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Old 01-18-2006, 12:39 AM   #1
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Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Hi All,

I underwent (ACDF) fusion of C5-6 in May, 2005 as a result of a work-related injury. The spinal surgeon did a graft by extracting a piece of my Iliac crest bone. I had herniated the disc and it was protruding by 4 mm - causing extreme pain in the right arm and neck as well as numbness in fingers - the other thing that would happen is my fingers would feel like they were asleep and then the pain would start running up my arm into the upper arm area and increase in intensity as it climbed - this would also set off a burning sensation that would build in intensity as it climbed and it would suddenly release after it reached a certain height. To make a long story short, the MRI confirmed what the problem was after PT just made it worse and WC authorized the fusion. I still have pain but nowhere nearly as bad as it was prior to surgery, however, now that winter is here I'm noticing that the pain has increased substantially.

I'm negotiating with WC about a settlement and I've been offered either a "compromise and release" which would result in a lump sum payment which includes a certain amount for medical, however, no future medical would be covered once the settlement has been reached.

The other option is a bi-weekly rate which would result in me probably losing our house, car, etc....however, it would include future medical.

Now I need to make a decision - do I go ahead with the Compromise and Release and hope for the best or go with the bi-weekly and risk losing everything?

My decision is difficult because I had always thought that fusion was permanent and once done, I'd have no more problems - but with everything I've read here, I'm not so sure.

I'd love to hear anyone's comments/suggestions or advice on how they'd proceed and if anyone knows what the long term prognosis is on fusion - can the injury reoccur - can the fusion go bad - can the fusion cause other neck problems resulting from the fusion?

I'm soooo confused.....and any suggestions would be greatly appreciated. Thanks!

 
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Old 01-18-2006, 04:00 PM   #2
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Hi there,

I can only give my personal experience and hope others share theirs so you can make an informed decision.

I had a two level anterior cervical fusion in 2001 on levels C/5-C/6 and C/6-C/7 using my own hip bone and NO plates or screws. It took away my neuro symptoms of numbness and tingling and most of the pain for about a year. (Mine was not caused by an accident, I have had pain off/on and was tubing behind a boat during vacation and had pain the next day but thought it would go away)

Starting in late 2002, I started having pain in the neck and right shoulder. It kept getting worse and worse and went to Primary Dr. I was also diagnosed with Fibromyalgia back in 1995 so she thought that I was just having pain from this and it was aggravated by lots of plane travel for my work. So, we tried all sorts of pain meds from Ultram, Percocet, Oxycontin,Morphine, and Duragesic patches. The patches helped with pain but made me sick as a dog.... And, I didn't want to be living on pain medicine and knew something else was going on and wanted to get to the bottom of it.

So, after years of trial and error, she sent me to a pain mgmt. Dr. in July of 2005. I begged for an MRI and it showed a total NON-fusion on level C/6-C/7. I didn't have any recurring neuro symptoms of numbness, only severe pain and it was also in my right scapula region as well. So, after the MRI, they sent me to another Neurosurgeon who said it needed to be fixed promplty. Well, I do missionary work and had a mission trip to NC with our high school youth group in Aug., a 2 week vacation with hubby planned in Sept.(saved forever), and a 2 week mission trip to Africa in October. So, I asked if postponing the surgery until Dec. would injure me any further and they said no, only cause more pain. I decided to go on these trips since living with Chronic pain keeps me from doing so many things and the Dr. said that even with this second surgery, I will probably have pain the rest of my life. This made me even more determined to go and do these trips that would bring my heart so much joy and to enjoy them to the fullest even though I am in constant pain.

It was worth every second even though I paid for it dearly with extra pain I got to experience things that I may never get to do again like my trip to an orphanage in Africa and white water rafting, canyoneering, biking, hiking, on our vacation.

Ok, sorry, I digress,,,,, Reliving those great moments... Back to reality here....

I had the surgery on Dec. 12th to re-fuse the one level, they used donor bone and put in a plate with 4 screws... I am still having constant pain and can't tell any difference, even a little worse than before since my neck has started to curve the opposite way in the past years...

I haven't been lower than a 6 (on a good day) on the pain scale in 4 years. I am only on Oxycodone 7.5/325, four a day right now since my pain mgmt. dr. thinks I shouldn't be having any pain since the surgery. Isn't it nice how he can know that about me??? HA HA HA!

I am seeing a Spine Specialist on the 24th here in Northern Virginia and hope and pray they can help with my pain.

I am so sorry for the long post but wanted to share my story.... I am just one of thousands who have had this surgery and always pray that others have better outcomes than me but also want to show others that it's important to do joyful and meaningful (God-filled for me) things in your life despite the pain. Although the things I did are a bit extreme that's me but doing things that give back to others and fills your heart with love are crucial to living a life with pain.

I truly hope you come to the best conclusion for you and I am sorry that you have to be going through this and have pain. I suggest that you find a spine specialist to take over your healthcare to monitor your neck and help you with your pain.

Can you hold off on a decision until you see a specialist and get a medical opinion on what would be best??? That would be my best advice.

i will pray for you and keep us posted on your progress.

Many hugs,
Ingy

 
Old 01-18-2006, 05:52 PM   #3
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Hush,
I am in a very similar situation. My case is also a WC deal and Im` nowhere near as far along in it as you...I have been waiting for the ok to have my sx since last may and am going in for my acdf on feb 9th,. I also have pain in my right arm and neck and tingling in fingers and blah blah blah. Mine is a C5 C6 C& issue.. plating/fusion.
why would you lose everything with a bi weekly deal? is it that the amount isnt enough to cover expenses? the other question I have for you is, Would the lump sum be enough to cover a future sx and accomadate you for your injury?
Im wondering how they will work my case out.....

 
Old 01-18-2006, 09:22 PM   #4
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Hi Ingy,

Thanks for your kind words! I really appreciate hearing your story.

Ron - I wish you all the best - I read your story on the boards and I really feel for you - I know how painful and frustrating the wait can be.

Yes - the problem is the "lack of funds" - $880 a month will not be enough for me to be able to maintain my monthly payments and survive, however, I'm a little concerned about accepting a settlement and finding out down the road that something has happened to the fusion and I need to have it redone - I'm trying to find out what the chances are of this happening and if anyone else has ever heard if this is a frequent problem or whether it's rare.

 
Old 01-19-2006, 07:03 AM   #5
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

I too am a WC patient and I am confused about your options. My first injury also WC was settled and I have lifetime medical after a decompression laminectomy C6/7. My second injury is WC and will have a fusion C4/5 Feb 15th I will also have lifetime medical on that. Isn't it the employer who is responsible for the lifetime medical? Or just my employer who does that? I likely will not have a disability pension as I can stick it out for the next few years but if for some reason I can't then I get tax free my pension and medical. What I do not get now on my C6/7 is pay from my employer to compensate for the difference in WC pay or the time off just the cost of the medical.

If I were you with those choices I would keep lifetime medical as it will cost you a lot more down the road for follow up medical care and if you do not have the insurance or your ins will not cover it due to it being a WC issue you are out way more money. Just my thoughts on that. By the way what % of disability are they offering you?

 
Old 01-19-2006, 09:57 AM   #6
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Hi Back,

It's a long story - when I was finally released as "Permanent and Stationary" in August, 2005, the spinal surgeon had to rate the injury - it was classified as a Category III - 15%. My Claims adjuster at the Insurance Company upped it to 18% due to my age (49) and the type of work I was doing and the restrictions imposed by my spinal surgeon - (lifting no more than 25 lbs and no repetitive overhead work) - my job title was District Technology Network Coordinator, however, in reality I was a Network Administrator and Technician required to do every asset of the job from moving to repairing and setting up the machines including connecting cabling, etc. My claims person at the insurance company submitted what she had suggested to the Evaluation Unit for review - they said no - they changed it to a Category IV - 22% due to the Fusion. They are now waiting for an updated report from the spinal surgeon because apparently the new rating system here clearly states that a fusion is a Category IV - my job description required the ability to lift up to 100 lbs. Even though I was released by the Spinal Surgeon, my employer was unwilling to take me back due to the restrictions - their letter to me stated that they "could not reasonably accommodate the restrictions laid out by the Spinal Surgeon in his report". Since August, I've been utilizing all of my annual and sick leave and that's how I've been managing to keep things going, however, now that leave is depleted and effective as of January 10th, I'm now on a 39 mo rehire list, and my benefits expire at the end of January. At that point, I'll be required to pay for COBRA to continue with any type of coverage and in the interim, they're still awaiting a new report from the spinal surgeon.

There is no such thing as lifetime medical here - it must be your company who provided that. Here they include an amount they deem reasonable in the settlement for medical and you lose all rights to further medical treatment for the condition.

 
Old 01-19-2006, 01:56 PM   #7
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Yikes Hush that is tough. I understand that WC only requires an employer to retain the employee if they have accomodations. But heck do they not have a light duty position? Seems like a way out and that stinks. I would say 22% is very good. I only got a 5% down from the 15% my doctor recommended for my laminectomy in 03 even with permanent nerve damage. But good isn't good enough to live on. Is there a way to get another job even parttime? I am just not sure I would waive future medical. You are only 49 and it seems that so many people go on to have an additonal surgery down the road.

My employer would have to medically retire me if they could not place me in a light duty slot and that would cost them more then finding me a place. I guess I am lucky in that respect. Good luck with your decisions.

 
Old 01-19-2006, 03:53 PM   #8
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

Backinthesaddle, I know a little bit about the kinds of issues with which you are dealing. In fact, I've known a few lawyers who worked WC from the company side. The WC laws vary by state, though.

#1 - In a million years, I would NEVER give up future medical with that kind of injury. NEVER. It's a huge gamble.

#2 - Your state may require WC paid job re-training or other benefits if your current employer claims that there are no alternate positions.

#3 - WC lawyers - employee side - are generally only compensated a pre-arranged, fixed amount of the $ settlements (this may vary by state). I would recommend speaking to an EMPLOYMENT attorney about your possible ADA issues, etc.

#3 - The ADA and similar state laws provide a great deal of protection. Generally, IMHO, the problem is that the employer has the lawyers and knows how to manipulate the system.

#4 - I wouldn't go looking for ADA info from your employer. Its lawyers will do everything to protect the company's best interests. What is a "reasonable accomodation" is not for your company to decide.

Again, I would not allow future medical costs to be even remotely entertained with regards to any settlement.

Find someone to look out for you and your best interests. It will not be any representatives from your employer, its insurance company or lawyers.

Good luck.

Last edited by funny4mony; 01-19-2006 at 04:16 PM.

 
Old 01-20-2006, 07:58 PM   #9
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

I would push for retraining. WC will continue to pay you as well as all expenses for retraining.

Once you have been retrained for a new job, get a job in that field and go off WC. I wouldn't be pushed into a settlement that deprived me of my rights to future medical care for the injury.

Last edited by Katyana; 01-20-2006 at 08:00 PM. Reason: spelling

 
Old 01-20-2006, 08:20 PM   #10
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Re: Long Term Prognosis - Anterior Cervical Discectomy and Fusion Plating C5-6

The laws here have changed - now there is a voucher that is issued based upon your disability rating - this varies in amounts up to a maximum of $10K - and at the moment, I'm awaiting information on it. Thanks to everyone for the responses - at least I have an idea what I am facing and will hope for the best! In the interim, I'll just keep on trucking and hope that somewhere down the line that I won't have recurring problems with my neck as so many others seem to have experienced.

I wish all of you the very best should you ever have to undergo this surgery and hopefully, you'll be fully recovered in no time.

 
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