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I have had back issues over the years and about 15 years ago suffered from a piece of my L4-5 disc that broke off and was pressing on my nerves. I had drop foot, intense pain that required hospitalization with morphine every 4 hours, until I found a neurosurgeon who knew what was wrong and operated to remove the piece and clean up the remaining disc. He save my life at that time.

I have had two Carpal Tunnel surgeries and 5 (yes 5) trigger finger releases on my two hands. This was done years ago and frankly if I had to do it all over I may not have done the Carpal Tunnel surgeries, because you still get pain when typing and working with your hands for long stretches.

I have had numbness, tingling, etc. for some time now and thought it was because of my messed up hands, only to find I have DDD and Spinal Stenosis in my Cervical vertebra. All this time I had a large osteophyte growing in my neck and pressing against my esophogus which made it hard to swallow some food and large pills.

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 stetching 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. Thee 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 stretchiing 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.
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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.

The doctors I am using are:

I am using Doctor Frank Camissa, Jr. in New York.

hss.edu/physicians_cammisa-frank.asp

If you do a google on this man, you will be impressed with his background. The Neurosurgeon in New Jersey is Dr. Gregory Przybylski Director of Neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center, Edison, New Jersey.

njneuro.org/bios/przybylski.asp

So you can see from their profiles, they are the best out there, but 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?



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I recently had cervical surgery C5-6,C6-7 discectomy , fusion and graft. My symptoms were I thought carpal tunnel symptoms but then I started to have decreased sensation and then no sensation in my legs up to my waist and also an area on my back that had no sensation. I noticed this when I got in a bathtub one night and couldn't feel the temp of the water. I was also starting to experience muscle fatigue. I was at the time a 46 yr old acute care nurse with no history of any neck or whiplash injury and had no neck pain. I have had low back pain related to what I thought was my job. I had the surgery in March of this year and only saw one neurosurgeon following seeing the neurologist and an MRI. I had no choice on the surgery as the spinal compression was so severe that if I had fallen and had the discs move anymore into the cord I may have ended up in awheelchair. I had the anterior approach and and was home from the hospital in two days. It is a long surgery about 5 hours for me. I started physio three months after the surgery to allow the fusion to start before therapy started. It was not a painful surgery to recover from, only my throat hurt and very little incisional pain. I am now 8 months after surgery and now am starting back to some nursing duties but in a field which does not require the heavy lifting. If i had had a job that was not lifting and twisting i would have been back sooner. Also the swelling in the cord was no down three months after the surgery which it should have been therefore I had to take rehab slower. Not all of my symptoms are gone as I do have some permanent nerve damage but I am regaining strength slowly and the neurosurgeon did say it may take up to a year to know exactly how things healed. some of the things that I feel are the new me and I have to accept this. I have to change my love for acute care nursing and try a slower paced part of my profession. I like being able to walk therefore I will follow the Dr. orders
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I am new to this site but am researching many of the same issues you have after an unpleasant MRI result. What was your outcome? Did you have the surgery? I am awaiting an appt with the neurosurgeon.
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Degenerative disk disease is a misnomer. Everyone get it as they age. It means the disks dessicate, ie dry up, and shrink, bone spurs and end plate changes occur on the vertebrae as the bodys way to compensate, but sometimes they get in the wrong place or the wrong area. All neurosurgeons have outstanding credentials. There are no "best out there" unless you go to a world renowned neurosurgery center of which there are about 10 in the US. Scripps in San Diego is one, Barrows in Phoenix is one, Cornell/NY Presbyterian is one, Cleveland Clinic, UCLA, Hopkins, Mass General, I forget, it was in US NEWS and WORLD REPORTS rating, and I remember these. The point is this. For an anterior cervical discectomy you dont need a world famous neurosurgeon. you need someone who does the surgery a lot. A world famous neurosurgeon might be doing skull base tumors and spine surgery once in a while. A general neurosurgeon does these every single day.

I would not have surgery on any level unless it is proven that you are having instability of the spine or neurological deficit, ie weakness. Pain is not an indication, the swalowing is, if its bad enough, but getting 4 levels fused unless you have severe stenosis and weakness in your arms and legs and can't walk, you are getting poor advice. You need to ask what you will gain by having each level done, what does it contribute to your symptoms, and why is it getting done, and how will you feel different post op. Once you know that, you will feel much better about the surgery.

If you need the surgery you know it. I remember the first one I had in 1993 I dropped things with my left arm. It felt like it was asleep all the time. I had 2 levels done and the second I woke up in the recovery room, my arm felt normal for the first time in months. It was so awesome. Now I need a level above it done because my whole body gets weak and I cant make a fist with my hands, I cant lift my feet off the ground, etc. Find a dr who does "spine surgery". Dont get too impressed by their diplomas and certificates. Just find someone who has a good reputation and does a lot of spine surgery. Then you know you are in good hands. Also, make sure they use good hospitals. This is not a benign procedure. Bad things can happen so you want someone good, and you want a hospital with staff who can handle things IF something came up, which is extremely rare, but there is always risk. I think if you need the surgery have it, you will feel so much better, maybe not immediately like I did, but within a few months, and it is scary, but if you need it, the sooner you do it, the better the outcome. Good luck.
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Hi mtsaz100,
I like your post, it is very informative.
I was just wondering, you said that you need another surgery, is this due to a first one? I am asking this because I really don't know if you do one surgery what are the chances that you will be needing another one in few years.

Cheers.
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Thank you dark_red. yes I had the surgery yesterday, spent one night and am now home. When one has this surgery there is a 2.9% reoperation rate each yr for level above or below. So after 10 years somewhere between 25-30% need additional surgery. I was 17 yrs out, and c3 (above) went south causing myelopathy in all four limbs. I couldn't make a fist, couldn't do buttons, open a door knob, couldn't lift my feet to put socks on, or cross my legs, etc. I had a very difficult time getting in/out of chairs, and couldn't drive. So I had the surgery and everything feels normal so far--yeah!!

It sucks that anyone even needs it in the first place, but the facts are cervical surgery is the most successful spine surgery. Much more so than lumbar.
Take it easy.
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Hi mtsaz,
How is your recovery going? How long do you need to rest until you are fully recovered? When you said 2,9% it didn't sound too much, but in 10 years it is much. Well you almost waited for the 50%, that is little brave, but again do you think you should have done it earlier?
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That's really good to hear that it's been so quick for you to recover! It sounds like the surgery was a little scary but it sounds like the recuperation makes it totally worth it. Can you tell me a little more about the recovery process for you?
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This isn't a surgery that you go into the neurosurgeon and say "i want surgery". they do it when you are having progressive neurological deficit. The 2.9% are just stats, compiled over decades of doing this surgery. If you need it in 1 yr, then you need it in one yr. If you only need it once in your life, then so be it. However, the stats are that most people will probably need it at least twice. I'm slowly getting better, 4 days post op. Neck hurts, arms and legs lots stronger. More later.
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Hi mtsaz,
I'm glad that you are regaining your strength in your arms and legs.
Is it hard for you when you are laying down? And does your neck hurt then as well?
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ITs hard to get comfy, and yes my neck hurts like crazy. Last time (in 1992) I had 2 levels with no plate and my own bone as donor. That was a beast of a surgery. It took me over 6 months to recover from. This one, bone bank, plating, is much easier. Its still a painful procedure especially around your neck, shoulders, and brachial plexus, but each day is an improvement. I have been on disability now for 5 years. I got to the point that I couldn't look up, couldn't lift, and basically was so limited in what I could do that I've been disabled and on social security. Not by choice, but I'm thankful its there. My hope is once this surgery heals up, (fingers crossed), maybe I can transition into some kind of work. We will see. I'm optimistic. Thanks for asking. So now I have c3/4, c4/5, c5/6 fused. 3/4 via plate, the rest the old fashioned way. C6/7 has (according to mri) moderate to severe foraminal stenosis, so its likely I will need a foraminotimy on that level soon. That is done from the back, posterior. We'll see once things heal up.
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6 months in recovery!!! That is a long time.
Well I hope that you will heal well and that you will be able to work then.
How soon will you need foraminotimy on c6/7? I'm interested because i wonder will it let you heal from this surgery first?
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Yes the foraminotomy (sp?) is in a couple months. The last one that took six months was becasue it was two levels, my own bone for donor, no plating, had to wear a collar for 4 months until the fusion was solid, and then once I got that thing off, it took me a couple months to get my neck moving. It had been immobilized for 4 months, then all of a sudden to have free movement, it was hard. The muscles were atropied, the muscles were sore, and basically just took time to get range of motion and strength. This one, day 6 or 7 whatever, I feel better than I did at 5 months on the last one. Thats the difference the donor bone, plating, and one level makes. Its HUGE. I feel so much better than preop its not even a question if I should have or not done the surgery. Thanks for asking. 2
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mtsaz, I am assuming that this was your post? Do you have an explanation for why things changed so rapidly for you? it sounds to me like the recovery phase was pretty fast for you.
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The first recovery, was 2 levels, no plate. My own bone from my iliac crest. I had to wear a miami J collar for 4 months. It was 2 additional months once it was removed to get range of motion since my neck had been in a hard collar 24x7 for 4 months. It was dreadfullly slow recovery. The one I had on 11/5/09, was one level, bone from a cadaver, titanium plate, no collar unless in the car (No driving until I see dr on 19th), and yes, the recovery while I' am still in pain, and the fusion is not anywhere near fused, it is held in place by the plate. Its so much easier. I'd rate the first one on a scale of difficulty of 1-10, about an 8 or 9. Equal I'd say to open heart surgery or other major surgery. The second, about a 3. More difficult than knee arthroscopy, but not by much. It was night and day. They didn't do titanium plates in 1993, I think titanium was a top secret military alloy at that time, not even available commercially.
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