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  • 5 level cervical laminectomy & fusion, anybody?

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    Old 02-22-2010, 05:38 AM   #16
    leahhallett
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    Re: 5 level cervical laminectomy & fusion, anybody?

    <-edited->

    I posted a link to a government site for clinical trials and I posted a message from another message board with information about doctors who do the multi level ADR. Sorry about that.

    Last edited by leahhallett; 02-22-2010 at 08:24 AM. Reason: Please read the posting rules

     
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    Old 02-23-2010, 12:42 PM   #17
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Hi Cotton,

    I have researched spinal soutions since 2002. This info is a mix of my own experience, research, what I have learned from Doctors here in the US and in Europe. So, please don't take it as gospel, just a learning curve.

    I have had 3 Prodisc in my Lumbar L3-L4 L4-L5 L5-S1 by Dr R. B. in Vienna, Austria with great results since 2004, and a fusion at C5-6 by Dr. J. Y. in 2004 at Yale New Haven Hosp, Ct. Both at 37 yo.

    The cervical fusion was successful, because it fused, yet within 2 yrs the fusion herniated 4 other cervical discs. So, I return to my US Dr. and he recommends 4 Prodisc-C, which he can do even though ADRs are approved for one level. Drs. can use multi-level ADRs legally under what is called "Off Shelf" procedure. Now the trick is getting the insurance to pay for more than one disc. They will pay for the surgery for all the disc levels needed, but may only pay for one disc. Any other disc needed may cost you 6k each. So, it might cost me 18k. The hospital does have affordable financing if needed. I still hope they will agree on Germany with Dr. R. B. instead which they are entertaining.

    I am in the appeals process with my Massachusetts B's insurance now because they approved me for the 5 level fusion at 187k but are a little slow on the 4 ADR surgery for 60k. Yes, reread that again because it doesn't make sense to me either.

    This is what I have learned. Fusions are expected to cause adjacent segment syndrome within 5-10 yrs. What this means is the neighboring disc(s) to a fusion may fail, resulting in more surgery. For every disc level that is fused add 10 % more stress on the disc above and below the fusion length. So, a 5 level fusion will put 50%more stress on the disc above and below. Mine was one level (10%)and adjacent segment syndrome happened in 2 years. Keep in mind that my fusion is still considered successful even today because it fused, and it resolved my symptoms of that disc level. Disregard that it ruined the other disc.

    If you look at the back as a whole, it was intended to bend, and once you prevent that it has the potential to cause problems. So, there has been good results with ADR-Fusion-ADR, because it restores full range of motion on both ends. Since you would only have a 3 level fusion with an ADR on top, and the bottom then it reduces the stress to 30%. ADRs can handle 30% stress easily. I know because I have been weight training (carefully around my neck issues) but very heavy on my abs, low back, and legs since 2004, with no issues. So, maybe a mix of both may work for you. I also question the T-1 fusion, that is a very good point.

    Also, seek out surgeons that do both Fusions and ADRs to get there prospective on it. One of my Drs told me ADRs will never work, as I sat in his office surrounded by awards and patents for his fusion technology.

    I hope some of this can help you. I know you are very uncomfortable, and I wish no one had to suffer.

    It sounds like you might be from New England, and if so Ct. shore is beautiful this time of year if you know what I mean.

     
    Old 02-23-2010, 04:24 PM   #18
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Wow. Newbackguy! Thanks so much for your thoughtful reply. I'm reading this as I sit at a Holiday Inn, just a little north of New Haven, CT. If you know where I mean :-). I am going to see a dr. j.y in the morning. I don't know if I'm a candidate. I have been also looking at Germany. The info about the costs is and insurance is also really helpful. Do you know about how many of these multilevels our guy has done? It seems from my reading, the more experienced, the better. I will let you know how my appt goes.

     
    Old 02-23-2010, 04:37 PM   #19
    cotton1
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Everybody. Thanks so much for your thoughtful responses. I'm really grateful for all the info on both sides. I have found 1 or 2 clinical trials for multi level adr. And I think I've tracked down the rew places where it is done in this country, as well as Germany.

    I went back to my first surgeon yesterday, and got some answers to my questions re: fusion. Tomorrow I see another surgeon, and will try to get more info re: fusion vs adr, or even if I am a candidate for adr.

    It is very heartening to hear that some people do well with fusion and go on to lead their lives. Within a few days I will need to zero in on a choice, as I am concerned that my weakness, etc will spread or be irreversible after a certain amount of time goes by.

    None of this stuff is for sissies is it?
    Again, thanks to each of you.

     
    Old 02-28-2010, 12:42 PM   #20
    cwherry
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Quote:
    Originally Posted by cotton1 View Post
    Hi,
    I am scheduled to have a 5 level cervical laminectomy and fusion c3-4 to T1 at the end of this month. I keep looking on line but cannot find others who have had more than 3 levels fused at once. The PA at the doctors office said it is rare.
    I have myelopathy at 2 levels (3-4 and 4-5) and spondelytis throughout. I have a bulging disc at C2-3 and C6-7 and C7-T1. My neck is straight instead of the normal curve. I have no pain really, and pretty good range of motion in my neck. But numbness in my hands, weakness in wrists, tingling in arms.

    I have been to two orthopedic spine surgeons and both say the same thing.
    I'm scared, of course, and wondering if anyone has experience with something like this, with so many levels. I'm wondering if I should still try for a 3rd opinion, perhaps from a nuerosurgeon, although that might mean posponing this surgery. The symptoms are increasing, but very slowly. So, has anyone else been through this at so many levels? Thanks in advance for any advice you can offer.
    I have not been through this many levels, I had C4 through C7, but the most important thing I was told by my neurologist is NOT to let an Orthopedic Doctor do this type of surgery. He was adament that this only be performed by a qualified Neurosurgeon.
    If you have not already had this operation, I would suggest doing your homework and finding a hoghly qualified Neuro for this operation.
    Good luck...

     
    Old 03-31-2010, 09:30 PM   #21
    tl1446
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    Re: 5 level cervical laminectomy & fusion, anybody?

    cotton one ..

    thanks for asking... however i have had such a hard recovery, i am still in pain, not getting any sleep and feel like i was not prepared for this... i feel i should have been directed to a pain mgt doctor much quicker.. i just got referred about two weeks ago..i have been presribed over twenty different types of meds in the past ten weeks.. my lowere extremeties are extremely weak.. i have short term memory loss, and a buch of other complications due to the meds... i am border line depressed and very very frustrated at this point... i am not even sure if i would have done the surgery and took my chances but all 4 doctors said i would wind up in a wheel chair if i did not have it... so here i am today feeling only about 10% better and still have sleepness nites due to pain and stifness..i can only hope my pain mgt dr gets me on track ... i also just started pt but that doesn't seem to help at this point ...i am trying to remain optomistic but have to tell you ...i wasn't prepared for this both physically and mentally....hope your doing well ....sorry it took so long but i haven't been reading this at all..

     
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    Old 04-02-2010, 02:41 PM   #22
    cotton1
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    Re: 5 level cervical laminectomy & fusion, anybody?

    tl1446
    Nothing to apologize for. I'm so sorry to hear how rough it has been and continues to be for you. It is my understanding that this is a hard surgery to recover from. I trust that you are taking it very slowly, not pushing yourself. It is much harder if you have to go back to work, or if you expect too much of yourself. Can I ask, where is most of your pain? In the surgery area, or in the areas that were effected by the compression? Has anyone explained to you what you might be feeling, or why? If it is caused by your nerves regenerating, then perhaps there is a time frame for when that will end? If the pain management doc can help you manage the pain, then you might be able to make quicker progress. It is exhausting to be in pain, to not get a good night's sleep because of pain, etc.

    I have yet to have my surgery! In the course of setting it up, long story short, my new surgeon took an MRI of my thoracic spine just to see if there were problems, and found a tumor. They think it is possibly benign, but it is on the spinal cord. My symptoms are probably still coming from my neck, but now they want to take the tumor out first. So, in about a week I'll be having surgery, but still not fixing the neck. Oye!

    I understand what you are saying about not being prepared, but I have to tell you, being prepared still only gets you so far. Don't push yourself too much, and remember to include whatever progress you have made in your thinking--give yourself lots of pats on the back for coming this far. I wish you the best of luck in your recovery. Please keep me posted.

     
    Old 04-03-2010, 12:17 PM   #23
    cwherry
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    Re: 5 level cervical laminectomy & fusion, anybody?

    tl1446

    I am sorry to hear about your recovery being so difficult. I only had a C4 to
    C7 fusion, but I had been going to a pain clinic for about a year prior to the surgery. I do not think I would have survived the last 11 months since my surgery without him. The surgeon was no help in the pain management department.
    Like you, I was told by 3 doctors that without this fusion I had less than a year or I would be in a wheelchair.

    I hope you have a much better outcome than I had. Needless to say my surgery was less than successful and I am now facing 2 more surgeries to repair my neck.

    They want to do another anterior and remove everything they did, clean up and remove the huge bone spur that has grown directly in to my thecal sac and re-fuse from C3 to C7. The next day they want to perform a posterior C3 to
    C7 de-compression and put rods and screws through the back as well.
    I live in constant pain, although the pain clinic does everything they can to help. I have never made it back to work and am now in the process of filing for disability.

    Listen to your body, if something does not feel right, than it probably isn't. I had a few months of relief after the first surgery and that was it. Like you, I was not prepared either physically or emotionally for this surgery and often wonder if I made the right choice to begin with. I am no better off now, in fact worse than I was a year ago.

    Most good pain clinics are run by Neurologists, they will listen and if you feel something has not worked or you cannot control the pain they will move you in the right direction. Trust them, I do, much more than any surgeon I have ever listened to.
    I wish you well and would be interested to hear back on how the pain clinic works out for you.

     
    Old 04-04-2010, 03:32 AM   #24
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Hi cwherry - I am so shocked by your story. Having only had C6/7 op and with still pain in my arms I am horrified by what you have faced and continue to face. Mine has been bad enough and using my arms difficult. I wonder about a return to work. I wish you well and hope you can look forward to a time in the future that is pain free.

     
    Old 04-09-2010, 07:30 AM   #25
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    Re: 5 level cervical laminectomy & fusion, anybody?


    I am fused 4-7, had a cervical laminectomy in 1994 and now am suffering from another bone spur at C2-3 with disc protrusion. I have the expected head lean. They say they need to do a discectomy and fuse 2,3,4 and then insert a rod posterior from 4-t2. I am scared to death. Im 50 years old.
    The doctor says the complications are tongue paralysis, and swallowing problems. Im not sure what to think. He says we can wait until I start dropping things to do the surgery, but my thought are Im not getting any younger so maybe do this and get it over with? Anyone have thoughts on this?

     
    Old 04-09-2010, 09:41 AM   #26
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Hi Cotton....I've been lurking on this thread and wondering how you made out with the thoracic tumor removal? I am fused from C3 to T1 and had it done at New England Baptist in Boston. It is a long recovery but after 3 years, I feel pretty good.

    Let us know how you are.

    Jenny

     
    Old 04-09-2010, 11:37 AM   #27
    dunerkat58
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    Re: 5 level cervical laminectomy & fusion, anybody?

    I also am looking at a multi-level fusion in my neck. I have no curve in my neck at all and have numerous symptoms - headache, shoulder pain, tingling/numbness in hands & arms. Some days I feel better than others, so I am debating surgery.

    Cotton, I hope you are doing well since your tumor surgery. My surgeon also said it is rare to have multi-levels fused in the neck. I am just not quite ready to do the surgery yet, but I know the longer I wait the worse it will get.

     
    Old 04-10-2010, 10:37 AM   #28
    cwherry
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Saucer,

    I would seriously, if you have not already consider another opinion. If you read my earlier post you will find I am fused C4-C7 only 11 months ago and now they want to do 2 more surgeries very much like you. Up another level anterior and rod 3 to 7 posterior.
    Recent CT scan shows moderate bone spur C5-6 with moderate encroachment on the thecal sac and foramin closed as well.
    It is fantastic that you recovered from your 1994 surgery, may I ask what that was for?

    I went for a second opinion a few days ago since I am not to happy to rush in to 2 more surgeries less than a year later and was told that much further testing would be needed to even render an opinion on the value of a re-op.
    Let me know what you decide to do and if you do have this upcoming surgery, I would like to hear the outcome.

    I am scared to death and at 47 yrs old never imagined I would find myself where I am today. It was something the surgeon said to me when telling me I needed the 2 further surgeries that promted the 2nd opinion. It is amazing that the opinions were polar opposites between the 2 surgeons.

     
    Old 04-10-2010, 10:54 AM   #29
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    Re: 5 level cervical laminectomy & fusion, anybody?

    Quote:
    Originally Posted by Saucer View Post
    I am fused 4-7, had a cervical laminectomy in 1994 and now am suffering from another bone spur at C2-3 with disc protrusion. I have the expected head lean. They say they need to do a discectomy and fuse 2,3,4 and then insert a rod posterior from 4-t2. I am scared to death. Im 50 years old.
    The doctor says the complications are tongue paralysis, and swallowing problems. Im not sure what to think. He says we can wait until I start dropping things to do the surgery, but my thought are Im not getting any younger so maybe do this and get it over with? Anyone have thoughts on this?
    Dear Saucer,

    Like you I am fused at the same levels as you and now find the surgeon wanting to do another anterior to include C3 and also a posterior decompression with rods and screws.

    At least you had success with your 1st fusion and if you do not mind me asking what was the original reason for the fusion? Mine was 11 months ago and as you can see it did not work for me.

    I am 47 yrs old and never thought I would find myself in this position, but something my surgeon said when discussing the re-op prompted me to run and look for a second opinion. I am not sure if you have done this or not, but if not I would certainly suggest it before agreeing to this next surgery. I have now received 2 opinions and they are from one end of the spectrum to another.

    Recent CT showed large bone spur at 5-6 with moderate encroachment on the thecal sac and foramin closed.

    I would be interested to hear what you decide and also know how it progresses if you do go through with it. I am not rushing to get back on the operating table since I have still not recovered from the 1st fusion.
    Good luck in whatever you decide and please keep me posted as this progresses.

     
    Old 04-11-2010, 05:53 AM   #30
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    Re: 5 level cervical laminectomy & fusion, anybody?

    cwherry
    Thank you for your response. I have what they call congenital fusion. I believe the fusing started when I was 18 years old. Started with only 2 then went to the 4-7. Had a stiff neck all that time and then started feeling clumsy, pain in arms and legs. First diagnosed with carpal tunnel until the MRI which showed severe stenosis at C2-3 and C3-4. The laminectomy was done to relieve the stenosis. I have never been the same since the surgery.
    I'm stiffer now, have problems with the muscles in the back of neck (they are hard), and surgery has caused my head to lean forward. I have headaches all the time and since then the back is failing.
    Back has fusion showing at T1-T2 and bulging discs at L-3, L5-S1.
    Was going to back pain center for back only (since my neck scared her).
    Dr there said my back is doing all the work my neck is suppose to do.

    I will have the surgery eventually. I dont want to be in a wheelchair.
    I went for a 1st opinion and was told of the 2 same procedures. The 1st one wasnt sure if she should do just the fusion on C234, or both, with the rod, so they both said the same thing.

    I too cannot believe this is happening to me. I'm sorry to hear your story is so similar. I have been in pain for so many years, I try to ignore it and move on, but now is becoming unbearable.
    I found out that excercising helps with the stiffness but they say now to take it easy.
    CW, Please let me know how you are doing and what you decide to do.

     
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