I'm 61 years old and scheduled to have a cervical laminoplasty for severe cervical stenosis in 2 weeks. They'll be working on C4-C6 and a little bit of C3 & C7. I haven't had any real pain, just twitching all over and tingling in a hand. My spinal cord is compressed to 6mm. My NS told me I must have surgery to prevent further damage. Needless to say, I'm scared! I don't know anyone, personally, who's had this type of procedure. I already know it's supposed to be quite a painful, difficult recovery, though. Does anyone have any positive, optimistic stories of their recovery?
Sorry to hear your having to have this done. I had anterior cervical disc replacement & fusion at c4-5 & c6-7 in January of this year. I have to say the recovery was better than I thought but also different than I thought. You're lucky you haven't been having a lot of pain. I had a lot of pain & swelling for years before I was forced to seek help. I had had back surgery 10 yrs ago & said I wouldn't ever let anybody else cut on me. but I also had cervical stenosis & the n's said if I didn't I could be paralyzed. As far as recovery, I don't think the pain was as bad as I thought it would be. For the first week it was pretty bad pain,little sore throat. I had a friend that had it yrs ago & they cut one of her vocal cords,so I was really scared. But no problems with that,at first had a little trouble swallowing. About 2 weeks after surgery I started having "crushing " feeling in my shoulders. They said it was normal but it was a very intense pain! But it did finally go away! The main thing I can say is be patient!! Everybody kept telling me that but its hard to do! LOL now that I'm about 5 months post open, I'm glad I had it done. Every once in awhile I still get"electric" shocks in my arms but that too is also normal they say. Good luck & hope you have a speedy recovery!
At least 2 regulars here, including me, have had laminoplasties. I had mine on C3-6 and a C7 decompression. My cord was also down to 5-6mms.
I woke up from surgery with all problems GONE!
It is a tough surgery in trying to hold up your head afterwards but once you get through that healing process, it was great. Unfortunately, I later broke my neck including the grafts put in but it was unrelated to the laminoplasty. Tore ligaments in my neck and the docs are now suspecting it was rheumatoid arthritis in the ligaments and tendons of my neck. My Ra has now caused me to develop multiple dislocating joints from the same problem.
But as for the laminoplasty itself...it was miraculous to wake up and all numbness, tingling and muscle weakness was gone. You won't realize what you've lost until you get it back after surgery. And you still have a full range of motion....no fusion! I am now fused and what a difference...take the laminoplasty!
Webdozer has also had a laminioplasty and I'm sure he'll be along to tell you about his surgery. But it is great surgery.
I went back to work 2 1/2 weeks after my laminoplasty but only 4 hours a day. did that for 2 weeks then went to 6 hours a day for 2 weeks. Then my gallbladder crapped out on me and I had to have that taken out 6 weeks after the neck surgery. I returned to work a couple of weeks after that full time. But my neck broke 12 weeks after the surgery and I had to have my entire neck fused for that.
No....as far as anyone can tell, the surgery had no effect on my neck except that it was more fragile at the time. I really wondered at the time but we got some answers with this last surgery on my lumbar spine. I have rheumatoid arthritis and I've been on very strong drugs for several years. They had to stop my Ra meds for surgery and since they were originally talking surgery in January, I stopped them last October(takes a long time to get out of your system). Well, surgery ended up being in late March so I was off for 6 months and during that time, my joints were fine but I got tendinitis all over the place and developed lax tendons and ligaments all over the place. My doc now says I have a type of Ra that affects soft tissues more so than joints. This may explain why I've torn ligaments in my spine more than once and why I probably tore them in my neck. They become tissue paper thin and tear very easily. My Ra doc feels this is why my neck broke and my neurosurgeon agrees. There was no reason why his surgery should have caused it and a thorough literature search showed no other cases of this happening so I have to agree with the docs. I was getting something down out of a cabinet the other day and I dislocated my left wrist, elbow and shoulder all at the same time.....getting out a bowl. This is a new phase of Ra for me and it's getting very scary. But it explains a lot of weird injuries I keep on getting....including my neck.
As a result of these findings, my neurosurgeon refused to do any kind of fusion in my lumbar and instead, just did an aggressive cleaning out of the foramina and laminectomies at 2 levels. But it worked beautifully. But this time, he put me on tons of restrictions as far as movement after surgery. I'm working with physical therapists to try to figure out how I can move and exercise safely.
So my problems are medical and not from the surgery. In fact, once they fuse vertebrae, it's supposed to stop bone spur formation but in my neck, it's almost as bad as it was when they did the laminoplasty in only 5 1/2 years. I've got cord compression again and moderate foraminal stenosis at all levels. It just won't stop. Frustrating!!!!!!!!!!!!!
I read your chronicles, and found them a bit frightening! How long before you finally felt better? Your last chronicle was about 1 month past surgery. Are you feeling good one year later? I certainly hope so!
Unfortunately, the site administrator cut me off at that point. Actually, I would say that within five weeks of surgery I was fairly active again, and within three months pretty much completely active. The pre-op symptoms, which returned after the surgery, have mostly - but not entirely - gone away. I did develop new symptoms, post-op, "chills" in both arms and both legs. These were more worrisome than bothersome, and they've gone away now. This spring, I'm back doing pretty heavy work, and my spine problems are now more lumbar than cervical.
It remains to be seen how much time this surgery bought me. One year so far, and I'm hoping for at least five.
I hope that if you get C7 worked on, it's just a laminotomy (carving away a little of the inside of the lamina, but leaving it in place). I also hope your surgeon is quite experienced with laminoplasties, and whatever the latest techniques are for dealing with the neck muscles.
I've dug up my pre-surgery MRI, and I'm going to post it. It might be helpful if you could post yours, too. I don't think enough people are aware of the laminoplasty option, and we could provide examples of where they were deemed appropriate.
So glad to hear that after 5 weeks you were so much better! Why were you "cut off" by the administrator? Also, what do you mean by "It remains to be seen how much time this surgery bought me. One year so far, and I'm hoping for at least five." Once your cord is decompressed, doesn't it stay that way from the laminoplasty?
My surgery is 2 weeks from today. My NS is rated in the top 1 per cent of surgeons in the country. He said he was just going to "trim" a little something at C3 and C7. Originally, he was going to do an ACDF C4-C6 (because it's an easier recovery than laminoplasty), but after a cervical x-ray and CT scan he decided on laminoplasty. He will be accompanied by a top flight orthopedic surgeon who has also done this surgery a number of times.
Can you recommend anything I should do in preparation for this surgery? I've been living a pretty sedentary life style (card-playing grandma). I do love to walk, and will walk 4 miles for exercise.
Wow, you say you read 250 pgs. in a book the night you had surgery. Weren't you drugged out from painkillers? I imagine I'll be in La-La land for a few days, no?
Thanks for all your info. I wish others had chronicled their experiences!
<< Why were you "cut off" by the administrator? >>
He said what I was doing was blogging, and he wanted me to use the Blog section of Healthboards, which no one reads.
<< Also, what do you mean by "It remains to be seen how much time this surgery bought me. One year so far, and I'm hoping for at least five." Once your cord is decompressed, doesn't it stay that way from the laminoplasty? >>
The "bridging osteophytes" that were intruding into my canal from in front will, I suppose, continue to grow, as will the hypertrophy of the uncovertebral joints. Maybe I'm just being pessimistic, but I'm assuming it's just a matter of time before they'll need to be addressed directly. Maybe ten years... and in ten years I'll be so decrepit it won't matter.
<< My surgery is 2 weeks from today. My NS is rated in the top 1 per cent of surgeons in the country.>>
Where is he? Who does this "rating"? I've never heard of such a thing...
<< He said he was just going to "trim" a little something at C3 and C7. >>
That may be fairly standard practice in a laminoplasty, that laminotomies are performed on one or both of the adjacent lamina. It makes a lot of sense. My surgeon did a C4-5-6 laminoplasty and a laminotomy at C3.
<< Originally, he was going to do an ACDF C4-C6 >>
I wonder why. This would make your MRI of even more interest on this site, as it would demonstrate a situation where the traditional approach would have been ACDF.
<< (because it's an easier recovery than laminoplasty) >>
<< He will be accompanied by a top flight orthopedic surgeon who has also done this surgery a number of times. >>
I think that means he HASN'T done laminoplasties, himself.
<< Can you recommend anything I should do in preparation for this surgery? >>
Can't think of anything, other than to have objects around the house in locations where you don't have to reach for them. You may have need of a recliner, too.
<< Wow, you say you read 250 pgs. in a book the night you had surgery. Weren't you drugged out from painkillers? >>
Sure, but that doesn't mean you're asleep. I actually think they give you stimulants.
<< I imagine I'll be in La-La land for a few days, no? >>
Yes and no. You probably won't be asleep that much, and you will likely THINK you're alert, but I have to say that I didn't know I had a soft collar on until the surgeon came in and took it off, and I didn't know I had a drain in my neck until it was pointed out to me.
Web...you gave me an idea...maybe we need to explain what a laminoplasty is as opposed to an ACDF as maybe the docs don't always explain it to their patients......they should but they don't.
The traditional approach is to do the ACDF. In that surgery, they go in from the front of the neck, remove the disk that is hitting the cord(provided it doesn't break into pieces) and then they fuse the 2 vertebrae with titanium plates and screws and something between the vertebrae to keep it spaced apart...like a cage full of bone or just a bone graft.
In the laminoplasty, the surgeon goes in from the back. This means cutting muscles and that makes the recovery more painful. When they get to the spine, they cut off the spinous process(the part that makes the spine look like a stegasaurus) and then they open the spinal canal. Now they have 2 options. The canal looks like a triangle(they open it at the top of the triangle) and the 2 sides closest to the back are the lamina bones. In the "Open Door" surgery, 1 of the lamina bones is broken and re-set from a 30*angle to 90* and a bone graft is used to bridge the gap between the top of the lamina bone over to the other lamina, making a much larger triangle so the cord has room to move away from the disk and it's bone spurs. The other type is the "French Door". In this technique, they break both lamina bones and reset both from 30* angles to 60* angles and then used a bone graft to close the gap. Only advantage of this one over the open door as I understand it is that the graft is smaller and the back of the spine remains symmetrical. But the advantage of the open door is that only 1 lamina bone is broken. But the result again is double the amount of room for the cord to expand and get away from the disk and bone spurs.
But the disadvantage of this approach is that the disk and osteophytes are not removed and can slip or grow further and eventually hit the cord again. The big advantage with the laminoplasty is NO fusion is done(and that is huge) and you still have a full range of motion. The spine is not meant to be solid and it can have major effects on the vertebrae above and below the fusion and lead to the fusion begin extended.
Also, if you have blocked up foramina hitting the nerves, they can not be opened up in an ACDF...that has to be done from the back and can be done during a laminoplasty although mine were done during my subsequent surgery.
Web....did you have forminotomies during your laminoplasty?
I have become a true believer in that you do the absolute minimum is surgery on the spine. If you can avoid a fusion, do so...it is old school and should be avoided. We are about the last country still doing them. Go abroad and laminoplasties are being done on the entire spine to relieve cord compression.
So I hope this helps explain in more detail what they are proposing. And I would ask your doc straight out....have you ever done one of these? They've been around for over 10 years. Do you want to be his guinea pig? More big questions.
I supposedly had foraminotomies also. I don't see how the laminoplasty could have addressed the foraminal stenosis from the uncovertebral joints, and that was probably causing most of the neck and arm symptoms.
As for neck muscles being "cut" in a laminoplasty, I asked the PA about that, and she insisted that the muscles were NOT cut. I got the impression, from her, that they've figured out how to avoid that. Maybe, if they'd done C7 (which is much more of a muscle anchor than C4-5-6), they would have had to cut, but the surgeon didn't think that doing even C7 would have been a problem (although, for me, it was not necessary).
Also, I would infer, from my recovery, that muscles were not cut. My post-op pain could easily be ascribed to inflammation, and nothing more.
As for ACDF's not being able to address foraminal stenosis, I would think that depends on the source of the stenosis. If a protruding disk is narrowing the foramen, and that disk is removed, then it would seem to me that the problem is addressed. If, however, the foraminal stenosis is due to hypertrophy of facet or uncovertebral joints, then I guess an ACDF won't help. As for bridging osteophytes, I don't know whether or not the surgeon can get at them when doing the ACDF. I would GUESS that he might be able to.
Webdozer and Jenny, you both sound so knowledgeable about the spine and surgeries to repair it. Thanks, Guys, for all the info. My NS said he's done at least 30 laminoplasties, and the ortho. surgeon even more. They said the reason for the painful recovery is that they must cut muscle when going thru the back of the neck. I believe I'm having an "open door" from the diagrams he showed us.
On Thurs. I'm having MRIs on the thoracic and lumbar regions, to make sure nothing else is going on. Ugh, and I really wanted to enjoy my summer!
Thanks so much for all of your answers.
Here is the site I found that rates doctors, although I believe that "word of mouth," is the most important rating of all, and I know several people who have used my team for intricate back surgery with happy outcomes: http://health.usnews.com/top-doctors
* Bauer, Jerry, MD Advocate Lutheran General Neurosurgeon
Park Ridge, IL
*Icon denotes that a doctor, in Castle Connolly's estimation, is among the top 1% in the nation in his or her specialty. Doctors listed in U.S. News Top Doctors without this icon are determined to be in the top 10% in their region.
Dr. Mardjetko (the orth surgeon) is listed in Becker's Orthopedic & Spine Review, "50 of the Best Spine Specialists in America."
I got a second opinion from a dr. who wanted to do ACDF, but Bauer feels, after reviewing MRI, X-ray and CT scan, laminoplasty will save me from having a 2nd surgery down the road, as the ACDF eliminates pain (which I don't have), but lamino is for decompression. In adition, I had a throidectomy 10 yrs. ago, with an emergency tracheostomy, so there's a lot of scar tissue and clips that he saw in the front of my neck!
Thanks again for all your advice!
Well, I'm 3 1/2 weeks post cervical laminoplasty. I'm so glad to be on THIS side of it, as the waiting, and not knowing what to expect, was torture!
The first couple of days after surgery I was in ICU, and I don't really remember too much. They kept me pretty well sedated with a morphine pump. I just have "glimpses" of memory, such as rinsing my mouth with Listerine. I woke up in a hard cervical brace, and was told to wear it only for my own comfort. After moving to a regular room, my pain was kept at bay with pain meds. I remember being very weak, and having to use a walker to go to the bathroom. PT came in and took me for a walk and had me go up some stairs. Four days after surgery, they sent me home with hydrocodone and muscle relaxants. The back spasms and burning nerve pain down the arm were pretty bad, but hydrocodone helped manage the pain during the first 2 weeks at home. A visiting nurse noticed I had the beginning of an infection in my incision, so Keflex was ordered and did the trick getting rid of it.
So now I'm here...feeling pretty good, excerpt for a stiff neck (LOL) and neck muscles that tire out after 2-3 hrs. I need to rest my head at that point, but no more collar! I'm going to start driving in a day or two, as I'm totally off pain meds., and can twist my body to see over my shoulders. I'm also going to start out-patient PT this week, to get more range of motion with my neck. I'm not totally back to my social activities yet, as I can only go out for short periods of time. But all in all, I'd say I'm doing pretty well. This surgery was difficult, but if it gives my spinal cord the room it needs to be healthy, then it's well worth it. Good luck to anyone else who is scheduled to go "under the knife." If you have any questions, I am more than happy to answer them!