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Old 07-26-2012, 12:27 PM   #1
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C1-C7 Neck Fusion Surgery

I am a 34 year old female and I just found out that I will have to have neck surgery due to my neck closing in on my spinal cord. It is already causing brusing. They will have to fuse C1-C7, has anyone had this problem or had this surgery done? They are hoping to go in through the front, however we are waiting on x-rays to see if my jaw bone is in the way. Please help in anyway. Thanks!!

 
Old 07-26-2012, 12:50 PM   #2
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Re: C1-C7 Neck Fusion Surgery

May I ask what your MRI findings were?

I have never heard of anyone having their entire cervical area fused...That would be a 6 level fusion!!!!

Unless you were in a horrible accident and this was immediate surgery from the ER to the Operating room...

I would not be having this surgery until you get at least 2 more opinions from Board Certified Neurosurgeons...

Obviously I am not a Dr...but anyone who is well enough to be at home...be using their hands/arms to use a computer....there is no way in heck I would allow someone to do that many levels....It's pretty much un heard of....

 
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Old 07-26-2012, 01:14 PM   #3
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Re: C1-C7 Neck Fusion Surgery

I have had 2 neurosurgons look at my MRI and CT scan and it is true. What is happening is that my neck is closing in on my spinal cord all the way down. They figure I was born with neck issues. C2-C3 are already naturally fused together as well as C6-C7. I can post my CT and Mri reports, however they are about a page in length each. I started having problems with my balance and arms going numb, as well as holding small objects, this is why I went in. The brusing of the spine is at C1 and C2, the only fluid left around the spinal cord in my neck is at the very top. I saw Dr. Jackson in Dallas and I am going is Dr. Ellis in Fort Worth both seem to agree on the issues. Do you know of anyone that has had something like this done?

 
Old 07-26-2012, 01:31 PM   #4
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Re: C1-C7 Neck Fusion Surgery

I've had 3, two-level fusions because of herniated discs and yes...the same thing where the vertebrae have collapsed on the spine..

I had loss of feeling in arms/hands and dropping things....

I've seen 3 level and then some who have had 4 level as the absolute max.

I still have never seen a 6 level fusion unless someone was in a bad accident and as I said...being wheeled from the ER straight to the OR and this was the only way to save their life and keep from being paralyzed...

Are you still working? Driving? Can you still walk?

Again..I'm just speaking for myself...and all I can say is there is no way I would let them fuse all 6 levels based on just those symptoms....that would be based on a two to three level issue..

I was more just asking about the findings of the MRI which is usually the "conclusion" at the end of the radiologists report...

To me....I would rather go back again like I have done with having 3 surgeries and have them do more levels "if needed" than have them do all 6 at once and you can't go back...

My last surgery for the two levels they went in from the front of the neck and then turned me over and went in through the back to shore up both sides with titanium plates/screws/rods..

Because you are not in the ICU or in the hospital right this moment and they aren't doing this as an emergency surgery...I just can't see their reasoning to fuse all 6 levels......

That's just my thoughts though...you obviously need to make your own choice...

Are they telling you this is elective surgery or mandatory?

I would just be asking each of these Drs....( I'm assuming you have met with both of them face to face?) what risk is there for not fusing all 6 levels and how many of these surgeries have they done before?

Last edited by Ilovemycutedog; 07-26-2012 at 01:34 PM.

 
Old 07-26-2012, 01:57 PM   #5
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Re: C1-C7 Neck Fusion Surgery

They are tell me that it is mandatory to keep me for being paralized. I still work full time and dirve, I am also a mother of two who keep me running. I have seen each face to face and both told me that same thing. Due to the fact that the top and botton is already fussed, the middle has several bone spurs and are starting to fuse as well. I was told that if I did not fuse them all due to the shape that they are in from doing all of the work, that they would blow out within a year. I am guessing that you are not the only one who has not heard of this beacuse I also posted this on the Back page and after 200 viewings you are the only one who has responded. I was also told any bad hit to my head or car accident would more then likly paralize me.

 
Old 07-26-2012, 01:59 PM   #6
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Re: C1-C7 Neck Fusion Surgery

When I see Dr. Ellis again, I will ask how many of these he has completed, I do know that he is the best in the area for doing this.

 
Old 07-26-2012, 02:00 PM   #7
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Re: C1-C7 Neck Fusion Surgery

HM - It's good that you've gotten two opinions. Given the extreme nature of the surgery, I think it's very advisable to get TWO MORE. Seriously. And make sure they're surgeons who don't even know the first two.

I believe there have been people posting here who've been fused C3-T1, but fusing from C1 is a whole 'nother ball game. I've been told that 50% of your neck's range of motion comes from C1-2 (or maybe it was C1-2 + C2-3), while 50% comes from the other cervical vertebrae. So you're looking at virtually no range of motion in your neck, which means no driving.

I, too, would urge you to post your MRI findings. Of course, we aren't doctors and can only give amateur opinions, but we can at least provide ideas for you to discuss with the doctors you talk to, and if there's a possibility of less drastic surgery, that may also occur to us.

 
Old 07-26-2012, 02:17 PM   #8
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Re: C1-C7 Neck Fusion Surgery

Thanks for the input, I will type up my MRI and CT tonight and post them. My C1 and C2 are already naturaly fussed, so I am already very limited on my neck movement. I never though to ask if I could drive or not after, he seemed like he had done a lot of these and it was no big deal. I will do some more checking now.

 
Old 07-26-2012, 02:21 PM   #9
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Re: C1-C7 Neck Fusion Surgery

Quote:
Originally Posted by hmoser View Post
They are tell me that it is mandatory to keep me for being paralized. I still work full time and dirve, I am also a mother of two who keep me running. I have seen each face to face and both told me that same thing. Due to the fact that the top and botton is already fussed, the middle has several bone spurs and are starting to fuse as well. I was told that if I did not fuse them all due to the shape that they are in from doing all of the work, that they would blow out within a year. I am guessing that you are not the only one who has not heard of this beacuse I also posted this on the Back page and after 200 viewings you are the only one who has responded. I was also told any bad hit to my head or car accident would more then likly paralize me.
I just can't imagine needing all 6 done right now if you are not in the hospital and are able to work, drive, and do regular things...

I had dozens of bone spurs and all "severe" herniations in 5 areas of my spine...

I still have 3 severe hernations as well as many bone spurs in my lower cervical to thoracic and lumbar area but there is no way I am having more fusions/surgery unless I am admitted to the hospital and they "have" to do this...

Any one of us with bulging / herniated discs "if" we got into an accident could paralyze us....

There are hundreds of thousands of people who over the age of 25 start having changes in their spine....If you took 100 people off the street right now that age and older....their MRI's would "look" bad....

But many people do not have any symptoms at all....So the MRI is only one small way to see what is going on...

Are you on heavy duty pain medicine right now? How about nerve pain medication ?

I am on 90mg of MSContin a day plus OxyIR for breakthrough....as well as Flexeril (muscle relaxer) and Ambien for sleep at night...

Again...my Neurosurgeon is rated as one of the top 25 in the country...(I am lucky to live just outside of DC and the spine institute surgeons take care of all the sports teams here and people fly from around the country and Europe to see them...Same with my PM Dr...

The reason I mention this is because they would never do a 6 level on those cervical levels if someone was still active and living their life but having "some" numbness and tingling....

I am just really worried for you that you are being given information based on them wanting to do surgery....

As Webdozer mentioned.....seeing two or even three more BC Neurosurgeons who do not know these two Dr.s is imperative to do....

Since you are not in the hospital now (I know I keep bring this up but it's an important distinction)....you have time to get more opinions and make decisions about this surgery....

Being fused in all 6 levels...you will have literally no movement in your neck....

Are they going to put titanium rods/screws/plates?

Are they using donor bone?

Are they using BMP?

How many days in the hospital for this surgery?

And when I asked if they had done this before...I'm not talking fusions...I'm talking 6 level cervical fusions...how many times have they done this?

The part that makes me skeptical is why they need to do an x-ray to see if your jaw is in the way....If they have done this before...wouldn't they already know this? Everyone's spine is set up the same way.....

*And just want to add...I'm really not trying to give you a hard time...I am just very concerned for you and I don't even know you!!! You have two kids who need you....So that is why you absolutely should spend a lot of time researching and getting more opinions on such an extreme surgery that is truly un heard of for most people in the cervical region..

Last edited by Ilovemycutedog; 07-26-2012 at 02:29 PM.

 
Old 07-26-2012, 03:43 PM   #10
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Re: C1-C7 Neck Fusion Surgery

I will look into another opinion, that was why I got two after my initial back doctor told me the same thing. Here is my MRI, if anyone can understand it please let me know. As for a jaw x-ray, my first doctor took one, however he told me that he need to see if my jaw bone was in the way for him being able to get to the top. Not eveyones spin is created the same. I have a straight neck(was born with it, no curve). Take a look at my MRI and can type up my CT as well if need be.

MRI Findings:
At C2-C3, osseous fusion is identified at this level without canal stenosis or neural foraminal narrowing. At C3-C4, posterior osteophyte/disk complex measuring 3.5mm and asymmetric right facet arthrosis cause severe bilateral neural foraminal narrowing with severe canal stenosis. The thecal sac measures 7.5 mm in AP dimension. At C4-C5, posterior osteophytes and disk complex measuring 3mm causes moderate right/severe left neural foraminal narrowing with severe canal stenosis. The thecal sac measures 7.7mm in the AP dimension. At C5-C6, posterior osteophyte/disk complex measuring 2mm causes moderate to severe bilateral neural foraminal narrowing with moderate to severe canal stenosis. The thecal sac measure 8.8mm in AP dimension. At C6-C7, no HNP, canal stenosis or neural foraminal narrowing is indentified. At C7-T1, no HNP, canal stenosis or neural foraminal narrowing is identified. At T1-T2, osseous fusion is identified at this level without canal stenosis or neural foraminal narrowing. At T2-T3, no HNP, canal stenosis or neural foraminal narrowing is identified. No evidence of compression fracture or subluxation is identified. Faint T2 hyperintense signal within the cervical cord at the level of C3-C4 suggestive of cord myelomalacia due to sever canal stenosis. The craniocervical junction is unremarkable. The marrow signal is normal. A small Schmorl’s node is identified along the superior endplate of the C6 vertebral body. Heavily T2 weighted STIR images reveal no adnormal edema signal. Incidental note is made of prominent lingual tonsils. Mild adenoidal hypertrophy is noted.

Impression: Congenital changes of osseous fusion identified at the levels of C2-C3 and T1-T2. Sever canal stenosis is identified at C3-C4 and C4-C5. T2 hyperintense focus within the cervical cord at the level of C3-C4 suggests cord myelomalacia. Moderate to severe canal stenosis at C5-C6. Severe neural foraminal narrowing on the left at C4-C5 and bilaterally at C3-C4. Moderate to severe bilateral neural foraminal narrowing at C5-C6. Moderate right neural foraminal narrowing at C4-C5.

 
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Old 07-26-2012, 03:52 PM   #11
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Re: C1-C7 Neck Fusion Surgery

I will look into another opinion, that was why I got two after my initial back doctor told me the same thing. Here is my MRI, if anyone can understand it please let me know. As for a jaw x-ray, my first doctor took one, however he told me that he need to see if my jaw bone was in the way for him being able to get to the top. Not eveyones spin is created the same. I have a straight neck(was born with it, no curve). Take a look at my MRI and can type up my CT as well if need be.

MRI Findings:
At C2-C3, osseous fusion is identified at this level without canal stenosis or neural foraminal narrowing. At C3-C4, posterior osteophyte/disk complex measuring 3.5mm and asymmetric right facet arthrosis cause severe bilateral neural foraminal narrowing with severe canal stenosis. The thecal sac measures 7.5 mm in AP dimension. At C4-C5, posterior osteophytes and disk complex measuring 3mm causes moderate right/severe left neural foraminal narrowing with severe canal stenosis. The thecal sac measures 7.7mm in the AP dimension. At C5-C6, posterior osteophyte/disk complex measuring 2mm causes moderate to severe bilateral neural foraminal narrowing with moderate to severe canal stenosis. The thecal sac measure 8.8mm in AP dimension. At C6-C7, no HNP, canal stenosis or neural foraminal narrowing is indentified. At C7-T1, no HNP, canal stenosis or neural foraminal narrowing is identified. At T1-T2, osseous fusion is identified at this level without canal stenosis or neural foraminal narrowing. At T2-T3, no HNP, canal stenosis or neural foraminal narrowing is identified. No evidence of compression fracture or subluxation is identified. Faint T2 hyperintense signal within the cervical cord at the level of C3-C4 suggestive of cord myelomalacia due to sever canal stenosis. The craniocervical junction is unremarkable. The marrow signal is normal. A small Schmorlís node is identified along the superior endplate of the C6 vertebral body. Heavily T2 weighted STIR images reveal no adnormal edema signal. Incidental note is made of prominent lingual tonsils. Mild adenoidal hypertrophy is noted.

Impression: Congenital changes of osseous fusion identified at the levels of C2-C3 and T1-T2. Sever canal stenosis is identified at C3-C4 and C4-C5. T2 hyperintense focus within the cervical cord at the level of C3-C4 suggests cord myelomalacia. Moderate to severe canal stenosis at C5-C6. Severe neural foraminal narrowing on the left at C4-C5 and bilaterally at C3-C4. Moderate to severe bilateral neural foraminal narrowing at C5-C6. Moderate right neural foraminal narrowing at C4-C5.

 
Old 07-26-2012, 04:21 PM   #12
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Re: C1-C7 Neck Fusion Surgery

OK, that report could have been better, but I've seen worse. What's missing is any direct indication of whether you might have what called hereditary (or congenital) canal stenosis, which means that you've always had a spinal canal that's narrower (AP, that is, front-to-back) than is optimal. People with this condition (including me... I'm not sure it's all that unusual) have less "leeway" in the canal (which is normally filled with spinal fluid), and thus, intrusions from things like disk/osteophyte complexes have an exaggerated effect on both the spinal cord and the neural foramina (the openings in the side of the spine through which pass the nerves heading down to your arms).

You may (as I do) have what are called "short pedicles", the pedicles being part of the side of spinal structure that serve as sort of "spacers". If the pedicles are short, both your canal and your foramina are more likely to be affected by posterior protrusions from the disks and vertebrae.

Anyway, if you DO have an abnormally small spinal canal, one surgical alternative is to directly address this by going in from behind, cutting through one side of the lamina (the bones in the back/sides of the spinal structure), swinging the lamina open, and then maintaining that opening with implants. This procedure is called a "laminoplasty". A similar (and one might say a more primitive) procedure is the "laminectomy", where the lamina are simply removed altogether.

I've had an ACDF at C3-4, then a laminoplasty at C4-5-6 last summer. I really could not say if you are a candidate for a laminoplasty or not. One countraindication is kyphosis, where the normal backward-bending curve (lordosis) of the cervical spine is reversed. You said you had a "straight" spine, so I don't know if that's bad enough to rule out laminoplasty, but it might be.

Another downside to laminoplasty, as you've probably already guessed, is that it does nothing about all those protrusions into your canal that are coming off the vertebrae and disks in front. The laminoplasty gives you more space, though, so your spinal cord can move backward to "escape" those protrusions.

Another thing about laminoplasties is that it may be best to avoid doing the C7 level, as that is a major muscle anchor. The surgeon who did mine said he didn't think that would have been a problem, so maybe they've figured out how to get around the muscle issue.

Anyway, I'm mostly casting about for a way for you to avoid having such a drastic surgery, which I think will pretty much finish your cervical rotational range of motion. (which reminds me, you said C1-C2 are fused, but the radiologist doesn't mention it, instead citing C2-C3 as fused. If you can maintain normal range-of-motion at C1-2, that'd be a big help). So I'd suggest you look into the possibility of a laminoplasty (or even laminectomy) as best you can. This may involve casting around a bit, as many surgeons seem to have a one-procedure-fits-all approach, that one procedure being the ACDF. Of course, the surgeons you've already talked to may have considered laminoplasty and ruled it out, I don't know.

You don't want to take a lot of time to do whatever you do. That myelomalacia you might have a C3-4 could well be the source of your leg troubles, and you don't want to give that a chance to get worse.

Of course, all this is coming from an amateur who's just had a little too much personal experience, and can't in any way substitute for physicians' judgment. I have to say, though, that your MRI is as bad as I've seen. Mine was worse at one level, but your problems are so much more widespread. I'm really sorry you've been dealt this hand...

Last edited by WebDozer; 07-26-2012 at 04:25 PM.

 
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Old 07-26-2012, 04:22 PM   #13
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Re: C1-C7 Neck Fusion Surgery

Since we aren't Drs. here we are just giving our thoughts based on what we know from our own issues...

It looks very similar to my MRI's as we mentioned...when the words severe are written...that is where there are the most issues.

I will say that there is nothing about any problems of C1-C2 or C6-C7. In fact with C6-C7...it says there is not any stenosis or foraminal narrowing.

And with C2-C3....it is a bit of natural fusing due to congenital issues but that also says there is not any stenosis or foraminal narrowing in that area...

This is why I don't see why they would touch C1-C3....Most of your issues are between C3-C6....That is only 3 levels....

Why would they touch any of the others? Why would they re-fuse an area that is already naturally fused and without any narrowing?

(These are questions I would ask of them)

Again....just from everything you have written....I can say if it were me....I would wonder why they are touching anything else but those 3 levels as it makes sense to try and fix those.

As I wrote...I still have 4 severe herniations but am managing them with medication, PT, and injections...

As Web mentions...it's all about weighing the pros/cons of each fusion level.

And I will reiterate...I know I am asking so many questions as I am a curious person..LOL....I just hope and pray that whatever is done is for your best interest and works out well for you.

Last edited by Ilovemycutedog; 07-26-2012 at 04:37 PM.

 
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Old 07-26-2012, 04:32 PM   #14
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Re: C1-C7 Neck Fusion Surgery

Yes, C6-7 and C7-T1 don't seem to need work. Maybe the surgeons are thinking that if they fuse down to C5-6, and T1-2 is already naturally fused, then the two currently-OK levels in between are bound to give way over time ("Adjacent Disk Syndrome"). This may be true, and it may not be. If that's the reason they want to fuse those two levels, then you have to weigh that against keeping at least a little range-of-motion by not doing those two levels, at least not now.

 
Old 07-26-2012, 05:47 PM   #15
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Re: C1-C7 Neck Fusion Surgery

Thanks for all the advice. I will see another opinion, however I am guessing that they will say the same. I have already had one back, doctor and two neurosurgeons, say the same thing. They all come from diffferent offices. I did ask Dr. Ellis if they could just fix the top and botton, however he did say that due to the ware on the middle section and more once they do the surgery that i would be back in a year to have them done because they would blow out(his words). They have to fix the natural fusion because they are still closing in on my spine. By putting in the nuts and bolts, i guess it will stop that. I was just hoping to find someone that had been through this, this is something that I have been dealing with my whole life, and with my spinal cord already bruised, I don't know what chance I want to take with it. I do not use my neck for driving as it is now because I can not move it much, including up or down I have to use my mirrors. I will let you guys know what my next opinon has to say. Thanks for everything.

 
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