/7 through T9/T10 levels with evidence of mild ventral thecal sac effacement at the T6/7 and T8/9 level. There is no significant stenosis of the thoracic spinal canal identified.
3. Peripheral vascular disease.

Lumbar
1. Mild neural foraminal narrowing bilaterally at the L4/5 level due to diffuse disc bulge and facet hypertrophic change.
2. Moderate right and mild left-sided neural foraminal stenosis at the L5/S1 level due to disc bulge and facet arthropathy.
3. Mild degenerative changes of the sacroiliac joints.

I'm waiting for my follow up appointment. What concerns me most is the cervical non-fusion after the OS said I was fully fused except C6/7 which he then put the wedges in.

 

[Grammy57]

I just read the xray report.
IMPRESSION:
1. Minimal grade 1 anterolisthesis at the C2/3, C3/4 and C7/T1 level with evidence of dynamic instability at the C7/T1 level. Anterolisthesis at the C7/T1 level measures 1.7 mm on extension and 3.6 mm on flexion views.
2. Postoperative changes related to ACDF at the C4-C7 levels and facet joint fusion at the C6/7 level.

 

[NightQuilter]

My goodness @Grammy57 - that is a lot of medical parlance to have to sort through. I am glad you are seeing a neurosurgeon now. May you and the doc find some options to relieve your pain!