anterior cervical fusion/choking and swallowing issues

I'm 9 months out (July 2009) from a C3,C4,C5 anterior fusion with a titanium plate. Just got out of the ER last night with swallowing issues getting worse. Got scoped by the Ear, Nose, Throat Docs and they didn't find anything that would cause the issues like I'm having. The CAT scan of the neck shows no pressing on the throat by the plate. No lumps in the throat, no masses. All good news really except I feel like someone perpetually has their thumb on my throat. All that was likely aggravated by being tubed in the OR by the other mystery in my life.

About 6 weeks after the cervical fusion I started having issues with my feet going numb when I sit. The symptoms, for several months, slowly ascended up the legs and thighs. It's been about 7 weeks from my L2-5 laminectomy that may or may not have fixed things. Very likely that the two are unrelated except for a genetic predisposition to spinal stenosis.

We all had swallowing issues first off. I have three questions for the folks that have had cervical fusions;
1) How long did swallowing issues last? I'm 9 months out and still having issues and flare-ups.
2) Anyone else have leg issues appearing after their neck surgery?
3) Did anyone have issues with the related Cervical spines next to the plate. Meaning, if C3-C4 were fused did symptoms involving nerves between C4-C5 start to appear?

Thanks everyone!

I have C5-6 discectomy and plate replacement on 1/15/2010. I have had the "lump in my throat" feeling since the surgery, however, it is now over 3 mos post op and the feeling is worse than initially after surgery. It feels like someone has their thumb pressing on my throat and
thus like my food won't go down well. I also have indigestion due to this.

I've asked the neurosurgeon at every visit and he keeps saying this is normal but at what point is it abnormal and needs further medical attention?? How long should this pressure on my esophagus last and should I consider having endoscopy and stretching of my esophagus?

I would really appreciate some input...this is so aggravating and uncomfortable. My neck still bothers me but I guess I just have to live
with the fact that the pain will never be completely gone.

Hello,

I too, feel like a thumb is pushing up against my throat. I was fine for 8 months, then all of a sudden, a felt this pressure on the back of my throat. Now I have pain, pressure and it feels like I have something stuck in the throat. I had a CAT scan and a barium swallow and my NS said I had nothing wrong. I had surgery on C5 & C6 with the titainum plate. It feels like the plate is pushing up against me, but all tests show, there is nothing wrong. Why would this happen so long after my surgery?

Rebecca

Rebecca,

I'm sorry you are having this problem and the docs cannot seem to find an answer. It's a bummer that you went for 8 mos
without any problem and are now having problems.

My problem has been with me since the surgery in January of this year.

At the end of this post there will be a surprise ending, or course of action, so to speak.

Here's a quick run down of my experience with ACDF c5-7 with a plate. I have many of the same issues as many of you have had. Painful swallowing, burning throat (like a sore throat), inability to swallow any mucus ( sorry for this but ... sniffle in and swallow does not work), difficulty eating (I've lost about 15-20 pounds and haven't weighed this much for a long time).

I feel like I'm constanly choking, as if someone had their hand around my throat. Pain in the upper chest as well as a shot of sharp pain down my right side so intense (just in the last two days - 6/5 and 6/2010) that I had to break out the morphine they gave me when I left the hospital. Thank God for morphine.

I've scanned many of the studies written by doctors and have learned that there are two categories of doctors with regard to acknowledgement of dysphagia, one acknowledges a range of 2-6% and the other acknowledges 40-60%. My doctor is in denial, i.e. the former group.

I am having a barium swallow test on 6/8/2010. This should be your first test. I have already indicated, nicely, to my NS that I'm anticpating removal of the plate. Removal, without a revision ( i.e. a replacement plate), is viewed as a negatively so doctors are very reluctant to do this.


I would recommend this approach to all, at least as a serious option, if you in fact have a very experienced NS. When speaking with your NS, expect told be told that it is a very simply thing to do, 1 hour in surgery versus 3 for the original surgery. Then expect to hear that it is risky.

Yesterday I finally saw a study that admitted that removal of the plate for dysphagia does in fact help, especially when you can see evidence of impingement in the testing, or you are certion that your symptoms match the concensus here online.
One study indicated that the plate, 2.4 mm thick in my case (Zimmer Trinica) is put into an area that ranges from 1.01 mm to 1.31 mm in depth. You don't have to be too smart to know that would interfere with existing physiology.

There is no need to suffer.

Who were your surgeons and where did you have the surgery?

I can feel all of your pain. I recently had my fourth neck surgery which was a fusion at C4-5 and C7-T1. I previously had C5-6 and C6-7 from one car accident, and the was the result of another (thank you drivers who do not know red from green). There was extensive cutting because of the scar tissue from previous surgeries, and the pain after the surgery (while I was told it was successful) was so intense, nothing could help it. I actually was hospitalized a second time because the pain wouldn't get under control and the swelling was so severe. While I've started PT and it's helping, the esophageal spasms and belching are so intense, I can barely stand myself. I'm finding myself googling everything under the sun because i'm so worried about this. My other surgeries, the hoarseness, spasms all stopped by about ten days. I'm 6 weeks postop and it's worse than ever. I am seeing a GI doc this week (I do have existing reflux that I take Prilosec for anyway) but this is crazy. I'm choking on pills (I understand that part of it) but the spasm is there all the time from the top of my scar into my chest. It is so uncomfortable. With it comes heartburn. I don't know if it's all reflux, but I think I'm so fried from everything, I can't stop obsessing. I wish all of you well on your recoveries. I'm so glad I found this website.

I had a cervical fusion 9 days ago. This is my second surgery (seven years apart). My family says that I'm doing much better this time, and I think that pain wise and nerve wise, I am. Last time, I lost a lot of use of my left side and regaining use was painful and lengthy. This time, my biggest issue is with the swallowing.

In the last 9 days I've lost nine pounds. The swallowing issue is gettting worse. I'm off pain pills now, just Advil twice a day. I'm hoping that the above post and I aren't in for the same.... I have to say, though, each time I've had surgery it was because I reached the OH GOD phase and couldn't stand the pain. That's the only reason I'd advise anyone to have the surgery.

Hi, I recently had a c4-c5 fusion for a stalph infection. The surgery went well and Im healing nicely. However , I do have a semi constant feeling of choking after eating especially around the incision site. My breathing is also a little faster in my throat area. The scar is looking great at least so I guess a little discomfort will be worth it. My nuerosurgeon says it might be up to 6 months before I feel normal again :-(

Hello to my brother and sisters with ACDF swallowing issues

I too had had 2 prev ACDF's 10 yrs apart. The last one was 18 mo ago. Since then food gets caught in my throat and sometimes I wash it down, when that doesn't work I hack it up. I decided rather than accept that this was whe way I was going to be for the remainder of my life I investigated, had a scope by a Gastero doc, then sought a 2nd opinion.

The scope proved nothing. Soc said I need a swallow study by x-ray while the radiologist was there and a speech pathologist. My plate has 2 hanging screw (only attached to the plate - not me) and my epiglottis - which is in your throat and is supposed to close off your airway when you eat so you don't choke to death b/c food goes into your lungs instead of stomach. The speech path said my plate was preventing my epiglottis to do its job. The plate was too far in and too large.

2nd opinion - he took upward looking x-rays and looking down x rays and he said too there are 2 screws loose and that the CAT scan I'd had just one week prior and the MRI's I brought were worthless. He recommended I get a repeat MRI and CT scan, go to an ENT with thes films have the ENT do another scope on my throat since that is their specialty, the go back to see him and schedule surgery with both the Neurosurgeon and the ENT present. The ENT would do all of the soft tissue work open me up properly, move the nerves arteries etc. and as long as I'm fused which will show by the tests he will try to get the plate out. He said he can't guarantee that my epiglottis will function properly again since it has bee not fuctioning for so long. He said I have a neck FULL of scar tissue.

I hope this helps someone. At least you'll know where to begin to look. If I had this to do all again, I would have gone to the ENT first let him/her scope me. Why in the world the dr's don't suggest this is beyond me, except for they screwed up and others will then see their mistakes.

May God bless each and every one of us. This problem has the possibility of having dire consequences.

Hi everyone, I also had a titanium plate for C4 & 5. The constant choking feeling sent me into anxiety attacks. I couldn't walk up a flight of stairs or even walk quickly without going into one of these attack. I also has a barium swallow, x-rays and an MRI, which turned out great. By month three I was fed up because this is when the NS said I would feel normal. I marched into his office and refuse to leave until we scheduled a date to remove this plate. I was totally horrified with the constant choking, it sort of felt like I swallow bread and it just got stuck in the middle of my throat. The good news is that after surgery the disk had fuse together so I felt way better than before. The bad news is that that plate had aggravated my thyroid. Anyway, I look at this as never doing this again. I don't care what the NS says I never got use to it. So I keep you all in my prayers because I totally feel your pain, you are not alone! You do have choices.

by th way, this took place in 2006 and by 2007 it was removed. Good luck

Hi, I had surgery on C-2, C-3 two weeks ago. like everybody else I'am having problems with swallowing. I cant even swallow my spit. I also had it done 9 months ago on C-4,C-5,and C-6,I was diagnosed with spinal stenosis. It seems Iam having a harder time with this one. alll of them have titanum disk in them. I cant even turn my neck.

I had my C-5 and C-6 fusion 4 days ago, and besides the difficulties swallowing for a couple of day, now i noticed a rash on top of my shoulders, I believe is contact dermatitis that I got during the surgical procedure, also a cough, which I have been treating with an expectorant, which it had helped, besides the bump on the side of my neck which  I believe is due to the sutures applied to every incision on my neck, and hopefully with time it diminishes.

I've read many of your experiences and am sorry we share the same problems after ACDF (C5-C6--C7 for me, 4mos ago). My swallowing and throat related issues started three weeks after surgery.

I will have the modified barium swallow study done in two weeks. I'm taking the food that causes the biggest problems and will be positioning my neck to maximize the occurrence of my issues, and hope this will finally show the impingement I believe is present My NS also believes "Speech Therapy" is the only option. I have never had eating, sleeping, gagging, snoring, and pressure on the epiglottis making it almost impossible to burp, feeling like a lump is present, or someone is pressing their thumb against my neck. It has been slow for me but am saddened to see how long so many of you have been having your issues.

I hope the removal of the plat and screws will happen but believe I still have many choking or uncomfortable swallowing experiences ahead of me.  I’ll let you know my progress.

In the meantime if any would like to give me an update, please do. Especially if you have done what I’m hoping to do. Positive or negative.