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Old 08-10-2012, 11:23 AM   #1
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neck surgery

I've posted a few times before, but i don't have the energy to list the MRI analysis. I have three levels in my neck that are bad, degenerated discs, stenosis, bone spurs, etc., neck pain for close to 20 years. The pain used to be limited to the neck and shoulder but has now traveled into my arms, so obviously it's getting worse. Tried PT many times, was totally useless. Massage used to help but not so much anymore. Nerve block helped but current doctor wants to try chiropractor, the only thing I have never tried.
Current doc also talked about fusion surgery, says that it's better than it used to be, they use plastic instead of bone, 25% failure rate. My insurance will not cover disc replacement surgery, apparently. I backed out on a fusion years ago when i heard about the likelihood that other levels might blow out from added stress and set me up for multiple surgeries. I don't take anything for pain because the pain meds ruined my stomach long ago, so when it's acting up I just suffer. It's actually not so bad in the summer months when things are loose, but colder weather means severe pain as things tighten up. I don't know what to do. I just noticed the rule that people are not supposed to give advice. Is that new? Not sure what to make of that rule, since that's why people come here in my estimation, to get some feedback from others in the same situation.

 
Old 08-10-2012, 12:34 PM   #2
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Re: neck surgery

You posted very old MRI's... do you have a new one?

I'm surprised at that 25% failure rate. Didn't know it was so high, especially considering that "failure" probably means "complete failure".

 
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Old 08-10-2012, 12:58 PM   #3
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Re: neck surgery

Yes, I have a new MRI, but the info is the same, just a bit worse. My primary care doctor said the failure rate was 40%. My luck in life has always been bad, so that's why I live with the pain instead of getting the surgery. It's bad now, but if there is a chance that they could make it even worse it scares the crap out of me. And I've pored over many of the horror stories on here, of course. I think the surgeon said that if successful it would give me a 50% improvement/less pain. But like I said before, from what I've read, the disc replacement is the better way to go, but I guess it's not quite the norm yet and insurance won't cover it. I'm not enthusiastic about the fusion surgery, although I'm resigned at this point to accepting the fact that eventually I am going to have to do something about this awful problem.

 
Old 08-22-2012, 03:01 PM   #4
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Re: neck surgery

I don't know what to do. The pain in my arms is getting worse. The doctor suggested I try a chiropractor, because that is the only thing I have not tried, but I'm not too sure I trust a chiro for neck problems. The surgeon also said that he could do a fusion, but that my insurance would not cover disc replacement surgery. I don't have much faith in the fusions, especially with all of the horror stories here. I don't want to do the fusion to find later that other levels need to be fixed. I try to push this issue away and go into denial, until I feel the pain and then I feel anxiety and disgust. I used to be a BADASS. I'm not taking this well at all. I mean, I'd probably go through with it if they could simply assure me that they won't make it worse, but the vague response is that,"Well, sometimes other levels do tend to weaken after the fusion..."
Great.

 
Old 08-22-2012, 04:10 PM   #5
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Re: neck surgery

Braveneck - Just a note on Adjacent Disk Disease, which is the fancy name for "other levels do tend to weaken after the fusion".

There seems to be widespread disagreement concerning just how valid ADD is. Certainly, it would seem to be common sense that removing the ability of one level to flex puts additional pressure on adjacent levels, making them more likely to fail.

However, it is ALSO common sense to note that, while there may be one disk that is the WORST, that one disk is seldom the ONLY one that's going bad. In fact, it might be said that there's a progression over time, with one disk leading and the adjacent disks naturally following. If that's the case, one would expect adjacent disks to fail after an ACDF, not because of increased pressure, but simply because, over time, those disks were going to go bad anyway.

You can find references online to a number of studies, which generally seem to come down on both sides of the argument. You can also find percentages of people who eventually required surgery at an adjacent level years after an ACDF. I believe that in all the studies, such people were in a small minority.

Just rereading your MRI results from four years ago... at the time, it did not seem like an ACDF was called more, that foraminotomies might be sufficient. Do you think that might still be the case?

FWIW, I had a C3-4 ACDF sixteen years ago. At the time, C4-5 was already borderline. Last year, the C4-5 was somewhat worse, resulting in severe spinal stenosis, a very compressed spinal cord. This was, however, somewhat due to the fact that my spinal canal was too narrow to start out with (congenital spinal stenosis), and the operation I chose to go with was a laminoplasty, where the canal was decompressed from behind. So far, so good... the C4-5 has not required an ACDF, although it has only been fourteen months since the operation.

Last edited by WebDozer; 08-22-2012 at 04:16 PM.

 
Old 08-22-2012, 05:23 PM   #6
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Re: neck surgery

A surgeon wanted to do the fusion loooooooong ago. And now, the latest surgeon also seems to want to do it as well. In fact, his assistant even called and asked me outright if I wanted to go ahead and do the fusion, even after I had expressed my doubts about fusions and said that I had heard that disc replacement was better. I don't understand why my insurance won't pay for disc replacement, especially if it is less likely to cause the requirement of more surgeries down the road. But thanks for your input, every bit of info helps me to get a better perspective.

 
Old 08-22-2012, 05:31 PM   #7
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Re: neck surgery

Braveneck... I am sure there are more than a few surgeons out there who just want to do ACDF's, if you came to them with a sore knee they'd want to do an ACDF.

Definitely an argument for rounding up as many opinions as you can, and from surgeons who are experienced in ALL the major alternatives.

As for insurance not paying for disk replacement, I think that's because replacement is considered unproven, and possibly even unreliable.

 
Old 08-22-2012, 05:44 PM   #8
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Re: neck surgery

Yeah, that's the thing...how do you KNOW for sure if it's the best and only way to go? My current doctor is a prominent man in his field, stellar reputation, kind of a big name I guess. Still, in the back of my mind I'm thinking that surgeons are trained to do surgery. That's what they do. Like you said.
I was under the impression that disc replacement is thought to be the better way to go, because there is no decreased mobility, and also the adjacent levels are not effected. But I know it's a somewhat newer procedure. I think they've been doing it in Europe for a while.

 
Old 08-24-2012, 12:35 AM   #9
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Re: neck surgery

One thing-don't let anyone manipulate your neck. That's what chiro's usually do and I'm surprised that an MD would suggest you go to one

Also, I have met several people who have had ACDF's and they have never had to have another surgery. One goes back to 1997.

Last edited by Realhousewife; 08-24-2012 at 12:38 AM.

 
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