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    Old 02-27-2009, 07:52 PM   #1
    jshu43
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    Need advice on cervical surgery

    I have had chronic neck and back pain (disabling) for over 20 years. I finally got insurance and was told by my neurologist to see a neurosurgeon. He did an MRI and a bone scan and told me that my neck was a mess. I think most of the problem is around C5-C-7. He said that he did think that surgery would be advisable for me and considering all that I have done in the past radiofrequency on my nerves, Botox, lidocaine, physical therapy, etc that my chances of any relief other than surgery was zero.

    He said what I would have is the ACDF and that he thought my chances of good recovery was about 80%. He said there would be no real risks involved other than going through the surgery and then not seeing any results.

    I'm of course excited that there might be some relief. I can't sit for any length of time without just being in agony. I am in bed most of the time. This could be a life changer for me. I am also concerned about having spinal surgery.

    I didn't know anything about ACDF so I couldn't ask him too many questions. He said to go home and do some research and then make an appointment with him if I wanted to proceed. I asked him if it would be day surgery and he said that we would sit down and he would go over my film and figure out exactly what he was going to do when I called back for an appointment. He said I that I might not be able to drive for 10 days or 8 weeks depending on what he did.

    I had asked him if it was a steel graft and he said no that it was a bone graft from a donor. After going home and looking at it I'm not sure what is best - my bone or a donors. Also, he didn't say anything about a metal plate for the fusion.

    He was recommended by several doctors who I respect. I live about 30 miles outside of Houston and he is nearby. I'm also considering going into Houston's medical center to get a second opinion. My cardiologist recommended someone and I looked at their website and they said they prefer:

    "partial hemilaminectomy and decompressive foraminotomy utilizing a less than one inch incision and microsurgical techniques. This can almost always be done in an outpatient setting. In our recent series, 93% of our patients had a good or excellent outcome and we had no serious complications. Preoperative arm pain and weakness almost always promptly improves. Our patients can usually return to restricted activities in a few days or weeks and unrestricted activities in two to three months. Symptoms rarely recur. We believe that treatment of cervical radiculopathies by the posterior approach is much superior to the anterior discectomy and fusion technique in most cases. Reasons for this included the fact that a laminectomy does not create temporary instability and therefore, a cervical collar or brace is not necessary. A scar in front of the throat is avoided. We have found that a fusion results in extra wear and tear on the joints above and below the fusion, resulting in the need for additional surgery years later. Also, the cost of a cervical fusion is usually double that of a laminectomy. In cases of the rarely indicated multiple level procedures utilizing screws and plates, the cost can be as much as four times that of a single level microlaminectomy."

    That sounds reasonable and I know the doctor must be great or my cardiologist wouldn't have recommended him, but I don't really find much support for that approach. Do ya'll have advice? I also know of a doctor at Methodist in Houston who does the ACDF. I was in PT and talked to a patient who raved about him and his new approach he has.

    Should I go to all three doctors? Any other advice on which procedure is the best and should I go with a donor graft or my bone, should I insist on a plate for the fusion? How much pain will I be in? Any other questions I should ask the doctors?

     
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    Old 02-28-2009, 03:36 AM   #2
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    Re: Need advice on cervical surgery

    I cant answer much for you but I would talk to every doctor you feel the need in order to make this decision. Its your life after all. I had the ACDF with plate & all that, the pain from the surgery was not to bad, still recovering. I hope to see you get some opinions here & curious to see myself. Smart to look at all your options. I hope all goes well for you. Good luck & god bless, Sammy

     
    Old 02-28-2009, 05:10 AM   #3
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    Re: Need advice on cervical surgery

    I had ACDF with titanium plate and donor bone in June 2008,and my recovery was very good. The key is to find a doctor that you trust. There was not much pain with my procedure. A neurosurgeon that does very many of these procedures is the way to go. Best to you.
    Kay

     
    Old 02-28-2009, 08:16 AM   #4
    feelbad
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    Re: Need advice on cervical surgery

    one BIG thing here that would actually even dictate just what you may or may not need would be just what exactly IS wrong up in your c spine and the overall severity of it. if you have any areas of spinal cord compromise it would severely limit your options to a few. its just the nature of having cord compression going on. if you have your actual MRI report there, could you post the summary at the very end of that report? this is where any pertinent hard findings would be listed by the radiologist. it would be alot easier to give advise if we knew just exactly what you have going on up there. the description by the rad,word for word really is important to know. marcia
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    Old 02-28-2009, 10:53 AM   #5
    jshu43
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    Re: Need advice on cervical surgery

    I actually didn't get the report - I need to get that I guess. My doctor gave me the film for the MRI and Bone Scan. I'll get that info and post it next week. Thanks!

     
    Old 03-03-2009, 01:38 PM   #6
    jshu43
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    Re: Need advice on cervical surgery

    I've got my bone scan and MRI reports. It's kind of long and drawn out and I'm not sure exactly what's important. Here's a bit of what the bone scan said:
    At the C4 level there was intense uptake involving the left transverse process and facet w/o sig involvement of the body of the vertebra or the right side. C5 & C6 there was intense uptake in the right transverse processes and facets w/o sig involvement of the right side. MRI: C2-C3 Mild left facet hypertrophy. Neural foramina are patent. Mild clockwise rotation of the vertebral body. C3-C4 - Mild left uncovertebral and moderate left facet hypertrophy w/ mild left foraminal narrowing. Mild posteer disc protrusion w/ mild narrowing of the anterior CSF space w/ mild clockwise rotation of the vertebral body. C4-C5: Moderate right paracentral disc extrusion w/ focal effacement of the anterior CSF space and mild mass effect on the anterior spinal cord. There is moderate to severe right and mild left facet hypertrophic changes w/ moderate right uncovertebral hypertrophy resulting in moderate right foraminal narrowing. C5-C6: Moderate to severe right and moderate left facet hypertrophic changes w/ mild bilateral uncovertebral hypertrophy w/ moderate right and mild left foraminal narrowing. C6-C7: Moderate left and mild right uncovertebral hypertrophy w/ moderate asymmetric left broad-based disc bulge w/ mild facet hypetrophy resulting in severe left foraminal narrowing and mild right foraminal narrowing. There is effacement of the anterior CSF space. C7-T1: Mild left foraminal narrowing. Impressions: C6-C7 moderate asymmetric left disc bulge w/ associated moderate left uncovertebral and mild left facet hypetrophy resulting in severe left foraminal narrowing and effacement of the anterior CSF space. C4-C5 Moderate right paracentral posterior disc extrusion w/ mild mass effect on the anterior spinal cord w/ moderate to severe right facet and mild right uncovertebral hypertrophy resulting in moderate right foraminal narrowing. C5-C6 Moderate to severe right and moderate left facet hypertrophic changes w/ mild bilateral uncovertebral hypetrophy w/ moderate right and mild foraminal narrowing.

    I would appreciate any input. I don't understand any of this - it's Greek! So it's kind of hard to know what decision I should make about surgery.

     
    Old 03-03-2009, 06:01 PM   #7
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    Re: Need advice on cervical surgery

    If you are having pain and it is too much and interferes with life, I would/did have cervical spinal fusion.
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    Old 08-21-2011, 11:51 PM   #8
    donoyy
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    Re: Need advice on cervical surgery

    I was reading your thread on surgery whether you do a foraminotomy or a fusion. I wonder what your decision was? You were possibly going to have surgery with neurosurgical group of Texas. I have a c5-6 disc herniation and I am going through the same thing. So I was wondering what your experience was like

     
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