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Old 05-14-2010, 05:01 PM   #1
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cervical spine disks

I have two cervicle vertebrae that are bone to bone and a third disk has only millimeters left before it is gone. I have been to one Surgeon who did an MRI, and did not seem to eager to operate,( he told me), untill the pain was unbearable.
What are my surgical options, if any other than fusion, and how dangerous would this surgery be with this much damage.
I have had intense itching in my head, neck and right arm for the past couple of years, which has gotten worse over time, plus the pain in my neck and shoulders is beginning to get unbearable. Range of motion in my neck is also very limited.
I am 70 years old, had a lamenectomy in 1970, and a total knee replacement in 2000. I came through those operations just fine, but am more than a little worried about total paralysis from a cervicle spine operation. I also do not have a clue as to who would be the best surgeon in my area (Des Moines, Iowa) to do this operation. I am not very confident in the surgeon I went to before (last Fall) for the MRI and consultation .

 
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Old 05-14-2010, 06:36 PM   #2
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Re: cervicle spine disks

The risk of paralysis from cervical spine surgery is about 3%. Pretty low. You had a bigger risk of blood clots or infection with your knee replacement.

What I do to find a good doc is to ask a doctor I already have and like and trust, who they would use. Ask you knee replacement doc...they would know. I use a neurosurgeon but some prefer an ortho with special training to do spines.

But the docs are the ones who know who is good and who isn't. And right now, with a lot of new surgeries being developed to treat spines, a younger spine doc is better than a older one.

So ask your docs but chose someone fairly young who has learned the newest techniques. Tough on some of us older folk to trust the younger ones but I just read a book that talked about a study showing that on average, it takes doctors in practice, an average of 17 YEARS to learn the newest stuff and get into using it regularly.....even something as simple as giving a patient having a heart attack an aspirin. So you can imagine why the older surgeons don't learn the newest techniques. So you go young because they learned it right from the start.

good luck.................Jenny

 
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Old 05-14-2010, 09:47 PM   #3
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Re: cervicle spine disks

While there is always a risk of paralysis with many spinal surgeries, ACDF (anterior discectomy and fusion) in the neck is usually successful and a fusion doesn't impair range of motion as much as many of us think before surgery.

Don't let your age deter you, or any doctor. Sometimes a doctor will say "no need to operate unless you are in total agony" but what they are saying is "at your age why bother". I went through this with my mom's shoulder replacement. The doctor actually said "I'd be worried about her recovery but she's elderly and I don't expect much" (and she was only in her 60's then - the doctor was so young he thought my mom's active life was over).

So explore the option of something that will alleviate your pain so you live the next 30 years in as much comfort as you can.
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Old 05-15-2010, 08:00 PM   #4
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Re: cervicle spine disks

I have heard of patients having one vertebrae fusion, but as I mentioned before, I would need three fusions. I have two bone on bone vertebrae and another that is so bad it also would have to be repaired. I am concerned
about how this will impact the surgury, Time in surgury, risk, pain etc.

 
Old 05-16-2010, 02:37 AM   #5
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Re: cervical spine disks

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Originally Posted by larry 70 View Post
I have had intense itching in my head, neck and right arm for the past couple of years, which has gotten worse over time, plus the pain in my neck and shoulders is beginning to get unbearable. Range of motion in my neck is also very limited.
When it comes to neck surgery you should consult with at least 3 surgeons(and even more) and see what they say. You can get the surgeon's patients phone number and ask them about the surgery and the surgeon.

I've never done a neck surgery as of today so I can't tell you. I know when it comes to neck surgery there is a high chance the pain will come back. Surgery doesn't take the pain away, in most cases it doesn't anyway.

I suffer from severe chronic neck pain plus head pain - just like you - it's unbearable and intense - you described it just fine.
Are you taking any pain meds?. You should take pain meds so you won't suffer like that.

Are you able to sleep at night like that with intense pain in the neck?

Let me know.

Last edited by nochange; 05-16-2010 at 02:43 AM.

 
Old 05-16-2010, 07:05 AM   #6
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Re: cervical spine disks

I have a lot of trouble trying to get to sleep, and when I finally do, I wake up often Because of itching in my neck, shoulder and head and a dull pain in my right shoulder and neck. It is hard to get comfortable in bed as I can not find a position to sleep in that does not cause discomfort. I do believe the itching is caused by compression of the spinal nerve in my neck. 20 years ago, I was told by an orthopaedic surgeon that one of the cervicle disks was collapsed and I needed to have surgury on it. The pain went away, so I never had it done. The pain returned about a year ago, along with the itching, and now I find I have three vertebrae that need to be repaired and the pain and itching get worse every day. I have had austio-arthritis since I was 12 years old and it has done a lot of damage over the years. A lamenectomy in 1970, total knee in 2000, with the other knee needing to be replaced, and now this.

 
Old 05-16-2010, 10:30 AM   #7
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Re: cervical spine disks

Larry....I have 6 vertebrae fused and very little pain now that it's healed. Don't expect the worse....it can work out.

Find the best spine doc you can and then explore options. Get at least 1 second opinion. And if anyone tells you you are too old, tell them you intend to live to 100 and you'd like to have a good quality of life for the next 30 years....that should shut them up about your age. I agree with Spine AZ on that one!

There are new surgeries for your type of problem but whether you'd be a good candidate for them I have no idea. That is why you need a top notch spine doc. They will know.

So don't think 3 vertebrae is a big problem. I met a man at my neurosurgeon's office who was in his 60's and had 10 vertebrae fused and was so happy he did it. He didn't mind the lack of movement as long as the pain was gone...and it was. He was 6 months post-op and so very happy with his neck and upper back. In the hands of a expert, you'll be okay. But I cannot stress the need for a world class spine doc to do it....it makes all the difference in the outcome....one thing everyone here has learned.....the outcome is often determined by the expertise of the surgeon doing it. Doesn't mean big money but it may mean some traveling to them. I'm lucky....I'm only a 100 miles from Boston and 150 from New York so I have the best and that is where I go.

Hope you find some really good.

Jenny

 
Old 05-16-2010, 03:24 PM   #8
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Re: cervical spine disks

I have seen the Prestige artificial disk relacement on the web and am very interested in having this proceedure done instead of fusion when and if I have surgury on the three vertebrae in my neck. Do you know of any one who has had this device implanted and what results they had. I would appreciate any information I can get on this device, how well it works and patient satisfaction. I am interested in it because it offers better range of motion in the neck and there is no need for doner bone,which I understand can be much more painfull than the cervicle surgury itself.

 
Old 05-16-2010, 03:36 PM   #9
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Re: cervical spine disks

Larry:

One key thing to find out is if your insurance will cover an ADR. Many insurance plans do not cover ADR as they consider it experimental treatment.
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Old 05-16-2010, 05:11 PM   #10
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Re: cervical spine disks

And on top of it, you have 3 vertebrae that need attention and that would mean you'd need 2 artificial disks and at this time, the FDA has only approved the placement of 1 disk in a neck. You'd still have to have the others fused and you can't do a fusion next to an ADR(I think that's what my doc said when I asked him about doing the same thing).

You really don't lose that much movement. With my 6 fused vertebrae(C3 to T1)I can drive with no problems(even in downtown Boston traffic), I paint watercolors with my head down for hours, I'm currently re-setting the rocks and my garden waterfall and I shovel snow all winter.....I'm 58. I don't know what you are so worried about.

Just find the best spine surgeon you can.

Jenny

 
Old 05-16-2010, 06:47 PM   #11
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Re: cervical spine disks

I agree, in regards to range of motion I had C5-C7 done and don't notice much of anything. I make a conscious effort not to strain to look either way (so I bought a panoramic rear view mirror for driving). I may be adding C4 to it this year (should have asked my doctor to do C4-C7 in 2006 but I wasn't wise enough at the time to push for it). Now I have a new doctor who agrees that if there's a problem he'll do every level needed.
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Old 05-23-2010, 02:49 AM   #12
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Re: cervical spine disks

Quote:
Originally Posted by larry 70 View Post
It is hard to get comfortable in bed as I can not find a position to sleep in that does not cause discomfort
Larry. I have the same problem. I cannot find any comfortalbe position on the pillow so I can fall asleep. Did you discuss your doctor about this and what did he say?. My doctor has me on Remeron 30mg so I can sleep. It helps a bit to fall asleep but not much. I can only sleep 2 hours a night and then I wake up.

I think you should do something about that. Let me know.

Last edited by nochange; 05-23-2010 at 02:49 AM.

 
Old 05-23-2010, 11:36 AM   #13
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Re: cervical spine disks

I only take aspirin occasionaly, when the dull ache in my shoulder gets real bad. Other than the itching and stiffness and slight ache in my neck and shoulders I do not have unbearable pain unless I do any labor that requires using my arms, neck or shoulders. I probably will not have surgery untill it Gets to the point that the pain will not go away. If I take it easy and watch what I do I can avoid most of the pain, but not the itching. I have read comments from people who have had this surgery, and overall I am not to enthused about having it done. The results seem to be about 50/50 with
patients who have had the procedure done. Some are better off after the operation and others are much worse off than before. Not very encouraging. Beside the fear of ending up a paraplegic, The pain from the bone graft site, sore throat, and sleeping in a recliner for 6-8 weeks is something to consider.

Last edited by larry 70; 05-23-2010 at 11:41 AM. Reason: mis type

 
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