New Member needs help! (Surgeon Recommending 2-level Cervical Fusion)

[tferg2000]

Hi, I'm Teresa. A new member to the SPS forum. I have a second f/u appointment with an orthopedic surgeon in two days, and I wanted to try to get some advice and feedback before then.

A little about me:

I started having pretty bad dull left arm pain, numbness, tingling and tricep weakness along with a sharp stabbing pain along my left scapula. My PCP sent me for xrays, then MRI's, then to a surgeon. It's apparently a C7 disc problem with some C6 deterioration as well. Spinal stenosis, osteoarthritis of the spine, along with some osteophyte formations in the area. I'm 41 and I have 2 year old son, so I hope/need to keep fairly active for some time! They are recommending a 2 level ACDF, with autograph and titanium plates. I've been in such misery for the last month, I was really all for it, but for the first time, I was put on a methylprednisone dose pack a week ago, and after 4 days, I'm about pain free. I'm off of pain meds and muscle relaxers today, and only took one of each yesterday. Which you would think would be great, but now I'm having terrible anxiety about having a surgery that I may not need. Ugh! See, I need some advice/feedback...PLEASE! The only other treatment I have tried for this so far is chiropractic the first 2-3 weeks, and when the pain became intolerable, I went to my PCP who started me on narcotics and muscle relaxants. So, I could be having some anxiety from stopping those as well. But my anxiety level is growing rapidly!

So sorry this is so long, but I've been reading so much and getting more and more confused. I think if I can go conservative, PT and epidural, I'd so much rather do that! But my doctors all (I've seen PCP, Neurosurgeon, neurologist, and an orthopedic surgeon) seem to be more concerned about my L arm weakness more than anything, and it is still pretty darn week. So I'm worried about doing permanent damage if I hold off.

Thanks in advance for any advice!

[scduggan]

Dear Teresa,
Hello and welcome to the website. I am so sorry you are having such problems with your cervical spine. I remember how much work a two year old can be. I do not have advice because I am a lumbar patient. There are several people on this forum who have been in your shoes. They are kind and wise and will chime in soon. It looks like you have already sought several opinions and that is very good. Good luck and I am glad your steroids are helping. Please keep us posted.
CD

[wendyayers]

Theresa, 3 herniated discs (C3-C6), along with nerve damage in my right arm. Couldn't even lift my fork. I waited 9 months b4 surgery (3 level disc replacement in Germany.) I would advise you to do everthing you can to avoid surgery. PT, accupuncture, massage therapy, epidurals ect.

Research all b4 surgery. I have my strength back, but still have some pain in my neck and shoulder area.

Good Luck

[tferg2000]

Thanks so much for your quick replies! It's so nice to have a place to come to talk with others who are or have gone through the same kind of things. It's scary feeling all alone! I had very little pain yesterday, with no narcotic pain meds and no muscle relaxants. I slept through the night with no trouble at all. Woke up this morning with a little tingling in my L arm, but changed positions and it went away. I did take some ibuprofen yesterday and this morning for a sinus headache, but the unrelenting pain I was having in my back and arm are better/gone. I just feel a slight twinge of pain every now and then, and it's better with position change and rest. I can't imagine going through with surgery if I'm not in pain. My appointment with the orthopedic surgeon in tomorrow morning at 8am, so I'll ask about the possibility of more conservative options for now. Does anyone have any experience with decompression therapy? Or cervical steroid epidural injections? Would they ever recommend surgery for weakness alone, in the absence of pain?

wendyayers: It sounds like your weakness was worse than mine is now, and it's only been a month for mine so far. Did you do PT for yours to come back, or did it come back after surgery? My surgeon said that with the amount of osteoarthritis I have in my spine, ADR would make it the pain worse with all the added movement the ADR's would give. Does that sound right? It made sense when he explained it to me. But it seems like a lot of people prefer the ADR.

Thanks so much for your kind advice! I'm sorry you all have had to suffer with this kind of pain too, but it is so wonderful that you are helping others this way! It really means a lot! If anyone else can offer any advice or their experience with a similar situation, I'd be grateful! Does a two level fusion C5-6 & C6-7 cause a lot of limited neck motion? If indeed it does come to that?

Thanks again!
Teresa

[Greg]

Teresa,

I spent 25 minutes last night typing you the most lengthy reply I think I have ever typed and hit the wrong button, my screen went back a page and I lost everything. Needless to say I was so enraged I couldnt go back until today. I'm gonna try and keep it shorter this time

You have definitely came to the right place as you will find a wealth of knowledge, experiences and sefless willing to help I have lumbar spine issues and dont know much about cervical spine but I can give you some input on how "I would approach any pain relating to the spine" and please remember this is just my opinion as I am not a licensed doctor.....that would be too cool!

I wouldnt do any surgery without failing at least 6 months of conservative treatment. Surgery is a last ditch effort and shouldnt be done unless there is nothing else to do. You need to research your conditions to death and become and expert. This way the decision you make is an educated one and one you feel 100% confident about. If you dont feel 100% confident then I wouldnt do something. This is your body, no 2 spines are alike so the decision you make is yours alone to make.

Your anxiety sounds like a mix of stopping the meds but mostly the thought of having surgery when you may not need it. Our bodies do a wonderful job of telling us whats going on, whats good or wrong. "TRUST YOUR INSTINCT" it's gotten you this far in life and a wonderful 2 year old If you responded so well to the steroid pack then that is great news. 90% of patients with spine related pain can be healed by up to 6 months of conservative treatment of maybe a year. 90%

And I personally feel that you may fall into that category....but I dont know as I am only basing this off the fact you responded well to the dose pack and what you stated as your condition. You may want to consider getting a epidural steroid injection. They inject the steroids directly into the area where the pain (and inflamation) is coming from maximizing the effect vs. taking a pill that spreads through the entire body. This may be your saving grace and prevent you from surgery....if not there are still many other option before you consider surgery. And about the weakness in your arm, you can go to physical therapy which will help you strengthen it and help you prevent yourself from doing anymore damage.


How long have you had this pain? What all have you done and for how long to try and fix this? I just cant stress enough that surgery is the absolute last resort. If you cant fix your pain with trying all the conservative treatments then I would consider surgery. And I would be getting MANY OPINIONS to make myself sure that the one you choose is "THE ONLY OPTION FOR YOU"

I want to say more but I'm so afraid I'll lose my message I look forward to hearing back from you as you may be one of the lucky ones who doesnt need surgery.

[KBear]

Spunds like you have done one of the most important parts, which is getting multiple opinions. I would also want to do more conservative treatment if I were you. However, ask them why they feel it is better to do surgery and not more conservative? There may be something they are seeing on the MRI that is not going to be helped by conservative and could cause more damage. The arm weakness could be part of it, some people do not gain back functions they lost prior to surgery, others do. So, if it is something like that, then I wouldn't put off surgery. I know this can be really confusing and overwhelming; but it is best to go in with no regrets. I can also tell you from experience that just about everyone has second thoughts as they get closer to surgery, I felt like I was feeling better and maybe I hadn't done everything to get better (I had been through 3+ years of conservative therapy and tried everything under the sun). The mind can play tricks on you. Lastly, I have noticed that it seems like people who have surgery sooner rather than later, heal faster and better than those of us who wait longer.
My advice, research, research, research, get multiple opinions and ask why the suggest what they do. Become your own advocate, in the end you are the one who has to live with your decision (and doing nothing is a decision as well and can have negative consequences, just like surgery). Make sure that whatever you choose, that regardless of outcome, you can live with it and know that you did the best thing you could with the information you had- no regrets.
My youngest was just turned 3 when I had surgery, and she did very well with being told mommy couldn't lift her and just sitting on my lap. I had help for the first 6 weeks and that was a God Send. My kids did ay better than I expected, my other daughter was 5.5 yrs.
Good Luck and ask any questions you may have,
Kathy

[tferg2000]

Thanks Greg and Kbear! Sorry you had trouble sending the message last night Greg, but I soooo appreciate you trying it again this morning. It really means a lot! You're too cool, even if your not a doc!

So far I've only had the weakness and L arm pain trouble about a month. I've always had neck stiffness and pain, off and on. But never anything like this. My pain has never radiated down my arm, and I've never had the weakness. I've been in 4 car accidents (not my fault) in the last 15 years, and I'm sure that's added to it. I never was really injured from the accident that I could tell. Just knocked around a bit and sore for a few days. I'm sure they must be partly responsible for my ongoing neck pain though. I found out I also have osteoarthritis in my neck, and all these years I thought the pain was just from tension! Anyway, I've seen a chiropractor off and on for the last two years. I started when I was pregnant, but that was mostly for lower back pain, but he didn't do xrays because I was pregnant, so I don't know if my spine has looked like this for the last 10 years, or it's something new. The only treatment I've tried to date is the chiropractor, heat/ice and rest, along with lots of pain meds and muscle relaxers. When I had my first visit with the second surgeon I consulted, last Thursday, he seemed surprised that no one had given me the methylprednisone dose pack yet to try. So he prescribed that and stronger pain meds. He did say I could try an epidural injection, but he wasn't that optimistic about the outcome. I can't remember exactly why. I think because my epidural space is so narrow. He said that most people have 2-3 times the space in there than I do. So that's why the onset of my symptoms were so fast I guess. I also have some osteophyte formations in there.

The neurosurgeon, neurologist, and orthopedic surgeon seemed most concerned about my lack of strength in my L tricep. With my narrowed epidural space, the discs are coming fairly close to my spinal cord, but I don't know if that's something new, or if they've been like that for years. I am concerned about doing permanent damage, which is why I was ready to do surgery, but that's when I was is so much pain. Now without pain, I feel like my strength may be coming back a bit, but like you said Kbear, your mind plays tricks on you. I do know the range of motion in my neck has improved greatly. Two weeks ago I had almost none, now it's back to almost normal for me. It's been a bit limited for years. I still do feel some tingling down my arm when I look up, but the thing is, I can look up. Two weeks ago, I could basically move my eyes in the direction of the ceiling and feel increased pain down my arm. So it does seem like a great improvement.

I guess my anxiety is coming from feeling like I have to make a decision tomorrow morning. I guess I'll see what he has to say about my improvement, and go from there. I guess a little more time to digest what he has to say won't hurt. And it will give me some time to do more research. I'm still feeling scared, just not in a panic like I was yesterday morning. And hearing from you all has really helped a lot!

Thank you all so very much!

[Gilbert P]

Hi Teresa

You have been given some great advice I would do everything before surgery, I am A Lumber Spiney,

If you have weakness and its getting worse you may need some intervention sooner than later..

Please keep us posted

SPS saved my life

Gil

[ajj1001]

hiya and welcome to the forum, you have got some really good advice. hope you get a plan sorted soon.

alison x

[Greg]

• Thanks so much for your quick replies! It's so nice to have a place to come to talk with others who are or have gone through the same kind of things. It's scary feeling all alone!
• Does anyone have any experience with decompression therapy?
• Does a two level fusion C5-6 & C6-7 cause a lot of limited neck motion? If indeed it does come to that

• It is very scary feeling alone in a painful world. We are here for you and if you ever need to just talk on the phone or email to someone send me a PM (Private Message)
• Actually the last conservative treatment I tried before I went after surgery…as I ran out of treatment options…was spinal decompression therapy. My insurance wouldn’t pay for it my total 24 session (with everything else involved) ran me $4,000. They wanted $6,000 but I talked them down some and if you go for this there is room for negotiation so be sure to try. Where I goofed up was I was in so much pain, didn’t have a doctor and couldn’t get any pain meds (last one I took was couple months prior) so I jumped into the 1st place I found. I later found out that there were places that were a lot cheaper to go to. So be sure to shop around if you try this. I would strongly urge that you mention this to your doctor to make sure they don’t see any issues with you doing it.

After about 6 sessions I felt that the “constant, daily pain” not the flare ups had reduced by about 20-25% but I didn’t get any better from that point on. I know several people who have been completely cured and swear by it. The tricky part for me is my discs have degenerated so far and that’s probably why I didn’t get the best results. I think if someone was to do it in the beginning and not after 8 years then they would probably benefit from it farely well compared to waiting too long.

• After 2 level cervical fusion it will limit some motion but there are several people on this site that stated that it isn’t that bad and they can live their life. To them, a little limitation of motion is far better than the chronic pain they had to live with But no 2 spines are alike and a surgeon could better answer that question. I’m sure some cervical spinies will chime in soon.

• Thanks Greg and Kbear! Sorry you had trouble sending the message last night Greg, but I soooo appreciate you trying it again this morning. It really means a lot! You're too cool, even if your not a doc!
• The only treatment I've tried to date is the chiropractor, heat/ice and rest, along with lots of pain meds and muscle relaxers. …He did say I could try an epidural injection, but he wasn't that optimistic about the outcome. I can't remember exactly why. I think because my epidural space is so narrow. He said that most people have 2-3 times the space in there than I do. So that's why the onset of my symptoms was so fast I guess. I also have some osteophyte formations in there.
• The neurosurgeon, neurologist, and orthopedic surgeon seemed most concerned about my lack of strength in my L tricep. With my narrowed epidural space, the discs are coming fairly close to my spinal cord
• I guess my anxiety is coming from feeling like I have to make a decision tomorrow morning. I guess I'll see what he has to say about my improvement, and go from there. I guess a little more time to digest what he has to say won't hurt. And it will give me some time to do more research. I'm still feeling scared, just not in a panic like I was yesterday morning. And hearing from you all has really helped a lot!

Thank you all so very much!

• I’m more mad at myself about losing the message because any lengthy replies I type I do in MS word and then copy in but I just got going and didn’t want to stop….I was just so deep in thought I didn’t want to lose my focus.
• Chiropractors to me are kind of like the decompression therapy…again, just my opinion. If you can see them in the beginning when your pain comes on than they can help. For me I was too far gone. I got some relief from the chiropractors but when I stopped going so did the relief. That’s what led me to believe that the relief I received was mental not physical. My brain thought that since the doctor was working to fix me then the pain should go away thus my brain stopped the pain signals.

It amazes me how powerful our minds are. When my pain flares up real bad I tell myself (and sometimes out loud…seems like it works better that way) about how good my back feels, how I feel no pain, how wonderful it is to not hurt, etc. When I do that my pain actually tones down a little bit. Kind of weird but a nice trick to have in the bag

• Did any of the surgeons say anything about physical therapy? Or did any doctor recommend PT? I guess a surgeon might not be the one recommending conservative treatments since they couldn’t bill you for the surgery then. Once I went to physical therapy I learned of how weak my left leg was and they built my therapy around that and other factors and I have gained back a lot of strength. I still do stretches at home everyday, twice a day.
• I am so happy that talking with us has helped you not be so scared about your decision. Just remember that you don’t have to make a decision tomorrow. You seem like you’ve got a good grasp on the situation now. I like to make notes before I go to the doctor listing all my questions/concerns I want to address so I don’t forget anything. Some people even take audio recorders with them and record the conversation to make sure they can remember everything the doctor said. Good luck with your appointment this morning and I hope the doctor gives you good news and explains what and why on the recommendations on things to do or not to do. Don’t forget to ask about it being safe for you to do decompression.

SPS saved my life



Gil

• I’m right there with you Gil. I would not have made it this far without my family on SPS taking care of me and giving me the support I’ve needed it through some of the darkest times of my life