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Old 03-31-2011, 11:21 AM   #1
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posterior fusion c2-c5

Hello! I am facing fusion surgery C2-C5 in about three weeks. I have a really narly C2-C3 facet issue with bone spurs and bone on bone that causes constant pain. The CT shows some degeneration at 3 - 7.

When I had my facet injections it did not relieve the pain which gave the NS pause to move forward. In fact the injection in the c2,3 joint hurt so bad I nearly came off the table and it hurt for days. The NS was not happy that the injections were not successful as that is a strong diagnostic tool.

In spite of the failure of the injections we have elected to go forward based on my pain and the CT scan. He has cautioned me that it may not be successful but he is optimistic about it. I am hopeful that I can resume my regular activities and move foreward in the years to come without being limited by pain that has begun to cause depression and isolation. It has made a difference in my personality for the last year and I am so ready to get my life back.

Here are my questions for those who have had cervical posterior fusion:
  • What did you do, if anything, to prepare your body for surgery?
  • Which vertebrae did you have fused?
  • How long were you in the hospital?
  • Was it really painful afterwards? For how long was it painful?
  • Did you need much help at home for the first week?
  • How long did it take before you felt like you were back to normal activity?
  • Does it still bother you at all?

Last edited by Jude4340; 03-31-2011 at 11:23 AM. Reason: typo

 
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Old 03-31-2011, 01:01 PM   #2
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Re: posterior fusion c2-c5

I was fused from the back at age 55 so I have some answers and suggestions for you.

BUT, are they planning to include C2 in the fusion as it is not typically done? When they include C2, you lose most of your ability to move your head. I also have C2 problems but they only fused me to C3 so I could still drive....doubt you'll be able to drive again(ever) if they add C2.

We do have someone here who is fused to C2 and if that is the case, I'll ask her to post to you when she can....still having some major problems from her surgery.

Once I know that, I can give you all sorts of hints as to how recovery will be.....it will be painful! But once fused, is not bad at all.

hugs..............Jenny

 
Old 03-31-2011, 02:30 PM   #3
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Re: posterior fusion c2-c5

They will be fusing c2 to c3 to c4 to c5 so basically three levels. Also with decompression between c2 to c3 because of the current bone on bone situation. The NS said that I should be fine to return to all activities that I did before but with some limitation on mobility. He did not say that I would not be able to drive but rather once I am off pain meds I will be able to drive again. If they were to fuse c1 to 2 then yes apparantly there is a more serious problem with mobility according to what I have been told.

 
Old 03-31-2011, 05:54 PM   #4
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Re: posterior fusion c2-c5

I've asked Saucer to come over and speak to you. She is just recovering from a major fusion that involved C2. She has tried driving. We have others here who were told no more driving as you lose about 75% of the movement of the neck. I am C3 to T1 and I lost about 50% but of late, that has been improving....but I am 4 years out from surgery. Initially, I could barely turn my head from side to side let alone see out the side windows. But she can tell you more than I can.

I really can't give you too much help. After re-reading your questions, I realized that since I broke my neck, I don't have the answers to your questions after all.

But I can tell you about the pain issue. I had 2 cervical surgeries both from the back. The first was to relieve stenosis and involved opening and re-shaping the bones. Pain was not good but the worst part was not being able to hold my head up until the muscles in the back started to heal. That surgery did not require a hard collar. But later, after breaking my neck, I had a hard collar for 7 weeks only as I was fused using an experimental bone putty that made you fuse faster. It is no longer available...the experiment failed but I did well with it. Again, the pain was tough but if you stay on the pain meds and don't allow break through pain to start, you'll be okay. Take the pain meds whether you need them or not at that moment. Keeps you from being in pain and starting the muscle spasms that make everything worse.

Use ice at home and once the staples are out, switch to heat to get the blood flowing well in the muscles. If they offer PT, do it.

If your doc was like mine, I got the back of my head shaved about halfway up the back of my head. Get it cut short before surgery as they don't exactly do a good job. And even then, they tape the rest of the hair out of the way and removing the tape hurts. You can expect a scar that starts above the base of the skull and goes down to about 1 level below the fusion area.

I was in the hospital for 8 days but I had complications.

You will probably need help at home because trying to do anything with a full neck brace on is hard until you get used to it. Sleeping is harder. My doc actually wanted to put me in a halo but I'm glad I avoided that. Hard enough with the full brace. Just try getting up out of bed with your neck totally straight and stiff(chin up so you see straight forward) and then you can see that you might need some help. Fixing food can be hard as you can't put your head down to see. Just spend a day holding your head completely stiff and then you'll get the idea as to what obstacles you'll face.

Since my problem was different, I never went back to "normal" and had to leave my job and go on disability. I had paralysis to battle. But I am now 4 years out and can happily say I've had very little pain compared to most. I take only Tylenol or ibuprofen if I hurt and an occasional muscle relaxant if I've overdone. No throat issues like the people with the anterior surgeries. But I do get the post-spinal surgery headaches and the only way I have found to get rid of them is to lie down.

Hopefully some others with long posterior fusions will give you more info. We had a guy here who had his at the end of January but he hasn't reported in for a long time. Guess he's okay so that is good. And hopefully you'll hear from Saucer.

Has your surgeon said anything about getting fitted for your neck brace before surgery? You might be able to. And then get your hair cut...nice and short in the back so they can more easily shave it...ask your doc about how far up he'll go. If I had it to do over, I'd make up lots of meals in the freezer or get in favorite TV meals for yourself(breakfast, lunch and dinner). Let others fend for themselves. The easier it is to do ANYTHING is what you want. The anesthesia leaves you very tired and the pain meds can leave you constipated and little appetite. My doc had me take a vegetable laxative prior to surgery and then once I woke I got them daily. They don't want you to strain to have a bowel movement. So make sure you have meals with lots of fiber. Start lining up drivers for any appointments you might have until your brace is off. In most states, it's illegal to drive with a hard neck brace on.

I'll stop there in hopes that Saucer joins us with ideas. Any questions, ask away.

hugs.....Jenny

 
Old 03-31-2011, 06:10 PM   #5
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Re: posterior fusion c2-c5

Thanks so much! I was thinking about putting the meals in the freezer over the next couple of weeks. My husband really does take care of himself and my kids are grown (and live nearby so they can help if needed).

I will definitely take your advice about the pain meds.

Yes, it is illegal in Colorado to drive with a neck brace. I have a really low key easy job and work just a ten minute drive from home on not so busy streets and not during rush hour.

I guess I'll stock up on prune juice!

Wow! that is a long incision. I am planning to get a short haircut and a pedicure before the surgery! Maybe I'll have my toenails painted neon pink! Just to cheer me up. I had been thinking about the haircut and now you have convinced me that it is the right thing to do.

 
Old 03-31-2011, 07:43 PM   #6
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Re: posterior fusion c2-c5

Hold off on the pedicure. They may not allow toenail polish. They check nail bed color to assess blood O2 and although you have fingernails, they do this surgery with you face down so they may want to be able to check the toes. and they do nerve testing all the way to your toes during surgery. Ask your doc first or his PA or nurse.

Don't plan on going back to work for at least a couple of months or longer. You will be TIRED. And spine surgery never goes smoothly in that you start to recover and feel better and then nerves starts to heal and they ZAP you with pain to say hello. So you actually hurt more during recovery than just after. And once that neck brace comes off, your neck will hurt. Those neck muscles atrophy while the brace is on and once off, it hurts to move and hold your head up. If the brace is on for 6 weeks, it will take about 6 weeks to get rid of the pain of having it off......8 weeks on and 8 weeks to recover and so on.

This is about as major a surgery as it gets. Remember, the spine is an extension of the brain. Give it and you plenty of time to heal.

Hugs..............Jenny

 
Old 03-31-2011, 08:06 PM   #7
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Re: posterior fusion c2-c5

good to know about the toenail polish

 
Old 04-01-2011, 07:37 AM   #8
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Re: posterior fusion c2-c5

Quote:
Originally Posted by Jude4340 View Post
Hello! I am facing fusion surgery C2-C5 in about three weeks. I have a really narly C2-C3 facet issue with bone spurs and bone on bone that causes constant pain. The CT shows some degeneration at 3 - 7.

When I had my facet injections it did not relieve the pain which gave the NS pause to move forward. In fact the injection in the c2,3 joint hurt so bad I nearly came off the table and it hurt for days. The NS was not happy that the injections were not successful as that is a strong diagnostic tool.

In spite of the failure of the injections we have elected to go forward based on my pain and the CT scan. He has cautioned me that it may not be successful but he is optimistic about it. I am hopeful that I can resume my regular activities and move foreward in the years to come without being limited by pain that has begun to cause depression and isolation. It has made a difference in my personality for the last year and I am so ready to get my life back.

Here are my questions for those who have had cervical posterior fusion:
  • What did you do, if anything, to prepare your body for surgery?
  • Which vertebrae did you have fused?
  • How long were you in the hospital?
  • Was it really painful afterwards? For how long was it painful?
  • Did you need much help at home for the first week?
  • How long did it take before you felt like you were back to normal activity?
  • Does it still bother you at all?
Hi Jude,
I was fused from C4-C7 since I was 19, Im 51 now. Mine occured naturally, they call it congenital. I had surgery in 10/10 to fuse C2-C4 and also to insert rods from C2-C5 to lift my head as is was falling down from the 1st surgery (a laminectomy) in 1994.

To answer your questions, believe it or not I excercised to get my body ready. Carefully of course but I wanted to be as strong as I could be for the recovery.
It was extremely painful in the hospital I was there for 5 days. The pain wasnt so much from the surgery as it was from the laying in bed. When I got up and moved around it seemed to help. I was in the hard collar for 4 months.
I am still numb from the top of my head (in the back) to the middle of my back. In front Im still numb in the throat area. They did the C2-C4 fusion anterior and the rods posterior.
Normal activity? not yet. Im hoping to start excercising again in a couple of weeks as I belong to Curves and I know I cant do the exact program never could but I want to do the best I can. My back hurts so bad due to problems with the neck being so stiff.
I started driving again in 2/11, with my husband with me. I do really good, no constant lane changes like before but still pretty good.
I went yesterday by myself first time since before the surgery and did fantastic though really nervous.
You asked about normal, I am quite stiff. Maybe I can turn my head left about an inch, right alittle more, up maybe 4 inches and down not at all.
I joke that Im like a PEZ container. My Dr didnt want to fuse C2 as it causes so much loss of ROM but he had no choice he said. I trust him.
I hope I helped you, and I wish you luck.
If I can be of any comfort let me know as these forums have helped me so much.
Good Luck,
Saucer

Last edited by Saucer; 04-01-2011 at 07:41 AM.

 
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Old 04-01-2011, 07:58 AM   #9
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Re: posterior fusion c2-c5

PS Jude,
I forgot to tell you, my doctor had Occupational therapists at my house within the first week I was home. They wanted to make sure I could take care of personal hygenine, feed myself, shower and dress even though I have a husband to help me. They said I was do well.
Also I have atrophy in the ligaments in my neck so no PT needed. The muscles are rock hard, happened after the 94 surgery.

 
Old 04-01-2011, 08:03 AM   #10
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Re: posterior fusion c2-c5

I have been such a couch potato for the last three months. I went out for a long walk yesterday and I am going out every day that I can. I have some light weights that I can use. My daughter in law recommended that I use Goodbelly probiotic drinks that support the digestive and immune system.

Since I have made the decision to go forward I have had some anxiety about my decision. It is elective and my decision. I don't have any nerve pain like other people do. No shooting pains, no numbness etc. but I just feel like I have an ice pick in my neck all the time. It makes me tired, weepy, impatient and depressed. When I try to do a normal days activity I suffer more. Now I am having weird scarey dreams about being lost in the hospital. Weird huh?

The recovery instruction sheet from the doctor says only about a week off work, return to driving in about a week and 1 to 2 nights at the hospital.

< edited >

From what I have been reading from other posts those goals seem pretty optimistic.

Last edited by hb-mod; 04-01-2011 at 08:29 AM. Reason: Please don't post unapproved website links, per Posting Policy. Thanks.

 
Old 04-01-2011, 12:00 PM   #11
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Re: posterior fusion c2-c5

I think they gave you the recovery sheet for the front type called an ACDF. It is nothing like a posterior fusion.......nothing.

If I were you, I'd think about a second opinion as they are not telling you the truth. You WILL lose at least 75% of the movement of your head. You will never be able to see your toes again. aAnd you will have to check with your state on whether you can drive again as you can't turn your head to see who is at the side of you, let along in your blind spot. Here in CT, you can't.

It is life changing surgery and not something to rush into, especially since you don't have the damage that others have.

Find a doc who will tell you the whole truth...I worry about docs who don't tell you the whole story. Just because it is scheduled, doesn't mean you have to go through with it. I would never have surgery like this without a second or even third opinion. Did he ever give you the stats on the chances of coming out of surgery paralyzed? Mine did.........3%. Chances of coming out of surgery pain free/reduced.......30%.

Your doc's lack of candor is scaring me. Should scare you too.

hugs..........Jenny

 
Old 04-01-2011, 12:23 PM   #12
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Re: posterior fusion c2-c5

No, it is the recovery sheet for posterior cervical fusion. I have been moving toward this surgery for a year now and have had a second opinion as well. Thank you so much for your concern though - it is helpful to have input. Believe me I do not take it lightly and I have asked tons of questions.

Maybe I didn't represent my doc very well because he did say I would definitely loose significant range of motion and I would know it and feel it. He showed me by moving his own head. He also told me that 30% of patients do not have success. Which is actually not the same as having a 30% chance of failure. It either will or won't help. I may be in the 70% or the 30%.

My brother had c2-c7 fused and he drives just fine so after talking a bit with him I feel pretty confident that I will be able to drive as well. He is also returning to his part time job of umpiring women's softball but he is about 3 years out from his surgery. I will ck with my state driving laws for sure but I had never heard of that being a law. I do know that you can't drive with a brace.

Given how much I am currently limited with my pain and energy I have decided that it is definitely worth it to sacrifice mobility for comfort. I am anxious to get back to gardening and visiting the museum and the zoo and site seeing and exercise all of which my doctor assures me I will be able to do. I am not an athlete so I wouldn't want to be doing any thing like volleyball, golf, biking etc.

 
Old 04-01-2011, 12:45 PM   #13
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Re: posterior fusion c2-c5

I had an ACDF C5-C7 in 2006 and spent 2 nights in the hospital. I was out of work for 6 weeks from my desk job (required travel but even without travel 6 wk was the minimum). I used to work in Short and Long Term Disability and the standard for ACDF is 6 wk out of work minimum. For posterior fusion of multiple levels 6-10 weeks minimum from even the most light job. Heavier jobs went into months out of work.

Posterior fusion means they dissect through muscles (in ACDF they do not) thus it's more painful than ACDF. I had a 2 level cervical posterior foraminotomy in 2008 and was out of work 7 weeks. The impact to my muscles was permanent, I still have significant muscle pain and spasms. Massage therapists and physical therapists can alleviate it, but the minute I get in my car to drive home it all comes back the first time I turn my neck.

My ACDF went relatively well, but even with C5-C7 I had a small amount of loss of range of motion. With the C6-C7 posterior foraminotmoy I was only in 1 night but that was not a instrumented fusion, it was just opening up the foraminal openings that nerves pass thru and he added some bone chips to help the prior fusion. I lost a bit more in range of motion. I do drive but I have to use special panoramic rear view mirror. After the posterior surgery I found the impact on the muscles made range of motion a bit more limited.

I've been advised I may need C4 added and my surgeon will do it via ACDF. He and the physical therapist said starting at C4 the range of motion becomes more limited. My surgeon said he won't allow me to drive for at least 6 wk after C4, and if he has to add C3 it's could be longer.

Perhaps getting a second or third opinion in the next few weeks would be helpful. I am very worried that you have been provided unrealistic expectations as to post op pain level that can impact ability to be released, realistic hospitalization period, time off work, driving ability, range of motion impact, etc.

You are having a very very very significant cervical surgery. It will change your life forever. In a good way, it will relieve your symptoms if all goes well. But your range of motion is permanently affected and the impact to your muscles can be significant. I have a friend who had extensive posterior cervical fusion and while he has few, if any, symptoms he has severe range of motion limitation and it's noticeable the moment you meet him. He says he only buys cars that have good views from all windows and also purchases the same type of rear view mirrors I have (the ones I buy are "portable" since hubby and I each have a car and we have pick up truck as well so I have to be able to pop it into any car I drive. We both lament about never riding roller coasters again, etc, and having to take special care of our spine after any type of cervical fusion so the remaining areas hopefully remain healthy.

For me, as I said, I now need C4 and possibly C3 added to my C5-C7 fusion. I am SO glad I had the ACDF and the posterior foraminotomy. Both relieved many symptoms, but it has changed my life. Due to a combination of other problems (lumbar spine, hands, knees, feet) I'm now out of work, likely permanetly, but my surgeries were worth it. However, I was always given very realistic recovery expectations. I remember on the posterior foraminotomy surgery my doc saying "this will hurt and for about a month you'll want to scream at me when you see me, but if we can free up the nerves eventually the pain will be reduced" and it was. And indeed I was ready to scream at him for quite a while.

In making my decision I looked at all types of resources to see if the restrictions, expectations, etc that the doctor gave me were realistic. If I had found anything that was far different from what he had said I'd have been right back in his office saying "how can you say I won't have a reduction in range of motion when from what I've seen........................." Etc
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Old 04-01-2011, 01:12 PM   #14
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Re: posterior fusion c2-c5

Quote:
Originally Posted by Jude4340 View Post
I have been such a couch potato for the last three months. I went out for a long walk yesterday and I am going out every day that I can. I have some light weights that I can use. My daughter in law recommended that I use Goodbelly probiotic drinks that support the digestive and immune system.

Since I have made the decision to go forward I have had some anxiety about my decision. It is elective and my decision. I don't have any nerve pain like other people do. No shooting pains, no numbness etc. but I just feel like I have an ice pick in my neck all the time. It makes me tired, weepy, impatient and depressed. When I try to do a normal days activity I suffer more. Now I am having weird scarey dreams about being lost in the hospital. Weird huh?

The recovery instruction sheet from the doctor says only about a week off work, return to driving in about a week and 1 to 2 nights at the hospital.

< edited >

From what I have been reading from other posts those goals seem pretty optimistic.
Jude,
Dont sweat the couch potato stuff, I sat after the first surgery for years.
I did the excercises they wanted me to do but that was it. I couldnt hold my head up. When they did the laminectomy on C4-5, that was it for me.
My newest surgeon said this can happen with that kind of surgery.
I put so much faith in the first doctor when he told me he made a larger gap between 3 and 4 so they would not fuse. Well that wasnt true as they fused in the back called a bony bar and my spine continued to fuse to T3.
I have never worked again. I filed for SSD in 94 and was denied. I just left it and have recently reopened it as this is a congential disease with me and the fusing is continuing.
The best thing Jude is to get all the information you can, all people are different. I wish you luck in your surgery.
Saucer


Fused C2-T3

 
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Old 04-01-2011, 01:53 PM   #15
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Re: posterior fusion c2-c5

Jude: Forgot to ask, but has the surgeon mentioned a post-op collar? I had an aspen collar after fusion and it helped support my muscles and keep me in good positioning during recovery. After my posterior foraminotomy I wore it but only when I felt muscle fatigue and pain (with ACDF I wore it 23.5 hours per day, only took it off to shower).
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Last edited by SpineAZ; 04-01-2011 at 01:54 PM.

 
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