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  • Cervical Spine Surgery - Rear Approach???

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    Old 04-10-2009, 06:51 PM   #1
    Robbie445
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    Cervical Spine Surgery - Rear Approach???

    Hi Everyone,

    I have another question. As some of you know, I'm soon to have C-5, C-6 & C-7 fused. However, I have an issue that I'd like to raise here and get your opinion on.

    Of course, I use my voice constantly in my profession. I am a Christian Recording Artist. My voice is the tool that I always utilize and need.

    I understand that there are some slight risks of damaging the Larynx and also the nerve going to it during this surgery. My surgeon and I are going to discuss the risk on Wednesday in depth and I will decide at that time whether or not I want him to perform the surgery through the front or the back, in other words a Posterior approach versus an Anterior approach.

    Has anyone here had Cervical Spine Surgery in a similar fashion and if so what was it like? What was the recovery like?

    My Surgeon told me that because of the muscle and tissue that would have to be cut into from the Posterior approach, the recovery and pain would be much more intense and lengthened.

    Anyone with insight into this situation, your input would be greatly appreciated.

    Thank you all once more as always and God bless!

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    Old 04-11-2009, 04:46 AM   #2
    sunshine221
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    Re: Cervical Spine Surgery - Rear Approach???

    Hi

    I dont check back often. I had the rear approach, a C4-C7 laminectomy in Sept 05. My understnding is that this is the older technique but it made sense to me as far as range of motion, etc. A laminectomy "frees" the constriction but without removing the disks so there are no plates and no fusion. The recovery wasn't that difficult. I was surprised that I couldn't lift my arms well right after surgery but within a week it was significantly improved. I couldn't drive for 8 to 10 weeks but I was back to work in 2 weeks (taking breaks to rest flat every few hours). See my old posts and I'll try to check back to see what you decide.

    Sunshine

     
    Old 04-11-2009, 11:23 AM   #3
    jennybyc
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    Re: Cervical Spine Surgery - Rear Approach???

    I've had 2 posterior cervical spine surgeries. The first was a new surgery called a laminoplasty. They remove the bone over the spinal cord and instead of just leaving the cord unprotected like a laminectomy does, they drill out and re-shape the bone and then replace it with bone sutures and a small graft. No fusion. It was great! Numbness gone, pain gone.

    Then 3 months later I ripped the ligaments in my neck which caused it to invert and go from curved in to curved out, re-crushing my whole spine all over again. So back into the OR and they opened me up from the rear again and fused me from C3 to T1 with a new modular system that allows screw placement before rods are attached so the screws can all be checked before anything is permanent. I awoke with partial paralysis in all 4 limbs and was told I would probably be permanently affected on my left side. NOPE! At a recent check-up with a new neurologist, he did the full exam and told me if I hadn't told him about the surgery, he never would have known. Worked my tail off in PT and about the only problem I have is strength over the long haul. My left shoulder gets weak faster than my right.

    And I am now facing my 3rd posterior cervical as I've herniated the only disk left in my neck...C2-3.

    The recovery is longer and more painful as they have to cut muscles to get to the spine. I haven't had an anterior so I can't compare but once the muscles recover the fusion should be any different. I still had to wear a hard collar for 7 weeks and a soft collar for 5 weeks. I was driving at 5 weeks. I can't say anything about work because I never went back. My job was discontinued while I was out. I applied for and got SSDI(I have rheumatoid arthritis too). It's been 27 months since surgery(today actually)and yesterday I was outside with loppers cutting down thorn bushes and vines and raking out the gardens. So I guess recovery is fine.

    If you fear losing your voice, do the rear incision. I think from what I've read on here that you get a better outcome than the front entry fusions. Seems like those folks are still complaining of pain even after surgery but my numbness and pain are gone and I have no complaints. I re-injured it doing aerobics.

    So talk to your doc and do what is best for you. But I wouldn't fear a posterior for any reason.

    gentle hugs..............Jenny

     
    Old 04-11-2009, 04:15 PM   #4
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    Re: Cervical Spine Surgery - Rear Approach???

    Hello Robbie, First, let me say the people on these boards are great. They give honest and do not hold back advice. I have posted many questions, looking for others who were in the same boat. I have talked with jennybyc many times, and others. I must tell you that I'm waiting to hear when my new surgery will be on my neck, Posterior Cervical. I have had the front done back in 07. I had 4 levels done, plus they removed an entire vertebra and put in what they call a cage. I have plates and screws, and they used my very own bone to help with the fusion. After I awoke from the surgery, I notice I had pain in my shoulders. After getting my meds for pain, I was told this was because they tape down the shoulders to gain more access to the neck. That lasted about 2 days. I was put into an Aspen Collar which I spent 2 months, 5days, and 4 hours!!!! Because of moving the windpipe, to get at where they needed to do the work, I had what felt like a chicken bone in there, and it felt swollen. I had to eat very small bites, because sometimes it felt like nothing would go down right. I must be honest here and tell you, my voice was funny sounding, like a little mouse, AND I could not sing. Just a flat one note. Doc told me this would go away. AND after 9 months, I woke up one morning, and my throat was back to normal, and I could sing in the shower once more. I could reach all the notes I did before. It just takes time. I will need another operation now on the neck , but this time they will approach from the back. I have asked many of these wonderful people for their outcome and results of what they went through. Their info has really helped ease my fear. If I do not get this taken care of, I will end up in a wheel chair, because this is effecting my legs, and walking. No matter what you need to do, or what you have to put on hold, even if its just for awhile, getting this operation in the long run will help with your health, and long life. I know the use of your voice is very important. As you know, I too have put my surgery in the hands of the Lord. He watched over me on my last operation, and I know he will be right there by my side on this one. I hope this has helped you, and not scared you, but we make it through. Each day gets better and better. I hope you find your answer. Good Luck. Janatee

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    Old 04-12-2009, 05:23 AM   #5
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    Re: Cervical Spine Surgery - Rear Approach???

    I realize there is no way of knowing as far as the voice goes. My voice was fine soon after. Although till this day my throat (front of the neck area) can bother me. I did find it a strain somewhat to sing. Not sure if anyone else noticed of felt that way. I cant give my opinion much on the rear approach but my surgeon said it definantly is not something I would want to do vs the front. This was as he was explaining how important it is to take care during the recovery or if he has to go back in he would do the rear approach & I want to avoid that if possable. I am sure your surgeon will go over the front vs the rear. Captnanny I believe had the rear approach done, perhaps she will see this & give her opinion. I really hope you hear several before making that choice. Everyone is different so either way it would be a tough decision to make. Good luck & god bless, Sammy

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    Old 04-12-2009, 11:00 AM   #6
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    Re: Cervical Spine Surgery - Rear Approach???

    Robbie,
    I was scheduled to have both an anterior and a posterior surgery at the same time last June, but my surgeon was able to stablize everything from the front, so he didn't do the posterior. My husband was prepared to wait for a 5 hour procedure, but it only took 2 and 1/2 hours. I too am a music minister, and my voice was affected slightly for about three months, but I am now back to normal. One of my friends specifically prayed that my voice would not be damaged, without me knowing about it, and that was answered. I had a C7-T1 discetomy with fusion and titanium plate. The recovery for the anterior surgery was not bad, I didn't have much pain. I believe you will have the peace to do what is right for you. Trust God and your doctor.

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    Old 07-20-2010, 04:48 PM   #7
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    Re: Cervical Spine Surgery - Rear Approach???

    HI Robbie
    Just wanted to ask you if you had the Surgery and what you actually eventually had done.
    Cheers Hilton

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    Old 07-20-2010, 06:58 PM   #8
    jennybyc
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    Re: Cervical Spine Surgery - Rear Approach???

    I don't know if Robbie is still around(I'd love to hear from him again if he is lurking) but I've had 2 cervical spine surgeries and both were from the back.

    What are your concerns?

    Jenny

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    Old 07-21-2010, 04:20 AM   #9
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    Re: Cervical Spine Surgery - Rear Approach???

    In 2000 I had cervical surgery for kyphosis. It was a long surgery. They actually had to do 2 surgeries on me. First they went in from the posterior which was to put in Harrington Rods. That part of the surgery was 8 hours long. The following week they did the anterior surgery which was another 4 hours long. This is where they did the bone graft/fusion. If I remember correctly for the anterior portion of the surgery, part of the surgery was done by an Ears/Nose/Throat surgeon before the Orthopedic surgeon did the bone graft.
    My healing process was long in that I had to wear a neck brace for about 5 months. But as far as my voice was concerned I don't recall that I experienced any problems at all from the surgery.
    Good luck and keep us posted.

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    Old 07-21-2010, 04:13 PM   #10
    hilt
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    Re: Cervical Spine Surgery - Rear Approach???

    Thanks for the input, Why did you have Kyphosis? Was it a result of Posterior surgery gone wrong or did it just happen natuarally?
    Cheers Hilton

     
    Old 07-21-2010, 05:48 PM   #11
    jennybyc
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    Re: Cervical Spine Surgery - Rear Approach???

    Hi Hilt. Robbie was considering a rear approach for his fusion as he sang in his church and was worried about his voice being harmed with a front approach(as can happen). In the end, he had the front approach and did fine. No damage to his voice.

    I had both a 4 level laminoplasty and single level decompression from the rear and then 3 months later, due to torn ligaments, had to have a 6 level fusion, also from the rear. A laminoplasty is a new version of the laminectomy except the bone is re-shaped and replaced to form a cage over a new, enlarged spinal canal. I may eventually need a laminectomy anyhow as the osteophytes just keep on growing. But for now, at least my cord has coverage. That's the point of the new surgery...to keep the cord protected.

    Anyhow, rear approaches hurt and take a long time to heal. In order to expose the spine well, they have to cut the muscles to the back(muscles heal much better than cutting ligaments) but it makes for a more painful recovery.

    On the positive side, I have a lot less pain than most of the people here. All I have it 2 screws in each vertebra and then the rods that hold the bones are attached to the screw heads. Everything is titanium so I can still have MRI's. The rods have some flexibility and that makes the bone stronger. Bone that is absolutely rigid does not heal as strong. I know this from my replaced knees. They were starting to lose calcium within 3 years post-op. So far, the fusion is very strong.

    So although it may be a more painful surgery, for anything long, you are far better going in through the back. In the long run, it heals stronger and with fewer complications. A front entry risks all sorts of problems with the voice, swallowing and other problems as the trachea and esophagus have to be moved over to do the fusion. And with 5, you'd be risking a lot of trouble within the throat.

    I'm very pleased with my 6 level fusion from the rear and even if it does have to be extended(a possibility)the new systems for long fusions allow for a lot more movement than they used to and can be done in segments. I've met people with their entire backs fused and they can sit and drive and do a lot of the normal activities of daily living.

    Any questions I can answer, I'd be glad to.

    Jenny

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    Old 07-21-2010, 06:19 PM   #12
    hilt
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    Re: Cervical Spine Surgery - Rear Approach???

    HI Jenny
    We have spoken before see 4 level Laminectomy or Laminoplasty. You have sure got a lot of knowledge! I agree that for multilevel stenosis plus all the foraminal issues that I have, a posterior approach is the best. Unfortunately in addition to the Laminectomy, I also have to have an ACDF at C6/C7. I know that I am shooting for the stars when I say this, but I really pray that when I have recovered I will be able to go back to Karate - no body contact though. It is part of my dailly living and I actually need it (like a daily fix!) Are you very physically active (gym or sport)?
    Cheers hilton

     
    Old 07-21-2010, 06:53 PM   #13
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    Re: Cervical Spine Surgery - Rear Approach???

    No, I'm not(and sorry I lost track of who you were....senior moment). It's not just my neck that is the problem. I've had 14 knee surgeries and both a replaced. I've had surgery on both shoulders and looking at more. Same with both wrists. Hips will be next on the replacement list.

    I've both osteoarthritis and rheumatoid arthritis with secondary Sjorgren's Syndrome(dries out eyes, mouth and throat, skin...all mucous membranes) and secondary gout(hitting ankles and big toes and even my replaced knees..not fair to have them replaced and THEN get gout!)

    Not much on me works. But I do get out and garden and I hope to be able to get out walking again when they figure out what is causing my newest symptoms with my spine. My biggest form of exercise is picking up and hugging my granddaughter!

    But some days, I'm just happy to be alive.

    gentle hugs.........Jenny

     
    Old 07-21-2010, 07:09 PM   #14
    hilt
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    Re: Cervical Spine Surgery - Rear Approach???

    I Know what you mean. I think it is all about perspective. A friend of mine recently took his vibrant healthy 14 year old on a diving holiday in Malaysia about 4 weeks ago). They did a dive in the morning no problem. Then they did an 18 meter dive in the afternoon. Hi son (the 14 year old) stopped breathing underwater. They pulled him out and he could not see at all. 1 hour later he was in a coma from an air embolysm that had shot through his brain. They have flown him back (on life support) and he is now back in Melbourne. He is completely brain dead. So I guess as serious as our aches and pains are, we have to be aware that there are many worse off!

     
    Old 07-21-2010, 08:41 PM   #15
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    Re: Cervical Spine Surgery - Rear Approach???

    Hello folks,
    I'm still around but haven't been on this site for quite sometime. I pray that you're all doing well or at least heading in that direction. I noticed that someone had inquired recently about my status. I'll give you a brief update.

    I am nearly 15 months post-op. I had the cervical spine fusion at levels 5-6 & 6-7 with an anterior approach. I had previously suffered with Cord Compression and felt that nerve relief immediately following surgery. My pain increased by about 60% or so and then leveled off there. I have been quite pleased with the results and say that it was well worth it. My surgeon was excellent!!! I'm looking at another one at the 4-5 level and also looking at some future lumbar surgery.

    When I first had the surgery I thought my voice just it had been prior. However it was only later after I really put it to the test did I realize that I'd suffered some damage. It's not major and I'm certainly not whining, but I did loose some of my vocal range on the high end. It's a minor problem compared to what some folks are dealing with. Overall my voice is still in good shape but it's not quite what it was before surgery and I definitely notice it when I can't reach ranges that I used to reach with ease. However I'm grateful because I know that I'm very blessed.

    Again I hope you're all well.

    Robbie

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