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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

Hi ghost, sorry i missed your question couldn't be on computer yesterday much. Answer to your question, sorry its long.

[U]Pre surgery DX:[/U] congenital stenosis, herniated discs at 4-5, 5-6 with
significant osteophytes causing moderate right foraminal narrowing at multiple
levels, reversal of lordosis, spondylosis, degenerative disk disease with
movement on flexion, good above C4, C6-7 early stage ostephyte
ridging at C6-7. some effacement.

[U]Pre-surgical pain:[/U] severe Right radicular pain, chest pain, blades, shoulder, arm,forearm, wrist. No neck pain. Some cramping/freezing forearm and numbness in middle finger. Go to emergency room and get knocked out kind of continuous pain.

Surgeries : one 12/04 ACDF C4-6 and second ACDF on 05/06 adding C6-7. Plating and donor bone and hard collars after for about 8-10 weeks.

Confirmed findings via EMG

First surgery opinions sought: 3 (1 ortho/spine, 2 NS) recommended surgeries: 2 (ortho and 1 NS) agreed on ACDF (clean up osteophytes and stabilize and fix lordosis) wait on 3rd level and stenosis till later. One NS recommended more agressive immediate treatment, posterior lami with acdf all levels same time.

I picked ACDF C4-6, Complete resolution of all symptoms by 8 weeks after surgery 1. Nine months later full symptoms returned including left side symptoms. This time Pain around 6-8 vs. 10 plus before first surgery.

After PT and injections, Second surgery opinions: 2 (1 ortho/spine, 1 NS) recommended surgery - same as first time. 1 said acdf, 1 said lami with acdf. My C6-7 continued to ridge. Because of success with surgery 1, I chose acdf again instead of the lami which scared me. And I was told I probably had future surgery within 10 years to deal with stenosis as I age. Body doesn't agree and now it looks to be within 12 months. Makes me
wonder if I had done Lami, with the 3 level ACDF procedure combined as recommended by 3rd opinion in the very beginning, maybe I would be in a better spot.

Pain has returned, more arthritic with routine bouts of severe radicular, chest, and blade pain. Stenosis is feeling worse and also causing problems. Finger numbness is improved but there, cramping is improved but there, I manage to stay stable by limiting activity, rest periods, drugs, and injections.

What I feel I learned from experience:

1. THe best pain management for the nerve root compression were cervical selective nerve root blocks, ESIs did nothing. SNRB Doesn't fix them, but does calm down the inflammation in there a bit.

2. BW noted some of info I know about bone spurs. The body grows bone spurs in reaction to the bulges/herniations. It can also be normal aging, from instability, movement, or the DDD and shrinking discs, the body trying to stabilize.

3. Artifical discs aren't going to make bone spurs better and even if they drill
spurs out, they can grow back. Who knows if they won't figure out how to reverse acdf's in the future anyway with inserting artificial disks. They can drill out bone spurs, etc. why can't they figure out how to drill out the fusion?
Ask doc about your ostephytes, are these significant or minor? Should you expect more based on what they see on MRI. Mine keep growing everywhere and they get big fast.

4. When you have so many problems you need to do something that
helps stabilize the neck.


6. If you have ridge in central canal, lami is in your future i think they would tell you, even if you dn't do it now.

When comparing your case try to compare to cases that have similar
problems. BW is having a good experience and that is terrific. I will pray he has an outstanding outcome- but I don't think his case sounds like yours. BW has been good at sharing and also pointing out he isn't out of the clear. Advise that you don't convince yourself on a procedure based on a case that isn't like yours.

I've been around the board for 2.5 years, most cases that sounded like yours, did go the route of Lami and/or ACDFs. You can look in the old posts and read stories. Some are still here lurking, they don't post all the time.

Don't mean to offend anyone, BW you sound great. Just sharing what i experience and have read over time.

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