No one is fused and artificial disk. The purpose is to preserve the movement. With a fusion when the movement stops (fused), the extra workload goes to the levels that still move, usually above and below the fusion. In time, 2.9% per year need surgery on them. After 10 years, 25-29% of patients who had a fusion need another. C1 and c2 provide about 50% of your necks movement. C3-C7 are 10-12% each, or 50ish percent. So if you lose one level to fusion, you have about 10% less range of motion. Me I have 3 levels done now. So technically, I have 30ish percent loss range of motion. If you have a really bad level like my c3 was (that was fused on 11/4), you get more range of motion because your muscles splint to protect and your neck gets stiff. I'm noticing things like driving etc I can turn my neck lots better than presurgery.
If you need the surgery, and qualify for the artifical disk, get it. If you don't, a fusion is a tried and true, the gold standard procedure thats been done for 60 yrs and it works very very well. Not perfect, but if you are in horrible pain, cannot use your arms, etc., a fusion looks very attractive.
Good luck to you all.
If you need the surgery, and qualify for the artifical disk, get it. If you don't, a fusion is a tried and true, the gold standard procedure thats been done for 60 yrs and it works very very well. Not perfect, but if you are in horrible pain, cannot use your arms, etc., a fusion looks very attractive.
Good luck to you all.
Please read the following (if this site will allow me to copy)
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Decompressive procedures may be accompanied by arthrodesis if there is concern for stability. Indications for decompression with arthrodesis include unstable spondylolisthesis, neural arch defects (as in spondylolysis), restoration of disc space height using interbody fusion to increase neuroforaminal volume, and surgically-induced instability from resection of facet joints or other stabilizing structures. (28)
Arthrodesis in the lumbar spine can be approached posteriorly by placing bone graft across the transverse processes. Other lumbar fusion techniques using a posterior approach include Posterior Lumbar Interbody Fusion (PLIF) and Transforaminal Lumbar Interbody Fusion (TLIF). (73,74) Interbody fusion techniques involve removal of the disc and replacement with bone graft and/or implant to induce fusion through the disc space. Interbody fusion in the lumbar spine can also be accomplished anteriorly via transabdominal or retroperitoneal access. Combined anterior-posterior approaches are also used, depending on the goals of surgery and needs of the patient.
In the case of thoraco-lumbar deformities (e.g., scoliosis) an anterior and/or posterior approach may be employed. The surgical approach used is dependent on the magnitude, flexibility, and location of the deformity and the surgical goals. Anterior approach to scoliosis correction can usually be accomplished over a shorter fusion construct than with posterior approaches, thus sparing mobile spine segments. (75,76) Anterior arthrodesis is accomplished using thoracotomy or combined thoraco-abdominal approach, depending on the level of the curve to be corrected. (75-78) Occasionally the facet joints are fused in combination with other posterior approaches. The approach and technique depends on the particular clinical needs of the patient and the goals of surgical intervention.
Arthrodesis in the cervical spine always accompanies anterior discectomy procedures because of stability issues. Anterior plates may be used. Some posterior decompressive procedures may require arthrodesis accompanied by lateral mass plates. Instability in the upper cervical spine may require a posterior arthrodesis with plating to the occiput.
Painful disc degeneration is a controversial indication for lumbar arthrodesis. The goal of arthrodesis for painful disc degeneration is to eliminate motion across the painful disc thereby eradicating the pain generator. (79) Both anterior and posterior, and sometimes a combined anterior-posterior approach is used.
Instrumentation
Instrumentation may be indicated to aid fusion healing by internal immobilization of the fusion site. Various instrumentation systems exist for the lumbar spine, including pedicle screws and rods, plates, intervertebral cages filled with bone graft and in some applications (e.g., scoliosis and trauma) hooks and rods.
Pedicle screws are placed posteriorly through the pedicles into the vertebral bodies, and connected by rods and crosslinking devices. Intervertebral cages can be placed transforaminally (through posterior incision) into the disc space after the disc has been excised, or anteriorly via retroperitoneal approach. The cages are filled with autologous bone graft or bone growth enhancers, with the intent of creating interbody fusion. Intervertebral cages are rarely used as stand-alone devices, and are most often used in combination with pedicle screws (Figure 13).
Figure 13.
Lateral radiograph of a patient with intervertebral cages and pedicle screws.
In the cervical spine, anterior plates and screws can be used in combination with interbody fusion (Figure 14). Posteriorly, depending on the level to be fused, lateral mass plates, wiring techniques, and special occipital-cervical plates and screws may be used. In the thoracic spine, hooks and rods, anterior plates, and more recently, pedicle screw techniques can be used. (80)
Figure 14.
Lateral radiograph of a patient with C5-C7 anterior arthrodesis and plating..
Bone Graft
Arthrodesis can be achieved through the use of autograft or allograft bone. Additionally, the use of bone graft alternatives is increasing as the understanding of their use is evolving. Spinal fusion healing depends on three capabilities of bone graft material. Osteogenesis; the growth of new bone, depends on the presence of cells that synthesize new bone at the fusion site. Osteoconduction is the ability of the graft material to serve as a scaffold for new bone formation. Osteoinduction is the recruitment of stem cells to differentiate into new bone. (81)
Autograft can be harvested from the anterior superior iliac spine or the posterior iliac crest, depending on the surgical approach. Local bone can also be used, such as spinous processes from posterior lumbar surgery, or a rib that is resected for anterior approach to the thoracic spine. Autograft possesses all three properties of osteogenesis, osteoconduction, and osteoinduction. Other advantages of autograft bone include its biocompatibility and the avoidance of disease transmission risk. The disadvantages of autograft are prolonged operative times for harvest of graft and closure of the incision, increased intra-operative blood loss, the limited supply of bone, and post-operative graft site pain. (81,82)
Allograft is human bone taken from a cadaver donor. Allograft is osteoconductive but has limited osteoinduction. Because it is not living tissue allograft is not osteogenic. The advantages of allograft include its availability, avoidance of a bone graft incision, and structural utility. The disadvantages of allograft include the risk of disease transmission, slower healing of fusion, rejection from tissue incompatibility, and greater risk of fatigue failure from the processing of cadaver bone. (81-84)
The use of autograft versus allograft depends on the area to be fused, its biomechanical demands, and in certain cervical procedures, can depend on patient or surgeon preference. In some instances, both are used at the same fusion site. Autograft is still the gold standard in posterior lumbar fusions. For further discussion on bone graft enhancers and substitutes, see the section, Trends in Spine Care (link at page end).
There are conflicting reports in the literature regarding the duration of and disability related to post-operative pain from autogenous bone graft sites. The pain from a posterior iliac crest autograft harvest site tended to peak at 3-6 months and by 12 months, was considerably less in one study. (85) The pain and functional disability from anterior superior iliac crest graft sites can be significant. A retrospective study of 187 consecutive patients from one surgeon demonstrated chronic pain (greater than three months) in 26% of the patients surveyed. (86) Questionnaires were completed by mail or over the phone for 134 of these patients at an average of 48 months post-operatively (range 24-72 months).
Of the patients with chronic pain, 43% required analgesics. The mean Visual Analog Scale for pain in these patients was 3.8. Functional limitations were also reported in these patients, with 13% reporting difficulty with ambulation, 12% reporting restrictions in recreational activities, and 15% reporting either restrictions in activities of daily living or ability to complete their household chores.
In another study of 144 patients who underwent anterior cervical arthrodesis with anterior superior iliac crest autograft, bone graft site pain resolved within one week in 58.3% of patients, and within four weeks, 90.3% had resolved their bone graft site pain. (87) It is clear that patients must be informed pre-operatively of the potential long-term pain and functional limitations from autogenous bone graft sites.
Last Updated: 06/01/2004
Continue Reading: Post-Operative Bracing and Halo Vest Immobilization
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SpineUniverse is committed to ensuring that all information on its site is trustworthy and of the highest quality. To maintain the site's quality, SpineUniverse relies on its exceptional Editorial Board. The Editorial Board is a "Who's Who" of more than 60 leading spine specialists, including surgeons, pain management specialists, chiropractors, nurses, physical therapists and more.
Peer Review by Leading Specialists
Mary Rodts, DNP, CNP, ONC, FAAN
The care of the Adult Spine patient is complex and can be difficult to understand. All spine surgery is not the same and the complex procedures are often misunderstood by some healthcare providers, case managers, and insurance companies. Ms. Holwerda has organized this topic into logical sections for review with current information. Most importantly, the wide variety of management issues are also discussed.
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Related Articles on this Topic
Trends in Spine Care
Comparison of Autograft vs. Demineralized Allograft in Anterior Thoracoscopically Instrumented "Scoliosis" Fusions - A Caprine Model**
New Technologies in Anterior Cervical Spine Fixation
Lumbar Interbody Fusion Devices: A Comparative Study
Lumbosacral Fusion: Cages, Dowels and Pedicle Screws
Subject Index: Acute Adult Spine
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Decompressive procedures may be accompanied by arthrodesis if there is concern for stability. Indications for decompression with arthrodesis include unstable spondylolisthesis, neural arch defects (as in spondylolysis), restoration of disc space height using interbody fusion to increase neuroforaminal volume, and surgically-induced instability from resection of facet joints or other stabilizing structures. (28)
Arthrodesis in the lumbar spine can be approached posteriorly by placing bone graft across the transverse processes. Other lumbar fusion techniques using a posterior approach include Posterior Lumbar Interbody Fusion (PLIF) and Transforaminal Lumbar Interbody Fusion (TLIF). (73,74) Interbody fusion techniques involve removal of the disc and replacement with bone graft and/or implant to induce fusion through the disc space. Interbody fusion in the lumbar spine can also be accomplished anteriorly via transabdominal or retroperitoneal access. Combined anterior-posterior approaches are also used, depending on the goals of surgery and needs of the patient.
In the case of thoraco-lumbar deformities (e.g., scoliosis) an anterior and/or posterior approach may be employed. The surgical approach used is dependent on the magnitude, flexibility, and location of the deformity and the surgical goals. Anterior approach to scoliosis correction can usually be accomplished over a shorter fusion construct than with posterior approaches, thus sparing mobile spine segments. (75,76) Anterior arthrodesis is accomplished using thoracotomy or combined thoraco-abdominal approach, depending on the level of the curve to be corrected. (75-78) Occasionally the facet joints are fused in combination with other posterior approaches. The approach and technique depends on the particular clinical needs of the patient and the goals of surgical intervention.
Arthrodesis in the cervical spine always accompanies anterior discectomy procedures because of stability issues. Anterior plates may be used. Some posterior decompressive procedures may require arthrodesis accompanied by lateral mass plates. Instability in the upper cervical spine may require a posterior arthrodesis with plating to the occiput.
Painful disc degeneration is a controversial indication for lumbar arthrodesis. The goal of arthrodesis for painful disc degeneration is to eliminate motion across the painful disc thereby eradicating the pain generator. (79) Both anterior and posterior, and sometimes a combined anterior-posterior approach is used.
Instrumentation
Instrumentation may be indicated to aid fusion healing by internal immobilization of the fusion site. Various instrumentation systems exist for the lumbar spine, including pedicle screws and rods, plates, intervertebral cages filled with bone graft and in some applications (e.g., scoliosis and trauma) hooks and rods.
Pedicle screws are placed posteriorly through the pedicles into the vertebral bodies, and connected by rods and crosslinking devices. Intervertebral cages can be placed transforaminally (through posterior incision) into the disc space after the disc has been excised, or anteriorly via retroperitoneal approach. The cages are filled with autologous bone graft or bone growth enhancers, with the intent of creating interbody fusion. Intervertebral cages are rarely used as stand-alone devices, and are most often used in combination with pedicle screws (Figure 13).
Figure 13.
Lateral radiograph of a patient with intervertebral cages and pedicle screws.
In the cervical spine, anterior plates and screws can be used in combination with interbody fusion (Figure 14). Posteriorly, depending on the level to be fused, lateral mass plates, wiring techniques, and special occipital-cervical plates and screws may be used. In the thoracic spine, hooks and rods, anterior plates, and more recently, pedicle screw techniques can be used. (80)
Figure 14.
Lateral radiograph of a patient with C5-C7 anterior arthrodesis and plating..
Bone Graft
Arthrodesis can be achieved through the use of autograft or allograft bone. Additionally, the use of bone graft alternatives is increasing as the understanding of their use is evolving. Spinal fusion healing depends on three capabilities of bone graft material. Osteogenesis; the growth of new bone, depends on the presence of cells that synthesize new bone at the fusion site. Osteoconduction is the ability of the graft material to serve as a scaffold for new bone formation. Osteoinduction is the recruitment of stem cells to differentiate into new bone. (81)
Autograft can be harvested from the anterior superior iliac spine or the posterior iliac crest, depending on the surgical approach. Local bone can also be used, such as spinous processes from posterior lumbar surgery, or a rib that is resected for anterior approach to the thoracic spine. Autograft possesses all three properties of osteogenesis, osteoconduction, and osteoinduction. Other advantages of autograft bone include its biocompatibility and the avoidance of disease transmission risk. The disadvantages of autograft are prolonged operative times for harvest of graft and closure of the incision, increased intra-operative blood loss, the limited supply of bone, and post-operative graft site pain. (81,82)
Allograft is human bone taken from a cadaver donor. Allograft is osteoconductive but has limited osteoinduction. Because it is not living tissue allograft is not osteogenic. The advantages of allograft include its availability, avoidance of a bone graft incision, and structural utility. The disadvantages of allograft include the risk of disease transmission, slower healing of fusion, rejection from tissue incompatibility, and greater risk of fatigue failure from the processing of cadaver bone. (81-84)
The use of autograft versus allograft depends on the area to be fused, its biomechanical demands, and in certain cervical procedures, can depend on patient or surgeon preference. In some instances, both are used at the same fusion site. Autograft is still the gold standard in posterior lumbar fusions. For further discussion on bone graft enhancers and substitutes, see the section, Trends in Spine Care (link at page end).
There are conflicting reports in the literature regarding the duration of and disability related to post-operative pain from autogenous bone graft sites. The pain from a posterior iliac crest autograft harvest site tended to peak at 3-6 months and by 12 months, was considerably less in one study. (85) The pain and functional disability from anterior superior iliac crest graft sites can be significant. A retrospective study of 187 consecutive patients from one surgeon demonstrated chronic pain (greater than three months) in 26% of the patients surveyed. (86) Questionnaires were completed by mail or over the phone for 134 of these patients at an average of 48 months post-operatively (range 24-72 months).
Of the patients with chronic pain, 43% required analgesics. The mean Visual Analog Scale for pain in these patients was 3.8. Functional limitations were also reported in these patients, with 13% reporting difficulty with ambulation, 12% reporting restrictions in recreational activities, and 15% reporting either restrictions in activities of daily living or ability to complete their household chores.
In another study of 144 patients who underwent anterior cervical arthrodesis with anterior superior iliac crest autograft, bone graft site pain resolved within one week in 58.3% of patients, and within four weeks, 90.3% had resolved their bone graft site pain. (87) It is clear that patients must be informed pre-operatively of the potential long-term pain and functional limitations from autogenous bone graft sites.
Last Updated: 06/01/2004
Continue Reading: Post-Operative Bracing and Halo Vest Immobilization
What is this?
Editorial Board Comments on SpineUniverse
SpineUniverse is committed to ensuring that all information on its site is trustworthy and of the highest quality. To maintain the site's quality, SpineUniverse relies on its exceptional Editorial Board. The Editorial Board is a "Who's Who" of more than 60 leading spine specialists, including surgeons, pain management specialists, chiropractors, nurses, physical therapists and more.
Peer Review by Leading Specialists
Mary Rodts, DNP, CNP, ONC, FAAN
The care of the Adult Spine patient is complex and can be difficult to understand. All spine surgery is not the same and the complex procedures are often misunderstood by some healthcare providers, case managers, and insurance companies. Ms. Holwerda has organized this topic into logical sections for review with current information. Most importantly, the wide variety of management issues are also discussed.
What is This?
Related Articles on SpineUniverse
To help you navigate through this wealth of information, the Editorial Board of SpineUniverse presents links to "Related Articles" at the end of each article . In addition, to help you find additional information you need, we encourage you to use the "Search" tool located at the top of each page.
Related Articles on this Topic
Trends in Spine Care
Comparison of Autograft vs. Demineralized Allograft in Anterior Thoracoscopically Instrumented "Scoliosis" Fusions - A Caprine Model**
New Technologies in Anterior Cervical Spine Fixation
Lumbar Interbody Fusion Devices: A Comparative Study
Lumbosacral Fusion: Cages, Dowels and Pedicle Screws
Subject Index: Acute Adult Spine
***edited by moderator*** web addresses not allowed
My surgical procedures were:
C5-6 cervical disketomy arthrodesis of spinal cord, nerve roots
anterior cervicle interbody arthrodesis
anterior cervicle instrumentation
application of prosthetic biomechanical device
So are you telling me I am not fused along with my Medtronic Mystique resorbable cervicle plate?
Thanks.
C5-6 cervical disketomy arthrodesis of spinal cord, nerve roots
anterior cervicle interbody arthrodesis
anterior cervicle instrumentation
application of prosthetic biomechanical device
So are you telling me I am not fused along with my Medtronic Mystique resorbable cervicle plate?
Thanks.
The cut and paste is great information. You get a better understanding from this. Bone grafts, peek cages, plates & screws all fuse the levels together where as a device that allows motion, which is better in the long run is not considered a fusion but it does stablise the area and protect the cord and nerves. I wish I could have had an artifical disk, but I just had to many levels. they will only do one level with an ADR in the neck. More research is being done, so who knows what we'll see in the next 5-10 years!
The sad part is even with an artificial disc I have very limited movement . That's why I was so curious as to what you were saying.
As far as I am concerned, and several others I have known that has had ACDF, I wish for further research! All three of us have very limited neck movement even with an artificial disc.
Thanks for your input.
As far as I am concerned, and several others I have known that has had ACDF, I wish for further research! All three of us have very limited neck movement even with an artificial disc.
Thanks for your input.
no I am not telling you are not fused with your medtronics mystique resorbable plate. That isn't an artificial disk. Thats what the discussion was. They dont do both in the US, fuse and artificial disk. They are starting to do trials, so maybe in 5-10 yrs it might be FDA approved. You have a fusion with a plate that basically is made out of a material that your body will absorb. It has nothing to do with an artificial disk like the bryan disc, or any of the other 5-6 different ones. I have a stryker titanium plate in me, and its not going anywhere unless someone takes it out. You have this: http://www.ncbi.nlm.nih.gov/pubmed/17473648
I am referring to these:compressed nerve, surgical decompression is indicated.
Standard Surgical Procedure
The standard surgical procedure approaches the cervical disc from the front with removal of the entire worn-out disc and elimination of the compression on the nerve. A fusion is usually then performed to stabilize the motion segment. A bone graft is placed between the vertebral bodies where the degenerated disc was removed.
This is a highly successful operation, however, limitations exist because of the fusion procedure. An increased incidence of degeneration of the disc above and below the fusion occurs due to the increased forces on the adjacent motion segment. Bone graft is required either from the patient's own iliac crest, or from cadaver bone. And finally, immobilization is required postoperatively with a cervical collar, an internal plate and screws, or both.
Cervical Artificial Disc Replacement
A cervical artificial disc replacement is a device that is placed into the intervertebral disc space instead of a bone graft after the disc is removed with the goal of retaining as much normal motion as possible while keeping the motion segment stable. The theoretical advantages are to reduce the incidence of adjacent segment degeneration while maintaining normal neck motion, the elimination of bone graft donor site complications and possible disease transmission from donor bone graft, and early neck motion without bracing requirements.
There are presently two artificial cervical disc replacement devices that are undergoing FDA approval study in the United States: the Bryan disc and the PRESTIGE® Cervical Disc.
Figure 1. The Bryan disc is a metal-on-plastic design (titanium and polyurethane).
The PRESTIGE® Cervical Disc is a metal-on-metal design (stainless steel) that has undergone a long history of evolution. The original stainless steel artificial cervical disc was the United Kingdom (UK)Cummins design implanted in the early 1990's. This was a ball and socket articulation. The Bristol disc evolved from this design with a ball and trough articulation in order to allow physiologic translation of the motion segment.
Figure 2. The PRESTIGE® Cervical Disc is a metal-on-metal design (stainless steel).
2 different beasts. I hope that helps you understand--its very confusing with all these names.
I am referring to these:compressed nerve, surgical decompression is indicated.
Standard Surgical Procedure
The standard surgical procedure approaches the cervical disc from the front with removal of the entire worn-out disc and elimination of the compression on the nerve. A fusion is usually then performed to stabilize the motion segment. A bone graft is placed between the vertebral bodies where the degenerated disc was removed.
This is a highly successful operation, however, limitations exist because of the fusion procedure. An increased incidence of degeneration of the disc above and below the fusion occurs due to the increased forces on the adjacent motion segment. Bone graft is required either from the patient's own iliac crest, or from cadaver bone. And finally, immobilization is required postoperatively with a cervical collar, an internal plate and screws, or both.
Cervical Artificial Disc Replacement
A cervical artificial disc replacement is a device that is placed into the intervertebral disc space instead of a bone graft after the disc is removed with the goal of retaining as much normal motion as possible while keeping the motion segment stable. The theoretical advantages are to reduce the incidence of adjacent segment degeneration while maintaining normal neck motion, the elimination of bone graft donor site complications and possible disease transmission from donor bone graft, and early neck motion without bracing requirements.
There are presently two artificial cervical disc replacement devices that are undergoing FDA approval study in the United States: the Bryan disc and the PRESTIGE® Cervical Disc.
Figure 1. The Bryan disc is a metal-on-plastic design (titanium and polyurethane).
The PRESTIGE® Cervical Disc is a metal-on-metal design (stainless steel) that has undergone a long history of evolution. The original stainless steel artificial cervical disc was the United Kingdom (UK)Cummins design implanted in the early 1990's. This was a ball and socket articulation. The Bristol disc evolved from this design with a ball and trough articulation in order to allow physiologic translation of the motion segment.
Figure 2. The PRESTIGE® Cervical Disc is a metal-on-metal design (stainless steel).
2 different beasts. I hope that helps you understand--its very confusing with all these names.
Thanks for the information. I was really confused.
Wasn't the Prestige and Bryan cervicle disc once recalled by it's manufacterer's?
It's been quite some time ago since I was doing research on artificial disc but somehow those names ring a bell and I was thinking it was because so many people were having issues with them.
I guess there is somewhat an issue with all surgical cervicle procedures. Just like everything else artificial it never quite replaces the human bodies original parts and its functions.
Thanks again for the info.
Wasn't the Prestige and Bryan cervicle disc once recalled by it's manufacterer's?
It's been quite some time ago since I was doing research on artificial disc but somehow those names ring a bell and I was thinking it was because so many people were having issues with them.
I guess there is somewhat an issue with all surgical cervicle procedures. Just like everything else artificial it never quite replaces the human bodies original parts and its functions.
Thanks again for the info.
I dont know because I dont have one. I just have 5 vertebrae fused, 4 discs removed. In my situation, once the disc's went south, (as yours too I'm sure), the disc's that my human body made were gladly disposed of by me. I felt so much better post op that I can't even put it in words. The last surgery 11/5, I was so incredibly miserable that I had this myelopathy which means the spinal cord is compressed and my legs had no strength, my arms none either and no coordination. I couldn't button a shirt, turn a door knob, brush my teeth, and so forth. One time I managed to get up and had to use the restroom. It was maybe 20 steps from my bed. I got up and felt ok so I didn't get my cane. I fell and my chin hit the tile and broke 3 bottom front teeth. That was bad. Then I found out, that one of them was the eye tooth and it was split so it had to come out. (the eye teeth are extremely important for anchoring a bridge to) I lost my eye tooth and the 2 teeth next to it (front teeth). So I cannot have a bridge now, I have to have implants. The eye tooth implant is 2200$ (just for the post thing), and the other 2 litle front teeth are $1500 each. So thats 5200$ just for the titanium implants. Once they are healed I need porcelon crowns. They are 1000-1200 here, so another 3000$ just to have 3 crowns (the tooth part) put on the steel post once its healed in 6 months. I am so incredibly frustrated.
The great part of this whole mess is that the myelopathy is one, everyhing else is starting to heal (the neck parts) and my nerves and muscles are all geting stronger. I dont have arm pain, I dont have weak legs, and I feel lots better.
I wish somehow I could claim the dental stuff on my medical insurance. Technically its a medical issue not a dental one where the problem is a result of poor oral hygeine or whatever. Thats going to be a losing battle but I'm going to pursue it primarily duue to the cost. Thanks for listening. Mark
The great part of this whole mess is that the myelopathy is one, everyhing else is starting to heal (the neck parts) and my nerves and muscles are all geting stronger. I dont have arm pain, I dont have weak legs, and I feel lots better.
I wish somehow I could claim the dental stuff on my medical insurance. Technically its a medical issue not a dental one where the problem is a result of poor oral hygeine or whatever. Thats going to be a losing battle but I'm going to pursue it primarily duue to the cost. Thanks for listening. Mark
Hello, I had a c5,c6 anterior decompression with allograft and plating done in May of 2003. 9 weeks earlier I experienced severe neck spasms/pain on the right side. 2 days after the onset of neck spasms, I experienced intense pain in the right arm and numbness and burning in the right thumb (I will speak about this more further on). A few days after the arm pain began I noticed a dramatic loss of strength in my biceps as well as atrophy. I became alarmed. Some people tried to calm me by saying I was not using the arm, hence the loss of strength but I knew that it was from denervation.
I found it very difficult to be treated quickly. My own doctor dragged her feet and offered therapy and some vicodin. An MRI was booked several weeks down the road. I was in a state of panic. I could not lie flat at all as the pain intensified tenfold.
I tried 3 times to have an MRI but could not lie in the machine for more than a few minutes as the pain was unbearable. One time I literally dragged myself out of the machine. The technicians thought that I was claustrophobic which was not the case at all!
Finally I found a place that gave me IV morphine an valium. 22 mgs of morpine and 15 mgs of valium is what it took for me to lie flat. With the results showing the disc crushing the nerve root, I abandoned my doctor and called a big universtity teaching hospital. I found a neuro surgeon who would see me. I had lost all reflexes in the arm and my thumb was so sensitive to the touch, I was going crazy. He performed the surgery but as I said, I had to wait 9 weeks. The pain in my arm got better but not completely. The burning thumb was unfortunately unchanged.
Four years ago (Jan 06) I began experiencing neck pain again. I always had a knot in my trapezius muscle on the right. I needed to have the pillow just right or I would be stiff all day. One morning when I got up, pain shot down my arm. Agonizing pain. I thought "Oh my God, it is happening again". I went through the entire process again, this time losing the strength in the triceps and now my index and middle finger felt like my thumb. I needed morphine again to have an MRI. The surgeon I had before left the state. I did not even call my doctor, I went to the university hospital emergency room. This time it was c6 and c7. I was told that the disc was pushing so hard that it was compressing even my spinal cord. I was operated on about a month later after a steroid injection did not work. This time it was done posteriorly. I was miserable for quite a while after that.
Now 7 and 4 years later my condition is as follows. My right thumb, index, middle finger, and palm constantly burns and I am unable to comfortably touch anything. My upper middle back burns and aches. My right arm twitches and aches. (twitching now as I try to type) If I yawn, sometimes the front of my neck goes into a painfull spasm.
I was unable to continue with my job as an Intravenous nurse, as placing delicate IV's with a numb and burning hand, twitching arm and upper back pain is impossible.
I would like to respond to the person who's surgical nurse mentioned workers comp or disabilty. That comment made by a nurse is totally inappropriate and demonstrates qualities that health care professionals should not have. I was granted long term disability after my second surgery and I did not magically get better after surgery. I am in pain and suffer every day, all day. I have taken lyrica, neurontin, and multiple other drugs prescribed by a pain doctor. Other than dizziness, nausea, and impotence, I had no relief from them.
If I could find some way to restore normal sensation to my hand, I could live with some of the other after effects.
I found it very difficult to be treated quickly. My own doctor dragged her feet and offered therapy and some vicodin. An MRI was booked several weeks down the road. I was in a state of panic. I could not lie flat at all as the pain intensified tenfold.
I tried 3 times to have an MRI but could not lie in the machine for more than a few minutes as the pain was unbearable. One time I literally dragged myself out of the machine. The technicians thought that I was claustrophobic which was not the case at all!
Finally I found a place that gave me IV morphine an valium. 22 mgs of morpine and 15 mgs of valium is what it took for me to lie flat. With the results showing the disc crushing the nerve root, I abandoned my doctor and called a big universtity teaching hospital. I found a neuro surgeon who would see me. I had lost all reflexes in the arm and my thumb was so sensitive to the touch, I was going crazy. He performed the surgery but as I said, I had to wait 9 weeks. The pain in my arm got better but not completely. The burning thumb was unfortunately unchanged.
Four years ago (Jan 06) I began experiencing neck pain again. I always had a knot in my trapezius muscle on the right. I needed to have the pillow just right or I would be stiff all day. One morning when I got up, pain shot down my arm. Agonizing pain. I thought "Oh my God, it is happening again". I went through the entire process again, this time losing the strength in the triceps and now my index and middle finger felt like my thumb. I needed morphine again to have an MRI. The surgeon I had before left the state. I did not even call my doctor, I went to the university hospital emergency room. This time it was c6 and c7. I was told that the disc was pushing so hard that it was compressing even my spinal cord. I was operated on about a month later after a steroid injection did not work. This time it was done posteriorly. I was miserable for quite a while after that.
Now 7 and 4 years later my condition is as follows. My right thumb, index, middle finger, and palm constantly burns and I am unable to comfortably touch anything. My upper middle back burns and aches. My right arm twitches and aches. (twitching now as I try to type) If I yawn, sometimes the front of my neck goes into a painfull spasm.
I was unable to continue with my job as an Intravenous nurse, as placing delicate IV's with a numb and burning hand, twitching arm and upper back pain is impossible.
I would like to respond to the person who's surgical nurse mentioned workers comp or disabilty. That comment made by a nurse is totally inappropriate and demonstrates qualities that health care professionals should not have. I was granted long term disability after my second surgery and I did not magically get better after surgery. I am in pain and suffer every day, all day. I have taken lyrica, neurontin, and multiple other drugs prescribed by a pain doctor. Other than dizziness, nausea, and impotence, I had no relief from them.
If I could find some way to restore normal sensation to my hand, I could live with some of the other after effects.
I'm sorry you've had to go through all that. I remember my first surgery, myelopathy but limited to right arm. I would drop things, and it would just be dead weight, then other times it was ok but had electric shocks (depending on my posture etc). I had the surgery and woke up and immediately knew it was fixed. It took me literally seconds to realize it. That lasted for 8 yrs. Then one day I started having pain in my arm again and this little voice (I'm not a nut) said "its your neck". Another voice said "no its not". And I had this little argument in my head. When it didn't go away, I knew it was. That was 1998 and I was on opiates from then until 2003 when my wife had a cardiac cath and her arteries were torn (cardiac arteries) wide open by the guide wire on the cath and she almost bled to death after coding 6 times==and 28 units of blood later she had life saving bypass surgery. I did property managment and so I kind of worked from home, and when I had to go inspect a house (tenants moved out whatever) I had a friend do it and take a cam corder and it was very inconvenient. Anyway, in 11/05 I went to social security to apply for her because she had hypoxia and other issues and she didn't qualify due to no work credits. (she was a stay at home mom). (which is work--and she should get credit for it because it allowed me to work and pay into the system. Otherwise I wouldn't have been able to). I argured that and got no where, but the guy there said "why dont you apply for you?" I said never thought about it. I did and within 4 months had 2 yrs of back pay and the beauty was my son was getting ready to graduate high schoool and go to colllege. He also got the 2 yrs of back benefits (800 a month) and then benefits until he turned 18. It turned out to be a tremendous blessing. I cant work, have had further surgery and just cannot do it. Typing this is a huge task.
I wish you well and hope you feel better. Neck issues are so incredibly frustrating. Be good to yourself. Disregard what others say, they can be very ignorant and mean. My two children 2/3 are nurses and they say "dad why dont you get a job". I say "did your 2 yr associate degree give you board certification in neurosurgery and or as a medical review officer?" "NO" "then mind your own business". My other son, who got the benefits is in graduate school and understands the situation much better as he was younger and was at home while mom almost died and he saw me struggle daily while the other two were out on their own at school or whatever.
Take care.
I wish you well and hope you feel better. Neck issues are so incredibly frustrating. Be good to yourself. Disregard what others say, they can be very ignorant and mean. My two children 2/3 are nurses and they say "dad why dont you get a job". I say "did your 2 yr associate degree give you board certification in neurosurgery and or as a medical review officer?" "NO" "then mind your own business". My other son, who got the benefits is in graduate school and understands the situation much better as he was younger and was at home while mom almost died and he saw me struggle daily while the other two were out on their own at school or whatever.
Take care.
I have found this to be one of the major issues with having a disability that results in not being able to work. On the outside we look fine. On the inside we are in tremendous pain. Never the less people look at me like I am lazy or I am faking it because I am on disability also.
Very demeaning to say the least! After 30 yrs of working retail....don't they realize I'd much rather being working than going crazy at home and being in pain 24/7?
Thanks for your post. It's nice to know I'm not alone.
Very demeaning to say the least! After 30 yrs of working retail....don't they realize I'd much rather being working than going crazy at home and being in pain 24/7?
Thanks for your post. It's nice to know I'm not alone.
You have that "adjacent segment disorder". Its a fact of life. Each year 2.9% of the people with a fusion in their neck need surgery. So do the math. After 10 yrs, almost 30%. 20 yrs, 60 or more %. I lasted 17 yrs. When I needed the surgery it became an emergency because of the myelopathy. (I've posted this already).
I have a therapist I see who says "chronic pain is the most discriminated disease in the world" I asked "why". The answer was provided by Kari B. No blood, no bandages, no scars (ugly ones) no casts or eyes missing or whatever. We look "OK". However, people dont know that I've had 2 spine surgeries, my entire neck (not c1/2) are fused, and I am not supposed to life more than 20 lbs. I get help out with groceries and park in handicap because my last surgery involved severe myelopathy as I posted and my legs are still a little squirly. Its hard to walk. I get smart as* remarks every time I park. "YOU DONT LOOK HANDICAPPED". I usually say "thank you doctor", or "neither do you". I had a guy in a cast on his leg say that and I said "really thats a great compliment". he go all upset and I said "lets go to the dr and compare situations. Whoever is the "most permanently disabled" owes the other 1000$". He shut up real quick. He has no idea whats wrong with me. What if I had cancer? Or heart condition? People can be real jack (donkeys). I was so ecstatic the other day I almost wet my pants. There was a guy in a wheel chair with a police uniform on and his job was to write tickets to those who didn't have handicap placards/plates and were parked in the handicap spots. Its usually a bunch of young guys running in for beer, and they come out and find a 500$ ticket. I just was so appreciative. Too many times I've seen people with conditons where they could barely get out and had to park not in handicap and it was because non0handicap people had taken the spots.
Off my soapbox, no injuries in getting off.
I have a therapist I see who says "chronic pain is the most discriminated disease in the world" I asked "why". The answer was provided by Kari B. No blood, no bandages, no scars (ugly ones) no casts or eyes missing or whatever. We look "OK". However, people dont know that I've had 2 spine surgeries, my entire neck (not c1/2) are fused, and I am not supposed to life more than 20 lbs. I get help out with groceries and park in handicap because my last surgery involved severe myelopathy as I posted and my legs are still a little squirly. Its hard to walk. I get smart as* remarks every time I park. "YOU DONT LOOK HANDICAPPED". I usually say "thank you doctor", or "neither do you". I had a guy in a cast on his leg say that and I said "really thats a great compliment". he go all upset and I said "lets go to the dr and compare situations. Whoever is the "most permanently disabled" owes the other 1000$". He shut up real quick. He has no idea whats wrong with me. What if I had cancer? Or heart condition? People can be real jack (donkeys). I was so ecstatic the other day I almost wet my pants. There was a guy in a wheel chair with a police uniform on and his job was to write tickets to those who didn't have handicap placards/plates and were parked in the handicap spots. Its usually a bunch of young guys running in for beer, and they come out and find a 500$ ticket. I just was so appreciative. Too many times I've seen people with conditons where they could barely get out and had to park not in handicap and it was because non0handicap people had taken the spots.
Off my soapbox, no injuries in getting off.
I am a 45 yr. old mother of 2 girls, 19 and 16. I had my cervical surgery less than 3 weeks ago. I lost strength in both arms, severe pain in my left shoulder through fingers with nerve pain in my hand and forearm, balance disturbance, shortness of breathe, loss of energy, and headaches. I started with Occipital Neuropathy in 2008 that was helped by a 3way injection at C1. Last year I had physical therapy on 2 separate occasions. Then an epidural last Fall followed by another in Jan. When the pain interferred with my job in Feb. I had to take off from work and surgery was agreed. I had a 2 level C5-6 and C6-7 Cadaver bone, fusion, plates. My normal speech took about a week to come back and I still have a little difficulty swallowing large bites (helps with the dieting), pain level has been managed since the surgery except for one bad night a couple of nights ago. I take 2 Tylenol in the morning, 1 Hydrocodone 7.5mg prior to bed but will be exchanging that for Tylenol this weekend hopefully. I realized that I was in more pain when I guarded my neck and shoulders than when I let it move naturally to what I could tolerate. It also hurt less when I didn't think about it. I live on a horse farm, work a full time job traveling over 100 miles a day in home health, I am an Occupational Therapist and I have always been active. I was terrified to think my life would come to a complete halt because of the movement limitations and pain.
Some people take advantage of the system using their pain. I've seen it time and again with some (not all) workmen's comp and disability claims. It hurts those that truly need the extra help. It's a shame. Folks, it is what it is. Everyone is different, but when you feel legitimate soreness or you are depressed, your body releases more chemicals that increase your pain. This is one of the reasons pain is subjective especially after surgery. We may have the same injury, but we will feel the pain differently. Smoking, lack of exercise, obesity, age and overall lifestyle and attitude are all contributing factors to your recovery.
I have decided not to let the fear take over, I can't I've got too much to do. I had to drive myself 42 miles to my 2 week post surgical Dr's appt. on Mon. because we couldn't afford for my husband to take off work. I took a lot of extra time and care and realized I had some limitations. I met with my veterinarian today because we have a foal due on the 20th and the other 9 horses needed shots. My daughter's Prom is this weekend and I'm trying to find a scarf that will cover this 3 inch scar when we take pictures. I have to be able to take care of my patients safely when I go back to work in 3 weeks. I will weigh out when I can push and when I need to rest, but I have faith that the operation that was performed was done with the utmost of skill and care. It was done to make my quality of life better. I write this and I feel a soreness across my shoulders up through my neck, I will not reach for the medicine bottle. When I am done, I will stretch, rest and contemplate which scarf will go with the shirt I picked out.
Some people take advantage of the system using their pain. I've seen it time and again with some (not all) workmen's comp and disability claims. It hurts those that truly need the extra help. It's a shame. Folks, it is what it is. Everyone is different, but when you feel legitimate soreness or you are depressed, your body releases more chemicals that increase your pain. This is one of the reasons pain is subjective especially after surgery. We may have the same injury, but we will feel the pain differently. Smoking, lack of exercise, obesity, age and overall lifestyle and attitude are all contributing factors to your recovery.
I have decided not to let the fear take over, I can't I've got too much to do. I had to drive myself 42 miles to my 2 week post surgical Dr's appt. on Mon. because we couldn't afford for my husband to take off work. I took a lot of extra time and care and realized I had some limitations. I met with my veterinarian today because we have a foal due on the 20th and the other 9 horses needed shots. My daughter's Prom is this weekend and I'm trying to find a scarf that will cover this 3 inch scar when we take pictures. I have to be able to take care of my patients safely when I go back to work in 3 weeks. I will weigh out when I can push and when I need to rest, but I have faith that the operation that was performed was done with the utmost of skill and care. It was done to make my quality of life better. I write this and I feel a soreness across my shoulders up through my neck, I will not reach for the medicine bottle. When I am done, I will stretch, rest and contemplate which scarf will go with the shirt I picked out.
I had acdf c4-c6 two levels in December 2010. If you are in pain it will definatly help it may not take your numbness away as in my case but definately helps with pain. The only problem is you risk having aditional lower disc collapse as in my case and some pain has returned. The longer you wait the less successful it will be in my opinion. I waited 10 months until i couldn't take the pain any longer and after several months of shots, physical therapy, you name it. Some of my coworkers had the same surgery as me but only 1 level and is back to work already with no problems what so ever. I also had shoulder surgery 6 months later so my recovery has been extensive. If you are in a lot of pain I would definately do the surgery and make sure you follow your doctors instructions and try to take walks as much as you can it helps in the success of your healing. Good Luck!!!!!!! I would find a good orthopedic surgion that specializes in the spine.
Has i i had the same operation july 2010 i had the operation because i had whip lash 5 years before and had several lots of physio theni started to loose the use of my left had i was told that the operation would get rid of the pins and needles and numbness in left hand and neck pain------ well now after the operation i cant feel my fingers of the left hand, my hand is always cold and i have got pain between my shoulders and lower down my back and at the sight of the scar in my neck i have no feeling from my chin to my ear, if anything i wish i had never had it as i am in pain most days have problems with the orginal neck problem and live on pain killers this has cause me to get depressed i just hope you are one of the lucky ones there are a few xxx