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    Old 04-05-2014, 03:25 PM   #1
    Backtolife2014
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    Question ACDF Recommended for Muscle Weakness?

    Hello everyone, this is my 1st post. I was involved in a motorbike accident in June 2013. I had some shoulder pain at the time but all was well shortly after. In December of 2013, I started having shoulder blade pain which was actually C6 C7 radiculopathy . I was going for therapy and was prescribed NSAID and lyrica with no relief. In January on vacation I was riding a motor scooter and immediately noticed shorting pain down my right arm with numbness as well as neck pain. I had some of these symptoms before going on vacation but it definitely got worse while I was away. When i returned back to work, the pain became worse and I ended up going to an emergency department January 28. Up until this time I did not sleep well for over 6 weeks. The emergency room doctor had the same diagnosis, cervical radiculopathy and would not send me for a MRI but told me to go back to my Sports Med Dr to order an MRI. They also prescribed me Percocet, more NSAID, and muscle relaxants. That afternoon my Sports Dr changed to a different narcotic and ordered the MRI which I had 4 days later. The MRI showed a large right sided disc herniation c6 c7 hitting the c7 nerve root with cord compression. I was sent to a neurosurgeon on Mar 5. He reviewed the MRI and did some tests and said I have Myolopathy. He said it is a slowly progressive spinal cord injury and the goal is to stop the progression. He said tingling transitions to muscle weakness to the arms and legs and transitions to loss of function of my arms and legs.
    I signed off to have an ACDF C6 C7.

    My question to all is, if the pain is better but my Tricep weakness is still there along with a little bit of numbness, is the surgery still recommended? I want to continue doing all the active things I have always done including working out and riding a motorbike. There still is a little bit of pain in my neck and occasional pain in my arm but nothing like it was. I don't want to lose any strength or risk the chance of having to be in a wheelchair if I fall a certain way.

    I am scheduled for surgery May 26 bit I can cancel up until I have it done.

    Thanks for listening!

     
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    Old 04-08-2014, 02:29 PM   #2
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    Re: ACDF Recommended for Muscle Weakness?

    if the MRI shows cord compression and you have myelopathy, less pain is not a sign of it getting better, actually it can be getting worse. I had major cord compression and not much pain. I didn't realize what my problem was for an entire year, and I have permanent damage with muscle weakness. It's best to get the compression relieved as soon as possible.That gives you the best chance to get your strength back.
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    Old 04-08-2014, 03:09 PM   #3
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    Question Re: ACDF Recommended for Muscle Weakness?

    Quote:
    Originally Posted by minstrel2 View Post
    if the MRI shows cord compression and you have myelopathy, less pain is not a sign of it getting better, actually it can be getting worse. I had major cord compression and not much pain. I didn't realize what my problem was for an entire year, and I have permanent damage with muscle weakness. It's best to get the compression relieved as soon as possible.That gives you the best chance to get your strength back.
    Hello Minstrel2, thanks for your reply.
    What if the myelopathy is very minimal or the NS is incorrect regarding his myelopathy diagnosis?

    Would surgery still be recommended as protocol without myelopathy or a minimal amount? At the same time, I don't want to always think if I fall a certain way I could suffer paralysis.

    Thank you again.

     
    Old 04-08-2014, 04:16 PM   #4
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    Re: ACDF Recommended for Muscle Weakness?

    Minstrel2, when you say you have permanent damage and weakness,
    how much weakness are you referring to? Is there more beyond the weakness?
    Thanks!

     
    Old 04-09-2014, 05:11 AM   #5
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    Re: ACDF Recommended for Muscle Weakness?

    My cord injury was caused by a fall. I fell backwards and hit the back of my neck on the base of a granite monument. At the time I didn't have any pain, and foolishly did not get an xray or any exam. However over the course of a year, I began to have pins and needles in my arms, feet, loss of strength in my hands and wrists. I had extreme difficulty opening the doorknob, etc. Also balance difficulties. I also began to have hyper reflexes in my legs as time went on. I finally returned for an MRI and discovered that the fall had pushed my C7-T1 vertebrae into the cord. I had an EMG to determine the nerve involvement, and two opinions from neurosurgeons, and both said I needed to get that stabilized. My spinal cord was actually bruised, which means that small area no longer functions. I have weakness in my legs, neuropathy with parasthesia, tingling, pins and needles, in feet and arms and hands. I still have hyperreflexes. I regained some strength in my hands with physical therapy, so I can open the door now. I walk with a cane. Climbing stairs is very difficult. I let my situation go on too long, I believe I would have more function if I had realized what had happened and had the surgery sooner.
    Did you have the EMG test? That will show what nerves are involved. If you aren't sure about surgery, get another opinion, but actual cord compression is something that just doesn't go away. Weakness in your extremities is an indicator of that. I hope you will be able to make your decision with peace. Discuss any questions with your doctor, then make the decision. My surgery kept me from being even more disabled.
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    Old 04-09-2014, 04:30 PM   #6
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    Re: ACDF Recommended for Muscle Weakness?

    Hello Mistrel2, thanks again for your reply.

    I have not had a nerve conduction test if that is what an EMG is.
    I do have a 2nd opinion on May 5th.

    It scares me to death to hear about your story.

    My symptoms started showing up around 6 months after the accident. The worst of the pain was on January 28, 2014 when I went to Emerg.

    Since then, the pain level has improved a lot and I am not on pain meds.

    My NS said surgery is to stop the progression and help with muscle weakness. He said the muscle weakness is caused by the cord being squeezed. He also said it is about quality of life and if I choose to not have the surgery, you don't want to live in a bubble.

    All I want is to get back to, is lifting moderate weights at the gym and ride my motorbike without worry that I am further damaging the area if I fall or have an accident. I have been riding my motorbike a few times last week and felt reasonably good, with a little discomfort. I know it is probably not a good idea, but we have had a bad winter and it just felt good to ride as the weather is improving.

    I am almost certain that I am going to go ahead with the surgery, however what if the 2nd NS says it is not required? I would not know what to do.

    Thanks for listenting.

     
    Old 04-09-2014, 06:01 PM   #7
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    Re: ACDF Recommended for Muscle Weakness?

    I know for me, I knew which doctor I wanted to do the surgery. The one who gave me my second opinion had a much better manner, and I had more confidence in him. You will know which doctor to trust. Most likely they will agree on the need for surgery, as I hear your symptoms. I know several other friends who have had ACDF and they have done well.
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    Old 04-09-2014, 06:26 PM   #8
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    Re: ACDF Recommended for Muscle Weakness?

    I had myelopathy from a central cord compression that was severe. In my case it didn't show up until the days leading up to my surgery even though the pain had significantly diminished. I had my pre op appointment a week before my surgery and had no major problems. On the day of the surgery the surgeon tested my strength in my arms and I had problems. I had the surgery and I still have weakness and numbness in the arm that was most affected. Like your surgeon says, it stops it from getting worse.

    You can still work out and ride a motor bike after the surgery when the surgeon clears you for it. I don't know where you got the notion you can't. Just take extra precautions like wearing a helmet on the bike. Shoot, Peyton Manning had a one level ACDF and he plays football!

    I had a 2 level acdf done in Jan '12 and I'm glad I did. Considering how many are done each year the stories with the bad outcomes like you read here are just a tiny fraction of them. The reason why you don't hear from a lot of people who have had excellent outcomes is because they are living their lives and not spending it on messages boards telling others what their experiences are and scaring them from having surgery they most likely do need.

    And I also want to add that you are taking a real chance by riding that bike without surgery because if you do fall and damage the neck any further you just might end up a quadriplegic in a wheelchair. Just because the pain is going away doesn't mean you are getting better.

    Last edited by Realhousewife; 04-09-2014 at 06:38 PM.

     
    Old 04-09-2014, 06:37 PM   #9
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    Re: ACDF Recommended for Muscle Weakness?

    I was very happy with the 1st NS. He spent a lot of time and explained everything. I just don't know what he is planning on using for the fusion. I have read about bone from your hip or artificial material. He is also young and certified as a NS only in 2012. I am not sure if this good or bad. He is eager but has not been doing this very long. There are only 5 reviews, but all positive.

    The 2nd NS was certified in 1983 but reviews show he has a poor bedside manner. At the end of the day, whoever can do the best job is who I want.
    The other concern is if he also agrees with surgery, it may be another 2-3 months after seeing him May 5.

    I don't know if the extra wait time can cause further damage. I want to minimize any chance of permanent damage after hearing your story.
    I know at least I can have the surgery May 26 with the 1st NS earlier.

     
    Old 04-09-2014, 06:58 PM   #10
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    Re: ACDF Recommended for Muscle Weakness?

    Quote:
    Originally Posted by Realhousewife View Post
    I had myelopathy from a central cord compression that was severe. In my case it didn't show up until the days leading up to my surgery even though the pain had significantly diminished. I had my pre op appointment a week before my surgery and had no major problems. On the day of the surgery the surgeon tested my strength in my arms and I had problems. I had the surgery and I still have weakness and numbness in the arm that was most affected. Like your surgeon says, it stops it from getting worse.

    You can still work out and ride a motor bike after the surgery when the surgeon clears you for it. I don't know where you got the notion you can't. Just take extra precautions like wearing a helmet on the bike. Shoot, Peyton Manning had a one level ACDF and he plays football!

    I had a 2 level acdf done in Jan '12 and I'm glad I did. Considering how many are done each year the stories with the bad outcomes like you read here are just a tiny fraction of them. The reason why you don't hear from a lot of people who have had excellent outcomes is because they are living their lives and not spending it on messages boards telling others what their experiences are and scaring them from having surgery they most likely do need.

    And I also want to add that you are taking a real chance by riding that bike without surgery because if you do fall and damage the neck any further you just might end up a quadriplegic in a wheelchair. Just because the pain is going away doesn't mean you are getting better.
    Realhousewife, thanks for your reply.
    I was aware that I would be able to get back to all my previous activities after surgery with medical clearance. I know that you are correct about riding the bike prior to surgery and that maybe the pain level is giving me a false sense of security. I am stubborn and just want to have some enjoyment as I know I will be not able to ride for some time after the surgery. I am trying to be selective when I am riding but I also know that I cannot guarantee full safety even if I did not have this problem.

    I appreciate your comments and thanks for your story!

     
    Old 05-10-2014, 10:49 AM   #11
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    Re: ACDF Recommended for Muscle Weakness?

    Hello All. I had a 2nd Neurosurgeon opinion this week. He recommended the exact same ACDF C6 C7 as the 1st NS. The only difference is he wants to use bone from my hip. The 1st NS is using a cadaver bone.

    Does anyone have any opinions on using my own bone versus a cadaver?

    My surgery date has been moved to June 5th.

    Thanks!

     
    Old 05-10-2014, 05:31 PM   #12
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    Re: ACDF Recommended for Muscle Weakness?

    Quote:
    Originally Posted by Backtolife2014 View Post
    Hello All. I had a 2nd Neurosurgeon opinion this week. He recommended the exact same ACDF C6 C7 as the 1st NS. The only difference is he wants to use bone from my hip. The 1st NS is using a cadaver bone.

    Does anyone have any opinions on using my own bone versus a cadaver?

    My surgery date has been moved to June 5th.

    Thanks!
    I had cadaver bone and had no problems with it fusing. I was thankful that I didn't have two surgery sites to heal.
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    Old 05-10-2014, 05:47 PM   #13
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    Re: ACDF Recommended for Muscle Weakness?

    Quote:
    Originally Posted by minstrel2 View Post
    I had cadaver bone and had no problems with it fusing. I was thankful that I didn't have two surgery sites to heal.
    I am thinking about also using a cadaver bone. The 1st NS even though is young just explained everything to me and was very patient and caring. I am very comfortable with him. He gave me the 3 options; cadaver, bone from my hip, or plastic. He said fusion is high for both cadaver or my own bone and a little less with the plastic.

    My only issue is I do enjoy Cigars. He said ideally, no smoking 6 weeks prior and 12 weeks after will provide a better chance of fusion. The percentage of fusion as a smoker using a cadaver bone is 12% less than using my own bone for someone who smokes a pack of cigarettes a day.

    I don't inhale the cigars but you always get some smoke inside, I would think.

    It has become a bad habit, but I want to make sure I don't have to repeat this surgery if fusion does not occur. I will probably go to the little baby cigars that you I finish in 2 minutes as opposed to the cigars that take me 25 minutes.

    I guess it is a little damage control.

    thanks.

     
    Old 05-23-2014, 02:31 PM   #14
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    Re: ACDF Recommended for Muscle Weakness?

    I'm curious what signs signified myelopathy in your case? If it was just compression on the MRI, do you know how much compression there was? I ask because my situation is that there is small disagreement about my symptoms coming from compression (in which case surgery would be more recommended) or from nerve root compression in which case pt and conservative means for reducing inflammation and improving stability may help. I have weakness in my left arm exactly along c6 but most of my des believe it is from a pinched nerve even though I have a very small amount of cord movement from bone spurs.

    Good luck on your surgery!

     
    Old 05-31-2014, 12:13 PM   #15
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    Re: ACDF Recommended for Muscle Weakness?

    Quote:
    Originally Posted by ChuckStr View Post
    I'm curious what signs signified myelopathy in your case? If it was just compression on the MRI, do you know how much compression there was? I ask because my situation is that there is small disagreement about my symptoms coming from compression (in which case surgery would be more recommended) or from nerve root compression in which case pt and conservative means for reducing inflammation and improving stability may help. I have weakness in my left arm exactly along c6 but most of my des believe it is from a pinched nerve even though I have a very small amount of cord movement from bone spurs.

    Good luck on your surgery!
    Hi ChuckStr,
    Sorry for the delayed response.
    I am not sure the actual signs that signified myelopathy. I think my gait test was off slightly but on any given day it could be better or worse. Obvious tricep weakness in the right arm. There is a very large disc herniation compressing the spinal cord and nerve root. It is not small. If it was just nerve root compression and not spinal cord compression I may have rethought about doing the surgery. My surgery is 5 days away now. I am nervous but want to get this finally over with as it was delayed 10 days from the initial date. My surgeon said to me that my strength will more than likely come back if I do the surgery but if I don't do it, my strength will not come back.

    Good luck to you.

     
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