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(Warning: this is a long post. To skip to the Recovery section, just scroll to the last paragraph)

Hi,

I am just writing to report my results for a cervical hemilaminectomy done three weeks (ok well, 23 days to be exact) ago. Some background: I am 25 years old, male, and have been diagnosed with a chiari malformation (treated in 2001 in New York), congenital stenosis (c3/4-c6), and bulging/herniated discs (worst at c3/4, present at c 4/5, mild at c5/6) which are what increased the stenosis. The disc problems only showed up on an extension mri; a standard mri only showed a slight bulge at c3/4. Anyway, I have had two episodes of temporary paralysis resulting from a heavy hit to the top of my head (once from wrestling, and once from being drunk and stupid with my friend). Anyway I have had symptoms for a few months since the second episode of paralysis which include slight numbness in my hands (mostly at night or after exercise), and electrical sensations shooting down my back, legs, and/or hands during neck flexion/extension (also mostly at night, or after exercise).

I have different diagnoses from different doctors; some say myelopathy, some say I didn't have it (yet), some say basilar invagination, others said that was a misdiagnosis stemming from the appearance of my chiari malformation.

I saw a neurosurgeon in Taiwan (I live in Taiwan) in June who told me to follow a physical therapy regimine for a few montsh and see if my symptoms go away (I had symptoms several years ago that seemed to go away once my spinal cord recovered from the first bout of temporary paralysis). If they did not go away, he said, the best first step is a hemilaminectomy, involving crossing the midline of the vertebrae from the inside to produce central decompression. Over the summer, I went to several doctors in New York while I was home visiting my family this summer. The first scared my whole family (especially me), by recommending extensive laminectomies on 4 vertibrae and occipitocervical fusion. The second said the best and easiest first step was to do an anterior cervical discectomy and fusion. The third said that he was not sure what my best surgery option would be, but I should start small before trying something like occipitocervical fusion (he was a chiari specialist from the chiari institute...he was also the one who corrected the basilar invagination diagnosis). One day later the doctor who recommended the occipitocervical fusion called to change his recommendation: his new recommendation was laminectomy on c3-4-5. That was much more comforting to hear from him.

Anyway after that not-so-wonderful visit home, I went back to Taiwan to discuss the hemilaminectomy. My doctor said that he has been performing this operation for decades, he is one of the pioneers of it in Taiwan, and no one had ever recieved nerve or spinal cord damage from him (although he was quick to let me know that I still must think of these as potential side effects from the surgery no matter how unlikely). He said that most of his patients recover very well, and my youth and physical health (I am very into physical fitness) should play in my favor. He mentioned that skilled surgeons can use a hemilaminectomy to cut away bone from underneath the spinous process while leaving the outside of the bone intact (along with the muscles and ligaments). This would hopefully provide adequate decompression of my spinal cord, but he was quick to tell me that he could not guarantee sucess, nor could he tell me how much bone he would be able to remove from the central part of the canal (he referred to this as "crossing the midline" of my vertebrea). He said that for me, he would operate on c3-4-5, but on c-5 he would perform a hemilaminotomy, leaving a portion of the arch intact. He said that I would be in the hospital for a few days, have moderate neck pain for a few weeks, and expect muscle recovery to occur in 2-6 months.

After weighing my options, I decided to go ahead with the hemilaminectomy. I liked the doctor a lot, especially his minimalist philosophy. I had the surgery on September 11. I was put to sleep, and woke up about 5 hours later watching my doctor wheel me out to the recovery room. He was very pleased and so was I. First thing to do: wiggle my fingers and toes...both worked, so I had not been paralysed. Second thing that I thought I would do was throw up from the anestesia (thats what I did for about 10 hours after my chiari surgery), but I felt fine, stangely enough. My mother (who came for the surgery), and two good friends came to see me, and we were all in good spirits. The doctor came to my hospital room to report: he said that I was more compressed than he thought. The surgery took 4 1/2 hours (he expected 3-3 1/2), because he had to be very careful when removing bone. He was able to cross the midline significantly, creating a good amount of decompression in my central canal. He also was able to leave the upper part of my c-3 lamina, and the lower part of c-5 lamina intact, meaning that only c-4 had a full hemilaminectomy and my anatomy is mostly intact.

Recovery:
My recovery has been amazingly positive. I wanted to leave the hospital after 6 hours, but I was not allowed to do so until the next morning. I was able to get up and walk around immediately after surgery. My mother brought me percoset from the states (they don't have it here), and suprisingly, I never needed it. All I needed was tramadol (50 mg) a few times a day for three days. After that, just advil was fine. I also take about 1200 mg of cissus quadrangularis powder per day to help muscle recovery (something is working; maybe it's that). I was able to return to work on Spetember 15 (four days post-op), and I felt 80% recovered after one week, 90% after two weeks, and 95% after three weeks. I have full ROM in my neck and only have pain in my neck muscles when I am stupid enough to lift something heav (I have been good, and only did this once or twice). My symptoms are decreasing. I still have occasional numbness in my hand when I wake up, but it goes away when I move it a little. I also get a pins and needles sensation in my hands, back, or legs later in the day, especially after showering or walking at a brisk pace (it is worst after showering, which I don't understand, but I think it is getting better). I have some new symptoms, such as numbness/electrical sensations in my abdomen after brisk walking (only with neck flexion or extension...the numbness shifts around, sometimes its my hands, sometimes back , sometimes stomach, sometimes i feel it in my gait). I think this is from blood flow to the surgical area or imflammation and I am pretty sure it is normal for several weeks (sometimes even a few months) after surgery. I am still taking advil a few times a day (not for pain, just to keep any inflammation under control), and taking it easy. I see my doctor again in two weeks for an x-ray and check up. He was very pleased at my 7 day check up, and so was I. My scar is also very nice. It is very narrow, only about 3-4 cm (less than 2 in) long, and stiched internally. That's about it so far. Hopefully I am 100% better in terms of symptoms and muscle recovery in another month or so and can get back to weight lifting and wrestling (I am BORED out of my mind so far) before christmas. Take care, and sorry about the lengthly post.

Best,
Tyler

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Just had a cervical spine surgery for stenosis laminotomy forminotomy c6&7 same on c5&6 so c6 is a hemilaminectomy
my surgery was minimal invasive and recovery is easy however I ocasionaly have pins and needles in arm and numb sensations in right leg when showering. Have right arm and hand muscle loss due to stenosis that probably started with injuries as a teen. I am 63 operate a portable saw mill and need my hand strength.
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tyrub42,

How are you a year later?

Yours, Norsk10
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