For the past few years I have had difficulty swallowing large pills and certain foods. I went to an ENT who sent me for an MRI only to discover that there was severe degeneration of C3-4 inervertebral disc. There is a diffuse osteophyte formation stretching across the entire width of the spinal canal, stretching from unconvertebral joint to unconvertebral joint. There is a small left foraminal strenosis and moderate central canal stenosis.
On my C4-5, the intervertabral disc is degenerated. There is a bilateral unconvertebral joint spur formation resulting in mild-moderate bilateral formaminal stenosis. No central compromise is noted.
On C5-6 The intervertebral disc is severly degenerated. There is diffuse osteophyte stretching across the entire width of the spinal canal flattening the ventral surface of the thecal sac. Focal central osteophyte results in indnetation of the cervical spinal cord centrally. The foramina appear unremarkable bilaterally.
C6-7 Both levels demonstrate relatively sever degeneration of the intervertebral disc with circumferential osteophyte formation stretching across the entire width of the spinal canal, flattening the ventral surface of the thecal sac, but not causing spinal cord or never root compression. Nor foraminal compromise is noted.
The impression is that I have relatively severe multi-level disc disease with spondylosis from C3-T1, The single worst levels is C5-6 and a moderate central spiinal stenosis at the C3-4 level.
Now I have been to 4 top doctors in New Jersey and New York. One is the head of Neurosurgery at JFK in Edison, NJ who said I should go for the surgery to remove the osteophyte that is quite large and giving me the swallowing problem and also to remove the disc, put in a bone graft and fuse the vertebra with the instrumentation. He said it wasn't a bit surgery and I would be out of surgery and home the same day. He doesn't believe in treating things on an MRI or Xray unless there are symptoms.
I explained I was also going to see the Chief of Spinal Surgery at the Hospital of Special Surgery in New York City and he approved. He did say that orhtopeadic surgeons tend to think different then neurosurgeons. The bone guys, look at the film, see a problem and go in to take it out or correct it. They don't look for answers on why this happened and how to prevent it from happening again after the surgery. I was told once I do this it could create problems higher up in the neck or even have a return of the osteophyte.
In New York, I met with my other doctor who said I also needed the surgery, so both agreed. He then wanted me to go to a ENT surgeon who specializes in head and neck surgery and I found out would be the surgeon to open my neck for the spine surgeon, since that was his specialty. He explained that they wanted to be sure that there is no damage to the two major nerves in the path of the surgery.
Then the spinal surgeon takes over and removes the disc, puts in the graft and the instrumentation and closes. The neurologist I was sent to see didn't like the level C3-4 and showed me how the stenosis had closed the opening and there was no spinal fluid in that area to protect the spinal cord. He also noted that it was already under pressure and the shape was not normal. He said this is the cause of the tingling in my arm and hands, numbness, and back and neck pain. He said with this condition if I had an accident or anything that hit my neck it could cause swelling, leaving some scarring and that could be big trouble.
So now I am freaked out. The reports are going back to the Spinal surgeon and I am asking for another consultation to see if I need a two level procedure instead of the one. But that also freaks me out since the two levels below are also self-fused by the osteophytes. So I would basically have 4 levels fused.
I can tell you that the discomfort is not that bad now. I am getting used to the tingling, but fearful of permanent nerve damage if I don't so anything. I am concerned about the surgery which I am told would keep me in the Hospital in New York for two nights on the one level. Now remember the Neurosurgeon said I could go home the same day and it was a short operation.
So now I just took a Swallow Test and was under a Flouroscope and they also told me I have spurs on many other vertebra in my back. I am 64 years old in decent health other then these issues and don't know what to do.
Will I be better taking care of this now? Will I get so bad that they would still have to operate years from now again when I am older and there is more risks. Should I simply do the two levels now and be over with it? Will I be able to function normally with all these fused levels in my neck?
Any suggestions or experiences would be appreciated. The NJ doctor said I would wear a collar for about 2 weeks, in NY they said 4 weeks at which time I would return and they would X-Ray my neck to see if the bone graft was working...I only wonder if it doesn't take, what then, all over again?
I keep thinking of my future. My father lived to 93 years old and didn't have this problem, my mother was 87 when she died. Does this mean I will be in a wheel chair or bent over a walker in the next 10 years or so?
Do I go with the top guy and one of the best in the country in New York, or a top chief of Neurosurgery at JFK in New Jersey? I can tell you my wife and I were impressed with both, but the NY head of spinal surgery had an office filled with awards, Best Doctor of the Year for 10 Years from New York Magazine, photos of Walter Cronkite and Henry Kissenger, etc.
I am sure they are both top surgeons, but as the one in New Jersey told me they would both look at my condition differently. So who is right?
I know this is a long posting, it is my first and I need all the advice I can get. One last thing...I have had Carpal Tunnel surgeries on both of my hands and also had a total of 5 Trigger Finger Releases on the two hands over the past 10 years. I thought my current tingling and hand issues were from these surgeries and never thought it could be a problem at the Cervical levels.
would like to hear from anyone who has had multilevel cervical fusion.
So far I'm feeling pretty good and have pretty good motion in my neck
Can you still turn your head side to side?
How far can you tuck your chin to your chest?
In case you are, I just thought I'd encourage you by telling you that I had a four level fusion /corpectomy with strut grafts and titanium plate with 8 screws almost 10 years ago (10 yrs in June '10). Before my surgery I had so much pain it was affecting all areas of my life. I had a technical job, and started feeling like I was just slipping through each day on autopilot. I was so distracted by the pain that I remember one day I couldn't even remember the name of someone I'd worked with for a long time. My symptoms had progressively gotten worse and even though I was being monitored more closely during the last 5 years before my surgery, I was trying to wait as long as I could.
I had the reversed lordosis, stenosis, spurs, and in general, spondyliosis (from degenerative disc disease/arthritis), 3 of my vertebrae had already fused but in a bad position and I had pain all the time. I had numb tingling sensations across my face, head, and chest on one side, numbness and tingling down into my arms and hands... some days worse than others, and sometimes I had a strangulating sort of feeling in my neck that would make me feel almost dizzy and a little out of sorts. It was all a major distraction. When I realized I was starting to weed my garden from a prone position because I didnt have the strength to stand and do it, I knew it was time.
I found a great surgeon who seemed confident, and I proceeded with a positive attitude. He opened up each of the vertebrae and using my own bone from my hip (ground up and put in a bone plug from the bone bank)he built them back up where they should be, and set it all in place with a titanium plate with screws. It all went well and I was back to work in about 8 weeks (though a little too soon, so I switched to PT for a while). I eventually got my life back and I am happy to say life is good and I feel very blessed.
For the record... I still think surgery should be the last choice (as long as there are other choices for you, and providing it's not something so serious that it needs immediate correction), and the choice is one that only you can make. If you do chosse to have it, I am here to say, there are happy outcomes. I am one of them. I think the most important thing you can do is to be positive about it. Do whatever you have to do to find a place of acceptence for the surgery (if you have it), and then allow that to be your point of transformation. The rest is up to you. There will be ups and downs, but it's normal. Anytime a person endures chronic pain for a long period of time it takes not only physical intervention, but often some kind of mental or emotional work as well. You have to "Build" a new life for yourself afterwards.. one that's no longer based on pain, and trust me.. you will like it, and so will others. : )
Best wishes wherever you are in the stage of this...
Yes, I wore a collar for a while. Mostly just a soft one.
Yes, I have flexibility in my neck. I can move from side to side, and front to back (chin to chest).
Every case is different, and something to be mindful of, is that if you have had severe symptoms for a long time prior to surgery it may not all clear up afterwards.
I am not a doctor... just a survivor who's happy with the outcome. Everything has it's risks.. either way. I simply chose the one that gave me the most options. After this many years (almost 10), I do have some pain again, usually when I move certain ways.. or on certain days, but it's nothing like before, and if I use ice or heat, and get a massage to help me relax, then it usually brings me right out of it (or at least a day or two later). I still have the degenerative disease, so in my case this is to be expected , : / but I am always optimistic that I will beat the odds and I continue to work on my own health habits.
I'm still smiling, and each day I get a little closer to reaching my other dreams in life. I feel like I got a second chance, and so I'm going for it. One I've already accomplished... I am now a certified massage therapist, helping others who deal with pain issues.
The next one has to do with art.... but I will spare you the details since I've already carried on... : )
For Your Health
San Ramon, CA
I do not like the limitations I have, (lifting, etc) but life is still great and it's a matter of adjusting to your new boundaries. Hope all goes well.
I want to let you know that I just recently had a level 4 fusion of my C spine and I'm in my last week of wearing a collar (4 weeks). Although there are some simularities regarding yours and mine issues, I didn't have any of my bones that broke off. Bone spurs do happen in our situation. It's kind of like our bodies are trying to protect itself. The operation was 5 1/2 hours long. They went in through the front of the neck. Some of the problems (discomforts) was directly after surgery, because they put a tube down my throat, I had difficulty in eating. I lost 11 pounds in three days. I'm back to eating somewhat normaly althougth I still have to completely chew my food and take smaller bits (not such a bad thing)
I was in the hospital (inpatient) for two days for my procedure and becuase your situation sounds more severe than mine I find it hard to believe that your Neurosugeon would do his procedure as outpatient.
My suggestion is not to wait. I had several eppidurals prior to my surgery and was okay with continuing with that method of pain relief, however after further research and discussion with my Doctor/Sugeon I realized that as I got older my condition would contiue to deteriorate and I might find myself in a much worse situation than what I am now (was) with a longer healing time.
Just to let you know, I am a 52 year old female in fairly good health. I live in the Phoenix, AZ area. I wish you luck.
Thanks for your post it was reassuring although there are no guarantees